[apartautonomous]

open enrollment is here! and my baby will soon follow...
also, i live in Virginia (which may sometimes couple with DC and MD)
typical scenario, have been seeing an OB on the preferred list of my current PPO but have seen the light(designated for me at least) and am transferring out of the care and hospital arena to choose one of the lovely local midwives in the DC/NoVa area. would love to take advantage of the best insurance provider available(ie best reimbursement and coverage of all things deemed 'alternative') before the end of enrollment (first week of december) but have become more and more frustrated in my search.
current plan: Federal BlueCross BlueShield, who only acknowledges the CNM license as an available reimbursement situation. 2009 benefits only seem to get worse with percentages and deductables. they do however, like every other prospective nationwide PPO provider gloat on and on about the incredibly large list of physicians and hospitals that will 'accept' us and cover 100% of everything. is this wondrous birthing event really treated like an illness? like some sort of life-threatening open-heart surgical procedure? a choosy face-lift?
in my search (listed far below) i have only found the same disturbing realities from incompetent customer service representatives for the maternity/mother/newborn care for 2009: no licenses are recognized unless it is that of a preferred or out of network CNM. are there work-arounds? how can this be possible? i have even tried to call numerous times to speak with various representatives of the same plan.

consequently, my options are A) i can blindly choose one of the PPO's for 2009 and hope that they could offer better assistance with reimbursment rates and understand the appeal process a bit better if i'm clever enough with a paper trail...or B) unwillingly stick with Federal BlueCross BlueShield regardless of the known fact that they are disregarding more home birth 'situations' and my percentage of reimbursement completely disappearing in '09 as there seems to be no hope in the world of helpful insurance providers anyway

assistance? reassurance? being that the list i have available to me equal to the same form of a 'benefit plan' does it truly matter if i switch or not? how can such inexpensive (in comparison to hospital births) natural rituals become such a dilemma? how awful!

thanks so much for reading.

just to get an idea, here is the list for my choosing of 2009 healthcare providers (maybe somebody, somewhere can shine a bit of light or clarity on what i've already mentioned on my findings/rant above) FFS=PPO, with the nationwide selections typically being a priority:

- Aetna HealthFund -CDHP- Most of Virginia CDP 877-459-6604 VA
- Aetna HealthFund -HDHP- Most of Virginia HDP 877-459-6604 VA - - - Aetna Open Access -basic- Northern/Central/Richmond Virginia Areas HMO 877-459-6604 VA
- Aetna Open Access -high- Northern/Central/Richmond Virginia Areas HMO 877-459-6604 VA
- APWU Health Plan -CDHP- Nationwide FFS 866-833-3463 Nationwide
- APWU Health Plan -high- Nationwide FFS 800-222-2798 Nationwide
- Association Benefit Plan -high- Specific Areas FFS 800-634-0069 Specific Groups
- Blue Cross and Blue Shield Service Benefit Plan -basic- Nationwide FFS Local phone # Nationwide
- Blue Cross and Blue Shield Service Benefit Plan -std- Nationwide FFS Local phone # Nationwide
- CareFirst BlueChoice -high- Northern Virginia HMO 866/296-7363 VA
- Foreign Service Benefit Plan -high- Specific Areas FFS 202-833-4910 Specific Groups
- GEHA Benefit Plan -high- Nationwide FFS 800-821-6136 Nationwide
- GEHA Benefit Plan -std- Nationwide FFS 800-821-6136 Nationwide
- GEHA High Deductible Health Plan -HDHP- Nationwide FFS 800-821-6136 Nationwide
- Kaiser Foundation Health Plan Mid-Atlantic States -high- Northern Virginia/Fredericksburg area HMO 1-877-574-3337 VA
- Kaiser Foundation Health Plan Mid-Atlantic States -std- Northern Virginia/Fredericksburg area HMO 1-877-574-3337 VA
- M.D. IPA -high- N.VA/Cntrl VA/Richmond/Tidewater/Roanoke HMO 877-835-9861 VA
- Mail Handlers Benefit Plan Consumer Option -HDHP- Nationwide FFS 800-694-9901 Nationwide
- Mail Handlers Benefit Plan -std- Nationwide FFS 800-410-7778 Nationwide
- Mail Handlers Benefit Plan Value Nationwide FFS 800-410-7778 Nationwide
- NALC -high- Nationwide FFS 888-636-6252 Nationwide
- Panama Canal Area Benefit Plan -high- Specific Areas FFS 800-424-8196 Specific Groups
- Rural Carrier Benefit Plan -high- Specific Areas FFS 800-638-8432 Specific Groups
- SAMBA -high- Nationwide FFS 800-638-6589 Nationwide
- SAMBA -std- Nationwide FFS 800-638-6589 Nationwide
- UnitedHealthcare Insurance Company, Inc. -CDHP- Virginia CDP 877-835-9861 VA
- UnitedHealthcare Insurance Company, Inc. -HDHP- Virginia HDP 877-835-9861 VA

 

[Belle]

Wow. Its great that you have such wide options to choose from. We only get one or two plans to choose from here.

