aetna choice POS II & Homebirth with CPM

LindseyJW

has anyone successfully had a homebirth covered with a CPM and aetna choice POS II?

 

we have to change insurance and for our other needs, this seems to be the best plan available to us. however, i've read aetna's statement on homebirth (and they cite that awful wax study), and they have basically said that it is dangerous and they won't cover it. i've seen some stories of moms who successfully had homebirths covered b/c the midwife just didn't mention that the birth was at home. i'm not sure how that works. would love to hear from you!

 

thanks! 

LindseyJW

thanks for your feedback. 

i don't think it's lying to not include the place of birth - it's an omission, it's not like the paperwork would say the birth was in a hospital when it wasn't. since it's worked for others, i'm wondering what process they had to go through. 

if you google Aetna and homebirth, you will find plenty of instances where aetna did cover a homebirth, so it is possible. but i'm not finding whether these were with a CPM or a CNM or if it even mattered. 

kegallagh

I had great insurance that would have covered about 90% of my home birth but then had to switch to aetna mid-pregnancy. Boo!!! I paid $4500 for the birth and have received a handful of claim payments totaling about $500. The biller from my MW's office said she's not expecting to receive any additional payments from them.... soooo they didn't pay much. I hope you have better luck!

LindseyJW

intheflowers:

I have an Aetna plan and my hb was covered with my CNM by using strategic billing codes. The billing service assured me that their billing method is perfectly legal, but the company is not told it is a home birth. I don't know too many details but I do know I had to have a certain number of in-office visits for the code to be applicable. They also told me not to call Aetna asking about hb coverage because they'll flag your account for extra review.

 

wonderful. thank you so much.  

robyn2201

intheflowers:

I have an Aetna plan and my hb was covered with my CNM by using strategic billing codes. The billing service assured me that their billing method is perfectly legal, but the company is not told it is a home birth. I don't know too many details but I do know I had to have a certain number of in-office visits for the code to be applicable. They also told me not to call Aetna asking about hb coverage because they'll flag your account for extra review.

When we were considering a home birth this what the the CNM told us. She also mentioned something in regards to billing it as an out of network exception due to there not being any CNM in the local network. 

We decided not to go forth with a home birth because I was nervous about it not being paid. It was something I personally couldn't do.