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-   -   new here -- insurance question (http://www.justmommies.com/forums/f341-home-birth/1444068-new-here-insurance-question.html)

jencarpent February 19th, 2009 08:01 AM

Hi I'm new here. I'm not pregnant, not even trying yet actually. I get my iud out tomorrow (hopefully). I'm really interested in having a home birth. I have two sons already, both born in the hospital and both less than ideal experiences. I have not approached the subject with my husband yet, I think it will take some serious convincing there. I'm trying to gather all of my info and make sure it's something that I feel confident that I want and can do before I bring it up with him.

I don't have the best insurance. It is a private plan and I'm paying for an expensive maternity rider. My maternity deductible is 2500 and wouldn't cover a home birth. If I have complications it would apply to my regular insurance. I raised my deductible there to 10,000 so we could afford the maternity rider in the first place. All in all, our premium is close to 500/mo.

My question for you all, if I decide to go with a home birth is it too risky to drop the maternity rider and just pay out of pocket? Is it better to keep the maternity insurance just in case my midwife would suggest it is better for me to birth in the hospital? OR does that not really happen. My first two births were uncomplicated, but I have since learned that I have a fibroid. If I could drop the maternity rider I could get much, much better insurance overall, it just wouldn't cover the maternity part. It would make it easier to save for the home birth, which would be 3200. I talked to one midwife about it and she would like to try to submit it to the insurance and try to get it covered. Although, I suspect that her motive is that she charges 4000 to insurance rather than the 3200 to those that self-pay. Not sure I would go with her just because of that. If they rejected the claim the cost to us between insurance and that fee would be enormous.

Thank you for any advice anyone can give me! I don't really know who else to ask these questions too.

Sk8ermaiden February 19th, 2009 04:52 PM

Hmm, I would keep it just until the baby is born. It would be useful in the unlikely event of a transfer as well.

MamaFish February 21st, 2009 10:55 AM

I have no idea what an emergency hospital birth might cost, but I do know that you can work with hospitals and get them to DRASTICALLY reduce their charges if you are self-paying. You already have a $10,000 deductible. Maybe an emergency hospital birth could be reduced significantly, though I doubt to $10,000. Just something to consider... with insurance it might cost you $10K, without insurance... $15K? $20K? I don't know.

You have to weigh the pros and cons. Would you have family to help pay the bill? A hospital will work out payment plans with you and I've heard they won't hassle you if you're keeping up with the payments.

Your mw may be able to charge your insurance for your prenatal and postnatal visits and you just pay for the birth? My mw did that once when I had insurance that would not pay for a homebirth. Her fee is also $3200, but she just charged $500 for the birth. But does that $10K deductible count towards everything?

jencarpent February 21st, 2009 11:09 AM

Hi MamaFish,

The insurance stuff is really confusing. The part of insurance that we have the $10,000 deductible on right now doesn't cover any maternity stuff, none of the doctors visits, not the birth, none of it. It would, however, cover emergency surgery, such as c-section if that was needed.

We are paying for a separate maternity rider that covers the maternity stuff and we have a deductible there of $2500. So if I keep the rider and opt for a hospital birth then it would cost us no more than $2500. However, the rider is expensive (monthly) and the insurance for the rest of my family is now worse because to make it affordable I upped our general deductible to $10,000. Does that make sense?

I'm thinking of dropping the maternity rider, because I'm thinking I'd rather birth at home and it wouldn't cover home birth anyway. It would be cheaper in the long run to drop the maternity rider, have better overall insurance in the case of emergency c-section (not to mention the rest of my fam) and pay for a home birth midwife at the cost of $3200.

I'm just wondering if that is maybe a big risk if something were to happen and my midwife said, "nope, you can't birth at home, you must do it in a hospital." This is where I'd be screwed because I would not be covered for any of that hospital birth.

I know this is really confusing and I'm not sure I'm explaining it well. I'm just hoping someone has been there or has some advice.

_Brandy_ February 23rd, 2009 08:34 PM

No idea, I am a Canadian, American insurance is so confusing to me. Good luck with it all.

MamaFish March 3rd, 2009 06:12 PM

Quote:

I'm just wondering if that is maybe a big risk if something were to happen and my midwife said, "nope, you can't birth at home, you must do it in a hospital." This is where I'd be screwed because I would not be covered for any of that hospital birth.

I know this is really confusing and I'm not sure I'm explaining it well. I'm just hoping someone has been there or has some advice.[/b]
Can you talk to a mw first and find out? If it were me I would drop the insurance. To me, the risk of having to go to the hospital is very low. That's just me, though.


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