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Insurance appeal for birth center birth?

msmeg26msmeg26 member
in Natural Birth
I am just finding out that my Midwife/Birth Center apparently isn't covered by my insurance. Their claim is that there are other in area services.. Ie, OB/Hospital which is NOT the route I want to go.

So I am having to write an appeal letter and was wondering if anyone was successful with this if they were in the same boat. Humana is insurance company. I need to give them compelling reasons as to why I want a birth center birth.  (open for ideas here)

Thanks for any insight!
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Re: Insurance appeal for birth center birth?

  • LilTiger15LilTiger15 member
    I know what you mean, it is frustrating.  My insurance (blue cross blue shield) doesn't cover any local birth centers either.  You would think they would since birth centers are so much less expensive.  I don't get it.
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  • msmeg26msmeg26 member
    So annoying!! I hate that they can dictate where I am allowed to birth or not birth!! 

    :( 
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  • msmeg26msmeg26 member
    My BC submitted two appeals already on my behalf and have suggested now I write an appeal letter. So that's what I am doing and we'll see where that goes before I make any decisions further. 
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  • FrodaBagginsFrodaBaggins member
    My insurance also didn't cover this. We looked into a birth center delivery out of pocket (it would have been $6800 all-in from the first prenatal appointment to the 6 week post partum check), but ultimately decided we could get the type of birth we're looking for at the hospital due to how great my OB is and the reputation of the hospital staff. 
    Southern California
    Together for six years, married for five
    BFP 12/06/13 - EDD 8/11/14 
    BABY BOY born 8/14/14!

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  • msmeg26msmeg26 member
    danisgossipgirl 

    CNM's.

    I found two private practice midwifes that will do a home birth. So looking into that as well. 


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  • LilTiger15LilTiger15 member
    @msmeg26 I'm looking into a home birth as well.  I actually meet with a midwife next Wednesday to discuss it more in depth and ask all my questions.  I never in a million years would have thought I would be open to the idea, but after already experiencing a hospital birth and seeing how there is so much I didn't like about it (even though my hospital claims to be very natural birth friendly, blah, blah)...I just can't see myself not worrying like crazy about doing it a second time there.  I almost think I would be worrying more about not getting the natural birth I want at the hospital than the 'risks' of doing it in my own home.  Not to mention, it would be cheaper, even though insurance won't cover it.  The midwife charges $2,800 in my area.  Good luck!  Hopefully we will both figure out what is best...
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  • fernanefernane member
    Our insurance would only cover CNMs. There was s only one group of them around here and in saw them twice and didn't like them. We finally made the decision that a provider we were completely comfortable with was worth paying OOP. They have a payment plan if we aren't able to finish paying by the end of the pregnancy.
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  • drpaynedrpayne member
    SweetTurnip said:
    So annoying!! I hate that they can dictate where I am allowed to birth or not birth!! 

    :( 
    They can't. But they can decide what they pay for. You can still give birth where you choose. Talk to your birth center and see what they can do in this situation. Maybe they have a cash payment schedule that is less for people with no insurance. It might not be that much more than your insurance coverage at a hospital. Ask for a fee breakdown. Mine provides one by the third appointment or so and it details what my portion would be after insurance , so you could just see what it is. Mine was a few thousand (like 4000 I believe) which really isn't that much more than some deductibles.
    Same here. 
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