Hi all, I am 22 weeks pregnant with my first child,I really have my heart set on a home birth, I just can't picture it any other way.However my insurance company (Horizon BCBSofNJ) will not cover this and I cannot afford to pay for a homebirth which is around $8000. I'm in NJ and all the in-network midwifes do not do home births, and since there are midwifes in-network they will not pay for out of network. Any advice would be appreciated on how to get my homebirth paid for.I have called Horizon about this issue about 10 times spoke with two supervisers and they will not budge.

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Are there any midwives willing to work on a sliding scale fee with you based on your household income?

Also, a student midwife might be an option. I know how frustrating it can be with the insurance companies. Many do not cover home birth so you're not alone with that.

$8000 - Yikes! I'm in Virginia and my midwife charges $3400 (includes post-pardum, too!). She does give a small discount for paying in full early. She even said she could stretch payments out as far as 6 wks post pardum or would consider barter offers. Have you asked the midwife if she does this? Have you checked around to other midwives to see what they charge? Is $8000 the going rate in NJ?!!

We do not have insurance (by choice - we pay out of pocket for all our medical care) so we did not face insurance issues. When paying out of pocket, WE make all the decisions on our medical care - who we see and when and where - not someone behind a desk at an insurance company! No referrals, hoop jumping, in-network/out-of-network, co-pays, claims, disputes, blah, blah, blah. And most doctors give us a discount of up to 25% for paying the day of service! In the long run, since everyone in my family is in generally good health, we save SOOOOO much money paying this way rather than paying HUNDREDS a month, PLUS co-pays, deductibles, etc. for services we rarely use. We also carry an inexpensive accident policy through Aflac as a "backup" that covers emergency care (even ICU stays), x-rays, follow-up doctor visits and much more, should someone get injured.

Here's an option most people haven't considered: Take the money you're GIVING the insurance company every month and set it aside in a sort of "medical fund." Then when you need to see a doctor, you have the money to pay up front, at a discounted rate. Then YOU are in control of your medical care! 

People need to know they have a CHOICE when it comes to their medical care!!! HMO's/insurance companies are NOT the only way to go. YOU are paying THEM!!! They should be bending over backwards for YOU. But in actuality, they do NOT have your best interest at heart. They have their own bank account at heart. They only see dollar signs $$$. So why give them YOUR money??? Sorry for ranting - it's so sad to see people who think they are under their HMO's/ins co control when deciding on medical care. 

I hope you are able to work something out!

(Disclaimer: This is my opinion and what works for us. Everyone has their own medical history and other factors to consider when making decisions on medical care.)

Alyssa

Are you looking at Certified Nurse Midwives(CNM) within network only?  I suggest looking into certified professional midwives(CPM) who attend only homebirths?  

Have you seen this directory? 

http://www.birthingnaturally.net/directory/midwife/newjersey.html

Maybe you can find someone within your area that works on a sliding scale like Lauren mentioned.  I know many midwives that work out payment plans with their clients so that they can have the homebirth experience.  I've had a few friends that have even bartered services with their midwife.

 

I've had 2 free standing, birth center births with CNMs and 2 homebirths with a CPM.  Our insurance covered the free standing center births but wouldn't cover the homebirths.  We paid out of pocket for both births and it was well worth the money we saved & spent.  Where there a will, there's a way.  Don't get discouraged or totally rule out a homebirth.  It seems as if you have lots of options in NJ.  You may have to forgo trying to figure out how to get insurance to pay.  I've know of women who have given birth, had their midwife submit claim forms and get some reimbursement for homebirths that they've said wouldn't be covered.  Good luck & keep searching.  

Janet

petition your insurance company in writing. Site how much money you will save them by birthing at home compared to a hospital birth. Also site the rates and percentages of intervention and c-section in the hospital, and the associated costs. Site a study on the safety of homebirth and detail that you are an educated consumer, in good health, and having a low risk pregnancy. Do this in writing to the higher ups. Send multiple copies. If it gets formally rejected in writing (it's easy to reject a phone call...this happened to me), appeal it and ask them to reverse their decision. By informing them about the costs associated with hospital birth compared to a planned homebirth, tell them they are taking a proactive stance in supporting hb. Also, the in-network mw's are certified nurse midwives. not the same as a certified professional hb midwife. Therefore, you are seeking coverage for something that they lack, as cnmws do not attend homebirths. And let your HR people at work know. They are the ones choosing plans and paying premiums...it's in their best interest to choose a provider willing to support hb...it saves them money. This is the route I took, it was long and tedious, but in the end, I did get my hb covered (and to boot, they cut me 2 checks by mistake!! But I only cashed one...karma). Good luck!!

Hi Nicole,

I am in the same boat! I also have Horizon BCBS of NJ and am hoping for a homebirth (I think we're considering the same midwife based on the rate you quoted :-) I talked to a friend who is a homebirth advocate and she suggested petitioning the insurance company in writing and outlining how cost effective it is. I'm only in my first trimester so I wasn't planning to start the battle quite yet. Keep me posted - 

 

Carley

Hi Carley, after doing a lot of research I have decided to switch to Oxford Insurance, I heard this is the best Insurance to have and you can get your home birth paid for with a gap exception. I would suggest starting you research now, it will come up fast and you dont want to get stressed out, which I had been. When are you due?

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