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I have an HMO with Humana, and am planning a HBAC. The problem is there is no homebirth midwife on the provider list. Someone told me if that was the case then the insurance had to pay at least the out of network cost. But the insurance has said that they will not pay anything. Anyone gone through this process and been successful? Who do I talk to, write letters too etc..., is there any hope. It is so frustrating to think that they will potentially pay $15- $20 thousand for me to have a csect., but won't even consider paying $5200 for a homebirth. I live in Texas if that makes a difference.
 

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I had a VBAC at a birthcenter, so my experience is not exactly the same but this is what I did. I had help from my step-dad who is a lawyer and I'm sure that helped a lot.
I wrote a letter to the insurance company asking them to cover what I had paid out of pocket (midwife visits) before the birth. It got denied. I waited until after the birth and wrote another letter to the insurance company with lots of details (cost of c/s vs vaginal birth, lack of access to VBAC dr on my plan, location of referred VBAC dr, previous successful VBAC, etc). It got denied again. Then my step-dad wrote a letter representing me, with all the details that I had already given them. His concluding paragraph basically said that if my costs were not reimbursed, we would seek payment releif in another forum. They paid up right away.
Sadly, I'm not sure I would have been successful without his help.
If you want anymore details, let me know.
Good luck,
Wendy
 
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