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WOW - Is this a reasonable homebirth midwife fee?

2566 Views 48 Replies 44 Participants Last post by  applejuice
I spoke to a direct entry homebirth midwife in my area today (the only one, as far as I can tell). Her fee is $3600... $1000 up front (at first appt) to secure her services, and the rest in payments before week 36. She will bill insurance after the fact, but I don't know yet if my insurance will cover it or not (she says she bills the insurance company $4600, then keeps $1000 of the insurance payment and gives the rest back to us).

Does this sound right? I was pretty surprised, actually - I guess I expected no more than around $2000. The free standing birth center I used with my first 2 births was only $3600 or $3800 total. I'm almost sure my insurance would cover them (I had to get a waiver for it before, but they did end up covering it). But I now live almost 2 hrs away from that birth center - I would LOVE to go back there but I'm afraid it would be pushing it to make it in time once labor begins.

I haven't met this midwife, just talked on the phone, so I'm trying to figure out if I am getting a bad feeling about her and the homebirth, or if I am just freaked out over the bigger than expected fee. I did schedule an appt with her for next week, but I'll have to decide for sure if we are going to go this route before that appt, since I'll have to pay the $1000 fee at that time.

ETA: I believe a major reason the insurance co agreed to give me a waiver and cover the birth center before was because I pointed out how much cheaper it was going to be than a hospital birth. This midwife intends to bill the insurance company $4600 - that's not all that much less than a hospital, is it? I'm afraid the insurance co will flip out at that and deny payment, even if they agree ahead of time to cover homebirth!
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YES 3-4000 is a standard fee for prenatal, birth, and postpartum care. this is MUCH less than the cost of OB care, and you get much more for you money. midwives are on call 24/7 for you before and after the birth, not to mention staying with your throughout your labor and postpartum, AND being available for you after the baby. 4000 IMO is more than reasonable.
I also had to self pay as my insurance wouldn't cover most of the cost. It cost me a total of 3500. Completely worth every penny. When your insurance picks up the bill you don't see a lot of the charges. You see what "deals" the insurance carriers have worked out. Good Luck!
First, $4600 isn't too bad. It'd be a bit much where I live (my midwife only charges $2300). I live in rural-ish north Idaho.
eta: She may have a sliding scale, I haven't gotten to the part of paying for maternity care.

Second, my hospital birth with ds was around $25,000, we paid $5000 out-of-pocket.
The insurance company didn't even blink.
That lovely price included a failed induction, followed by a spontaneous 4-hour labor (3 of which were in-hospital), 15 minutes of me pushing, them letting us see ds for a little bit, after which they whisked ds off to the NICU because he had fluid in his lungs (what else is he going to have in there, kool-aid?). I was only there 37 hours, ds was there for 3 days. I had no meds besides an IV to hydrate me, and nothing was out of the ordinary or spectacular. I was the easiest maternity patient that day the nurses said (and I was up and walking around in that stylish gown that afternoon).

Since you feel a little iffy about the midwife, can you make an appointment to just interview her? They typically don't charge for that, and you can get a feel as to whether you want to hire her or not. That's what I did with my midwife, and I ended up talking/chatting to her and her assistant midwife for an hour and a half. And dh and I aren't even close to ttc yet.

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Around here homebirth runs ~$2400- $4500+

I charge $3200, but offer an early payment discount: $1200 discount if paid by 30th week, $800 if paid by 36 weeks and then no discount if paid between 36 weeks and the birth. I bill insurance $3200.
My midwife charged 3000$ until 2 years ago, now 4,000$

Totally reasonable for the wonderful, in depth services.

Originally Posted by lmonter
(my midwife only charge's $2300, but she'll inflate it a little for the insurance company because they only pay 60% after our deductible is met).
This is considered insurance fraud and is strictly forbidden.

Yes, I know that insurance companies do the same thing (a $50 bill shows up as having $10 knocked off as a discount, and $10 copay, and $30 paid by insurance). But they do not want to be charged a different amount in order to work around the system.

That said, I'd like to not see anyone get in trouble with an insurance company - not my thing. To that end, I'd like to mention that...hypothetically, if I had done such a thing, I would (hypothetically) prefer if people made really sure not to mention my name in conjuction with such things, and (hypothetically, of course) avoided such a discussion with anyone involved in health insurance, even at my employer.
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I have only grabbed a 'sampling' of prices...but here in Northeastern/middle Ohio it seems to run approx. $1,000. some are below ($700-800), but that doesnt cover prenatals (some charge $25 each for prenatals and some dont seem to do them at all)

the higher ones are $1100, maybe more. I dont know, I found one I liked and stopped looking

we seem to have alot of midwives, though...maybe 5-6 within an hour of each other (and those are the only ones who 'advertise' somehow, by hosting birth groups or also acting as doulas) maybe that effects the rates?
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And, to add to the topic, going rate here is $3000-$4000 with an additional $1500 to $2000 additional if you use the birth center. There are prepayment discounts available with many midwives, and sometimes bartering for substantial trade is okay, too. Construction seems to be popular in trade. I wish my husband still did concrete sometimes.
Seems very reasonable. My midwife, who is a CNM, is charging about $5,000 but she is the most expensive in the city (but well worth it!). A lot of midwives ask for payment up front because a lot of them don't get paid once the baby comes (which I can't understand!). It is also common practice to charge less for patient self-pay then insurance pay and is common among all medical practices.
I'm seeing it varies widely with the area you live in. He in GA $2,000- $2,500 is the norm.
It was $4000 for me a year and a half ago.
There was a thread a few months ago about prices and from what I remember it ranged from $1500 to $5000, depending on where you live. So it sounds pretty reasonable.

Midwives spend a lot of time doing prenatal work, and I can't imagine your insurance company will blink at the cost. Hospital births run in the 10s of thousands.

Originally Posted by LoveChild421
I'm seeing it varies widely with the area you live in. He in GA $2,000- $2,500 is the norm.
Definately. One of the midwives I spoke to here in Abq, New Mexico, gave me a rate of 2500$ to be paid by week 36
Our midwife charges approx. $3000 all inclusive,.. though she does charge a $25 traveler's fee for home visits (except for the 36 week which is free)... which has been WELL worth it for us in the last few weeks here (so uncomfotable!!) and we gladly fork it over :LOL
Maybe it's just the exchange rate, but private midwifery care here (in England) in Expensive! Most of the midwives whose sites I've checked out charge about £2800, which works out to about $5100. And they all seem to charge £50 for an initial consultation - just to meet with them, even if you don't decide to hire them.

We've got lots of time to think about it, but homebirth can be free under the National Health Service, but the midwives who attend your birth will be whoever is on call that day. So it could work out to be someone you've never met before! Or we can pay the £2800 for continuity of care. Hmmm.
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THANK YOU ladies for all of the replies - I do feel better now knowing that her fee isn't outrageous. I had read somewhere that homebirths on average cost about $1500, and my sister is a midwife in another state and she said her fee is around $1700 for a homebirth. So I was just floored when I spoke to this midwife yesterday.

I have discovered that there is another midwife just a little further away than the first one, so I'll call her today, and I am going to call the first one back to ask for a face to face interview before the first official appt - I'm just not comfortable with giving her $1000 the first time I meet her, you know?

I'm also going to call my insurance co today to ask about homebirth coverage.

Thanks again for your input!
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My midwife (colorado) charged $3600 but did what Pamamidwife does and gave early payment discounts... We ended up paying $1800 becuase we paid by 20wks
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