United Healthcare covered a good percentage of our homebirth costs once we reached their deductible. We paid our midwives (CPMs) in advance and they billed insurance after the birth. We got reimbursed from our midwives once the insurance paid them. I think our total out of pocket was around $300. The midwives also billed insurance for things like newborn exams and home visits and they paid them no questions asked. Our midwives said that they've always had good experiences with United.

BCBS, Aetna, and Kaiser are notoriously bad for paying for HB. I don't know about the other ones.

 

[Reha]

I'm not familiar with all of the options, but Kaiser will not cover a homebirth AT ALL, and neither does Aetna.

Some BCBS pay homebirth well, but it all depends on the plan!

United healthcare usually covers homebirth (with a non CNM midwife).

 

[Gena 22]

I'm in your area, but don't have a good answer for you. I was covered by CareFirst. Like some PPers, Carefirst covered prenatals and well baby checks without a question. They paid some HB expenses, although they initially claimed they wouldn't. In the end I paid $1399 for my homebirth, plus $250 for a birthing pool, plus $500 (plus a $150 tip) for my doula. She was worth it!

It adds up to a lot, and I feel like CareFirst should have paid me for saving them thousands! A twin birth, would have been an induction, c/s, who knows, possible NICU time.

But in the end, I was happy with the services I got and wouldn't have had it any other way.

You'll have to weigh saving money you'll need for your growing family with choosing the birth experience that's right for you. I can't recommend ignoring either motivation.

You might post in our local area MDC board and get some local recommendations on MWs and prices.

 

[apartautonomous]

many thanks for all of your sincere replies...

i might begin to throw myself to random billing departments pleading for help (like my previous OB), and am even trying to work with any contacts of the CPM's that work in the DC area that use a billing service for assistance. (know anybody in Virginia?) hopefully they can at least peruse the most recent births and view the most cooperative insurances to share.

yes, it is very true that most federal plans, especially in the dc area with it's plethora of top providers it has to offer, is funny about licensures and homebirth, and even alternative treatments (clearly ruling out homeopathy and naturopathic reimbursements, for instance) but i suppose whatever is not clearly stated in their plans could become a work-around? Virginia does acknowledge the CPM and LM licenses, and given a lucky situation when doing births in the home, i've been told that these women are covered as an out-of-network provider after a certain percentage. when i began searching for a birthing facility early in my pregnancy, all those on the preferred list (which is unfortuantely far too few) were already booked, as were the CNM's that were associated with them. it's as if you must book with a CNM in one of those preferred provider facilities prior to conception! regardless, i am set on a homebirth, if all permits

though practically all similar in form, i've been able to gather some of the .pdf's for some of the 2009 calendar year providers for clarity. if by for some odd reason, or even out of curiosity, someone else could pick them apart on a whim, here they are:

Association Benefit Plan:
http://compassrosebenefits.com/docum...BPBrochure.pdf

Foreign Service Benefit Plan:
https://www.afspa.org/home/pdfs/2009FSBPBrochure.pdf

NALC:
http://www.nalc.org/depart/hbp/Benef...I%2071-009.pdf

GEHA: https://webaccounts.geha.com/public/...ghBrochure.pdf

Samba:
https://webaccounts.geha.com/public/...ghBrochure.pdf

United:
http://staging.uhcfeds.com/files/fea...-HDHPFINAL.pdf

AWPU:
http://www.apwuhp.com/openseason/2009Brochure.pdf

Federal BlueCross BlueShield:
http://fepblue.org/benefitplans/open...re_English.pdf

Aetna:
http://custom.aetna.com/fehbp/pdf/20...ochure-AHF.pdf

 

[annanicole]

our blue cross covers homebirth as long as there is an in-network provider.

 

[hapersmion]

We had Blue Cross Blue Shield when I had my first child. They paid decently (about 80%) when we were planning to have the baby at a free-standing birth center. When we had to switch our care to the Farm, we only got $600 back out of the $4000 we paid up front. That might have been the way the midwives submitted it - maybe if they'd itemized we would have gotten more. Also, there's something called a "Gap Exception" that I've heard of people using to get the insurance company to pay for a homebirth as if it were in-network, when they don't offer any in-network homebirth midwives. We didn't know to try it at the time though.

Now we have United, so I'm hoping for better things the next time around.

 

[MamaVolpe]

I don't know about many of the other plans but I do know the UHC ones. I would call UHC to see if your provider is in network or check their website uhcfeds.com. UHC does cover homebirth so if your provider is in network I would go with MDIPA the HMO option. If the provider is out of the network then I would choose the PPO CDHP as it has a $1250 HRA account with it then you would just have to meet the additional $750.00 deductable, after that the insurance would cover 60% out of network. The premiums are lower than the other companys as well, I believe.

Good Luck

Also Evelyn Muhlhurn is a midwife in the Baltimore area and will travel up to one hour away for homebirth...she takes most insurances.