Money & The Midwife: Dealing with Your Insurance Company.

Last week, I discussed my emotional and personal reasons of why I chose to see a midwife for this pregnancy. Today, I want to talk about the economic reasons, as well as some of issues that we faced along the way.

Becoming a parent can be expensive in the United States; hospital bills for the delivery that could break the bank, lack of paid maternity leave (or any paternity leave at all), and exorbitant costs if your baby may need any kind of medical intervention or to stay in the hospital for any amount of time. According to Parents.com, the average hospital birth rings up as $3,500. If you add in the cost of the prenatal appointments, delivery, and postpartum healthcare, the cost goes up to $8,802!

That's alot of enchiladas, folks.

With Bonnie's birth, we stayed in the hospital for the minimum amount of time, she never let my side, and it was a normal, vaginal birth. We still ended up paying around $4,000 for the hospital fees ALONE. Now, depending on your insurance company these rates can differ; but for most people in the United States it is similar. For this pregnancy's care and delivery, we wanted to be as cost efficient as possible - but still receive the quality care that I wanted and deserve. I did some research on our hospital choices here, and the cost seemed to be the same or even higher!

So when we found Kelly, my midwife, I was shocked to find out that her total cash bill for my prenatal care, delivery, facility fee (because I am delivering at the birth center and not at home), and postpartum care was $5,500 TOTAL. That's around $3,000 cheaper than the AVERAGE American's bill after everything is totaled up. Why does it cost so much more to go to an OB/GYN at a hospital, for an average, run-of-the-mill mother and baby with no complications? And why aren't more women seeking out midwives as their care providers during pregnancy?

Insurance.

Most insurance companies will not cover professionals like Kelly, because midwives order less tests (if you show signs of distress or disorder then tests will be ordered - but if the pregnancy is normal and healthy there is no real reason to have your blood drawn a hundred times in nine months), and women often need less medical interventions (which makes them less money). Most people who see Kelly find that their insurance providers do not cover a Certified Professional Midwife, or a Licensed Midwife; so they have to pay out of pocket in cash for her services. Though her bill is much less expensive for the total cost of care, and she breaks it up into payments over the course of your pregnancy, $5,000 is a scary number to see on your contract.

In my case, I have a pretty good plan with Blue Cross Blue Shield of Texas; so it was exceedingly easier for me to work with my insurance provider versus some of the other horror stories I've heard from friends. First, I had to have my midwife's third-party billing company contact BC/BS to estimate my potential in network and out of network coverage. At first they didn't think they would cover her at all, but then found that she did meet the requirements for an out-of-network provider. Next, I petitioned BC/BS to accept her as an in-network exception because she is the only midwife in the area for several hundred miles. To the surprise of myself and Kelly, my petition was accepted she is considered an in-network provider for me now! Lastly, I called personally to confirm my limits and coverage and had them send me a copy of what I was told for my own records, in case they decide to change their decision later on. 

My dealings with the insurance company was stressful for me, but ended much happier and easier than I would have ever expected; but many other women who want to receive care from a midwife aren't lucky enough to have the same outcome. My advice to other pregnant mommas out there who are interested in home birth or delivering at a birthing center with a midwife is to...
1. stay positive and persistent - If I had just accepted my fate and left it alone after getting my out of network quote, I would be paying $5,000 out of pocket (which is still considerably cheaper than most totals for pregnancy, birth, and postpartum care)!

2. Don't get discouraged if it seems difficult, just find the care provider that is right for you- and fight for what you deserve!
3. Do your research, and use all of your resources! 

I hope my story might help inspire others who might be faced with the same difficult journey! Did you have a hard time getting insurance to cover your birth choices? Or have a huge hospital bill that you weren't expecting? Let me know in the comments below! 

Stay sweet,