Midwife FAQ #4: Does your insurance pay for it?

My insurance pays for my midwife’s services and birth center fees at the out-of-network rate.  We have a PPO.  Those with HMOs are not so lucky.  Because the birth center fees are so much less than a hospital’s fees, we end up paying approximately the same amount as we would to have the baby in a hospital.  We do have to pay the whole midwife fee up front, though, and then we get reimbursed from the insurance company.  Thankfully, we got a big tax refund!  We’ll be looking forward to that reimbursement check from insurance, that’s for sure!

When I had my Lion Cub, I fought with the insurance company through appeals trying to get it covered at an in-network rate.  This time, after my first request, they flat out said it was not medically necessary for me to use the birth center.  I guess I can’t really argue with that.  (Well, it’s not medically necessary that I give birth in the hospital either.)  I’ve decided to bow out instead of getting angry every time my appeals get denied.  They know that I went ahead with it last time, so why would they pay the in-network rate when they don’t have to?  They know that I’m probably not going to switch to a hospital since I didn’t last time.  Sigh.

Would you like to know WHY there are no out-of-hospital midwives in my network?  Or in anyone’s network, really?  The insurance companies want the midwives to have a supervising OB.  Most midwives would probably like to have a helpful supervising OB as well, but they can’t get one (whether or not there would actually be enough OBs that would be willing to do this, that’s another story).  Right now, the malpractice insurance companies have put midwifery in a precarious position in California in this regard.  They refuse to insure an OB who enters into a formal supervisory relationship with a licensed midwife or certified professional midwife (the types of midwives that most commonly provide out-of-hospital birth services).  Fortunately, my midwife does have OBs she can consult with when necessary — they just aren’t officially supervising her.

In summary, insurance companies are the root of all evil.

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