Homebirth Insurance Coverage

I keep on forgetting to post on the victorious end-result of getting our homebirth covered by insurance. Yes, it's true!!! Our prenatal care, provided by our Certified Professional Midwife (CPM), plus the labor and delivery at home was covered by our insurance. I couldn't be more pleased.

Our CPM charged us $1,500 - plus gas at each prenatal appointment and any vitamins and/or supplements I purchased through her. Our grand total came to somewhere between $1,600-1,700. [NOTE: $1,500 is exactly half of what the CPM in Minneapolis I met with charged. I believe this is because our SD midwife works in an area where the cost of living is much lower, though she may also charge less than she should - I'm not sure.]

I called our insurance provider, Blue Cross Blue Shield (BCBS), sometime at the end of October or beginning of November to inquire whether they covered a homebirth with a midwife. They said they covered homebirths with a Certified Nurse-Midwife (CNM) but didn't see anything about CPMs. The difference between the two being: CNMs are Registered Nurses in addition to a Midwifery degree, certified by the ACNM, while CPMs gain their accreditation via a lengthy apprenticeship culminating in an 8 hour exam and skills assessment test, certified by NARM. So there is a difference (especially in the eyes of an insurance provider). CNMs most often work in correlation with OBs in hospitals, though not always. CPMs are generally the midwives who do homebirths, working with friendly OBs as back-ups.

The woman at BCBS told me to submit a claim, basically saying, "What's the diff?!" between CNMs and CPMs. While I have already established that there is a difference, I didn't get too technical with her. I complied and submitted the claim, hoping for the best. This was sometime in November 2007 - I sent in all the paperwork and attached an official Bill of Service from my CPM. Pumpkin was born October 2007.

We didn't hear anything for months and months. I finally called in to check the status on my claim sometime in February or March, but got the run-around. Every dept. I was transferred to claimed that they weren't the ones processing it, and after several hours on the phone I gave up. This was quite distressing, and I called my midwife the next day to explain the circumstances and ask advice. Unbelievably, she had gotten something in the mail from the insurance company requesting more information. A few weeks later, I got a request for more information as well - so at least we knew someone, somewhere in the behemoth that is BCBS, was processing it. This time I made copies of everything they sent me (as well as what I sent back). I wanted PROOF that I was in process, in case I had to call in again.

More waiting, more waiting.

Then, out of the clear blue sky, in MAY 2008, they sent us an Explanation of Benefit Payments and a check for $720. Unbelievable! One month later in June 2008, they sent us another Explanation of Benefit Payments and a check for $161.60. We'll take it! That is $881.60 - covered by our insurance company - for the prenatal and postnatal care, plus the labor and delivery provided by our CERTIFIED PROFESSIONAL MIDWIFE, in the comfort of our own home. Our total cost was somewhere in the vicinity of $600-700. Diego's hospital birth on the midwife unit - for just the birth, mind you - was a co-pay of $800-something. Victory!

Spread the word, ladies. It can be done. It might have taken forever and a day, but it can be done. We did it - hooray!!