Insurance and homebirth

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Permalink Reply by KM on August 25, 2009 at 3:34pm

You need to call your insurance company and ask them that question specifically. You need to specify that you are using an out of network person and paying out of pocket. If they say they will cover any complications once transfered then you need to request it in a signed letter for your records.(they are legally obligated to give you this)

My midwife told me that AETNA is one of the companies that covers births with a midwife the most in her experience. Maybe it's a state to state thing?(I'm in CA) Or the plan you're on? I'm not saying you're wrong I'm just surprised.

Good luck! Kate

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Permalink Reply by Miriam M. Maldonado on August 31, 2009 at 9:56am

Asha, if this is a self funded insurance unfortanelty they are not obligated. If they are by state find out if your state has a statue that reads about your rights being a woman and choosing were to birth. I have dealt with many insurances and some can be very tough. You can also speak to a pre-cert coordinator and explained that a homebirth is less costly for them and for you. If by any chance this does not get resolved and you have your homebirth, if you are transferred as long it is a in network hospital they should not deny any claims. It has nothing to do with the other. Once you are transferred out of care from the midwife to hospital the insurance should not give you any problems. I wish you well and good luck with your homebirth.

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Permalink Reply by Sara on September 2, 2009 at 9:26am

I am pretty sure that your ins company could not deny the hospital charges if they are maternity related and you have maternity benefits. Regardless of where your birth started or why you go to the hospital they have to pay for covered expenses and if maternity is covered they cannot deny the claim. Just make sure the hospital you are transferred to is covered on your ins and the OB that takes over your care is in their network.

I have Cigna and I'm in TX. Don't know about the laws/policies there but I can tell you about my situ. Cigna does not cover HB either but they do cover BC but there are none in my area in my network, nor do they have any HB/BC MW on my plan in my area. Also, I don't have out of network benefits on my plan. They are not offered. But the laws in TX say that if they don't offer Out of Network benefits than they have to make exceptions for providers if there is not a comprable one in the network. I demanded an out of hospital birth and b/c they had no network providers that offer that service, they had to give me an exception and cover an out of network provider for me at 100%. If I wanted a BC they would have to pay for the one in my area. But since I am having a HB, there are no xtra expenses above what the MW charges for delivery. It was quite a fight and it took weeks to achieve but they are paying for it.

Since we don't know about the laws in your state and they do vary, I would call the State Ins board/department of regulation and ask them about provider exceptions to achieve access to providers not otherwise covered on your ins. You never know....

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