[bluebunny]

Three weeks ago, I met with a midwife who delivers only at a birthing center. Her fee is $3700 for prenatal care and the delivery. I liked her and decided to schedule my first prenatal appointment. The earliest appointment that they could give me is next week. I'll be almost 21 weeks then. Is it unreasonable to ask that she reduce her fee?

My insurance doesn't cover any of her fee so I have to pay out-of-pocket. Since I won't have received the benefit of her prenatal care from weeks 6-20 (and therefore she won't have had monthly appointments with me--total of four), do you think she would lower her fee for me? I hate that it comes down to money but this would be moot if insurance would pay for midwife services!!

Also, do you think it is unusual to wait almost a month for an appointment? I was a little surprised that she wouldn't have me come in to meet with someone in her office before then.

 

[Mackenzie]

I don't know what the "norm" is, but mws I have known have reduced their fees for a variety of reasons before, such as limited prenatal care, military ins (which reemburses for a fraction of the cost), no ins etc...It can't hurt to ask.

 

[JeDeeLenae]

My fee wasn't reduced even though I started prenatal care at 26 weeks with my midwife. I didn't care though because my insurance was covering it and I was hitting my out of pocket either way.

It doesn't hurt to ask though since you're a self-pay. Also, what I found out is that even though my MIDWIFE wasn't contracted with my insurance company and my insurance company didn't cover midwifery, they DID cover the doctor that she "worked with," so the center bills everything through that doctor as well... which happens to be a doctor that's contracted with my insurance company. Maybe they have something similar. It wouldn't hurt to ask. Unless it's a stand alone midwife practice or something.

Good luck!!!

 

[onlyboys]

The midwives that I used for my last birth did not reduce fees if you joined their practice later in gestation. The reason for this is that they didn't want women to come to their practice late in the game just to avoid paying the fees. It's the same for everyone, whether you saw them first at 6 weeks, or at 36 weeks.

 

[CookieMonsterMommy]

I wouldn't reduce fees because of late entry to care alone.

IMO, she's still going to be giving you all the info, testing and counseling you "need", she just has less time to do so. She's still go to be available to you 24/7. She's still got her license on the line should there be some type of complication, etc etc etc. She's accepted you as her client, which means that she has to limit the number of full-fee paying clients she can take on.

(FWIW, i'm not a midwife--yet--but my doula fee is my doula fee whether I take you at 20 weeks and you get your 2 full prenatals or I take you at 41 weeks and you deliver 5 minutes later. Now if you're unable to pay for some other reason--laid off, single mama, teen, etc, that's a diff story and I'm willing to work with you.)

Kelly

 

[MothertheMother]

also keep in mind that it is pretty typical for OBs to see you for an initial visit but then not schedule again until you are closer to 18 to 20 weeks (at least this is how the army does it lol). So, minus a little bit of nutrition advice I don't know that you would have needed monthly visits anyway. I have not been under a midwifes care outside of a military facility so I don't know how different it is...

 

[homebirthing]

My midwife starts seeing families around 15-17 weeks, so there would still be a lot of the pregnancy left. Plus birth and five postpartums.

 

[Hayes]

I switched at 32 weeks with my last pregnancy. I paid her full fee out of pocket., gladly.

 

[Kidzaplenty]

MW fees are set fees, not per visit fees. So they should get what they usually get. I agree that it could lend to clients waiting late in the pgcy to seek the MW if the fees were based on number of visits.

"A workman is worthy of his hire". That's what my Mom always said.

 

[98741]

Doesn't hurt to ask!

I risked out of my midwife's practice and she had it prorated for cost per visit and reimbursed us the rest so I think some midwives probably do have it worked out over services. I'm sure they ask for the full rate but if there are services you will not be recieving due to late entry to the practice I think it is reasonable to recieve some sort of a discount. Some midwives will reduce fees simply based on a hardship to pay if this is part of the problem.

 

[lorijds]

Another route is this--I work at a birth center, and we automatically offer a fee reduction for clients paying out of pocket, if they pay at least half by the birth and continue to regularly make payments after the birth. Our reasoning is this: we estimate that it takes us approximately $700 worth of our fee to get reimbursed by the insurance company--time spent on the phone, time spent jumping through the hoops to qualify to be on a certain medical plan, as well as the automatic provider discount that many insurance companies require (they will tell us, Hmm, you say it costs you $3800 to offer your services? Well we will reimburse you for $3200. If you want to be on the plan, you will offer our clients a 600 dollar discount.). We do not offer this cash discount to our clients who have a history of late payment with us, or who make no attempt to set up a payment plan, dispite our asking them to, btw.

So, since you are paying cash and your birth center isn't having to go through the hassle of trying to get reimbursed, they might be interested in offering you a cash discount.