Aetna Homebirth

cig0010

I recently switched to Aetna (policy states that they not cover homebirths) with my midwife and I am afraid that if I say that I am considering homebrith that the insurance company won't just make me pay out of pocket for my midwife's expenses (that's fine), but if I transfer to a hospital that they will deny the entire birth expense even in the hospital. I really don't want to ask the people at Aetna because I don't want my account flagged...

Does anyone have any experience with trying to have a non-covered homebirth and then transferring?

Has anyone told Aetna that they're having a homebirth and had it covered?

Giving birth any day now, so I'm freaking out...

Thanks!

painttheair14

I am no expert but I feel like if you transfer and they normally cover hospital birth that they'd have to pay for the hospital fees.

aboodtobe

I do not have Aetna, but I do have an insurance that does not cover home births. The previous comment is correct, your insurance should cover a hospital transfer. Keep in mind, however, that if you are transferring to a hospital, it would most likely be under an emergency situation not a normal birth scenario (unless, of course, you decide last minute to have a hospital birth). Which, especially if you are admitted, your insurance will cover (minus any copays, your deductible, etc). What you're going to have to look at is which hospitals/services/procedures are covered as in-network and which are non-network and which are not covered at all. This will help you to determine your potential out-of-pocket costs and maxes. Don't worry about being "flagged", it doesn't really work like that. 

Also, even though your insurance doesn't cover the actual home birth, it may cover some of your midwife's fees as "prenatal care." I am planning on a home birth and my insurance will be billed this way. No guarantee that any of it will be covered, but it is worth a try. Most midwives have a billing service that can help you figure this out. They can also help you get a Verification of Benefits from your insurance. This will outline whether your midwife services (prenatal, postpartum, etc) will be covered. Very few insurances cover home births in the US. Do you have a flexible spending account? You may be able to use some of that money too. 

Feel free to private message me if you'd like. I've spent a ridiculous amount of time researching this kind of thing and I have family in the medical field who have given me some good hints. 

Congrats by the way! 

rboisvert

I have no experience with Aetna but I know several people who have fought to get their home births covered and won.  What worked for a friend of mine was the midwife charged only for prenatal and postpartum care (her full fee but basically didn't charge for the birth if that makes sense) and then my friend submitted that along with an estimate of what the insurance company would have paid for the same care including birth in a local hospital which was several thousand more than what the midwife charged.  Talk with your midwife, my guess is she has some experience with getting the most coverage for her clients.

DevynLynn

I worked for Aetna for a while and they are the worst insurance company to deal with. I would recommend speaking with your midwife about the insurance coverage, she may have some insight. Also, they will not flag an account just because you call to ask questions. You don't have to tell them that you are doing one or the other.