Insurance Company will not pay for home birth

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Permalink Reply by Cathy Ceigersmidt on February 8, 2011 at 2:18pm

Hi Nicole,

I am in a similar situation -- I am 23 weeks pregnant with my first child and my insurance won't cover home births. The best advice I can give is to find out what birthing facilities they do cover for their in-netwok midwives. My insurance covers both free-standing birth centers and hospitals. Insurance companies that don't cover homebirths just won't budge on this issue, as far as I know there's no loopholes. The good thing is that you can still have a natural birth with a midwife, which is the most important part. An independent birth center will be more homey and low-tech than a hospital. In the future, you could try switching insurance providers to one that does cover homebirths (if they even exist!)

Best wishes for a happy and healthy pregnancy!

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Permalink Reply by Nicole K Chopp on February 8, 2011 at 2:26pm

Thank you for replying, I have checked with a few different insurance companies and its not that they don't cover a homebirth its that the midwifes in their network don't do them. There are no birthing centers in NJ. NJ hospitals have a 40%+ C/S rates, so that means even with a midwife I have almost a 50% chance of having a c-section. To me a natural birth means being able to labor freely not being attached to a fetal monitor, being able to eat and drink to keep my energy up and no medications (to me iv fluids are not natural), this just does not seem possible to do in the hospital.

 

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Permalink Reply by Cathy Ceigersmidt on February 8, 2011 at 2:45pm

I understand your concern -- in that case, I recommend doing some research to find an area hospital that has the lowest rate of interventions and the most lenient protocols. The most important aspects of having the birth you want is having a written birth plan and either a midwife or obstetrician that is supportive of your birth plan. If you have that kind of support, even if you are in a hospital with a high rate of C-sections and other interventions, your birth team can make sure your wishes are granted to the extent that they are allowed by the hospital. Find out from the nurse midwives what the hospitals' protocols are. I was fortunate to find a practice of nurse-midwives that work at a hospital whose staff is very supportive of natural birth. They allow for intermittant monitoring and don't require women to be hooked up to an IV. They have soaking tubs and showers in every laboring/birthing room. While the hospital itself has a C-section rate of about 20%, the midwives' practice has a C-section rate of 9%. Interview several midwives and find out what their intervention rates are and all the info they can provide about hospital protocols they are required to abide by. Hope that helps!

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Permalink Reply by Leslie Reed on February 11, 2011 at 12:35pm

Hi I live in NY and was told at first the same thing by my insurance company.   (They would cover homebirth, but there is no one in network...)  However my midwife told me that there is a law in NY that states that insurance must cover any type of birth (homebirth, hospital, freestanding center, etc.)  It was not until I mentioned this law to the insurance company that they changed their mind about the homebirth and gave me a pre-approval letter for out-of-network coverage for the midwife that I was using.  I would try to find out if NJ has a similar law.  In NY Midwives can be licensed as licensed Nurse Midwives and this is the only type of midwife who an insurance company will approve.  My son was born August 2009 and I did not have trouble getting my insurance (Empire bluecross/blueshield) to pay.  However, because it was approval for out-of-network coverage for the birth (not prenatal care) They did not pay until after the birth.  This means that there was a small risks that if I was transferred to the hospital and gave birth there, I would be responsible for paying the midwife for prenatal care, as the insurance would have only covered the hospital birth.  That being said, I am expecting another in July and have made the same arrangement with my insurance.

 

Don't think the first no is their final answer!

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Permalink Reply by Nicole K Chopp on February 11, 2011 at 1:30pm

Thank you for your reply, right away I called the state of NJ Insurance Dept. and was told that there is no law and they are not obligated to pay. I have made several(probably 10 by now) phone calls to Horizon about this issue and they will not budge. Its so disheartening that someone else can tell you  where you should or should have your baby.

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