Which insurance covers midwives? (tx)

[Anjali]

Hey everyone!

We're in the process of getting insurance and we are trying to figure out which companies cover midwives and/or doulas. I'm currently in Texas. Does anyone know? I need much information on this as this will be my first child.

Appreciate it!

 

[LockandKey]

Also in the US, I just got back from my first midwife appointment the other day, but had already had my insurance, so had to find one that would take my coverage. I have Care First Blue Choice and only have to make a small co pay per visit.

Maybe you could get a better idea by doing a Google search for any midwives in your area or nearby. Usually the health insurance they will take is mentioned online, and if not, you could always call to ask too. That's what I did, and it worked out from my understanding, usually a midwife would take a number of different health care providers, so you should have a good number of options

Good luck, hope you find a great lady to work with

 

[Anjali]

Also in the US, I just got back from my first midwife appointment the other day, but had already had my insurance, so had to find one that would take my coverage. I have Care First Blue Choice and only have to make a small co pay per visit.

Maybe you could get a better idea by doing a Google search for any midwives in your area or nearby. Usually the health insurance they will take is mentioned online, and if not, you could always call to ask too. That's what I did, and it worked out from my understanding, usually a midwife would take a number of different health care providers, so you should have a good number of options

Good luck, hope you find a great lady to work with

We don't have insurance just yet but it seems that no individual plan covers pregnancy or maternity. This is just ridiculous. Through my husband's work, the insurance for us would be well over a grand a month with maternity included!! I couldn't believe it. Everything is super pricy and we can't really pay anything over 300 a month. I'm having no luck and have been looking online for a while :/

Hopefully we'll figure something out. Thanks!!

 

[LockandKey]

Also in the US, I just got back from my first midwife appointment the other day, but had already had my insurance, so had to find one that would take my coverage. I have Care First Blue Choice and only have to make a small co pay per visit.

Maybe you could get a better idea by doing a Google search for any midwives in your area or nearby. Usually the health insurance they will take is mentioned online, and if not, you could always call to ask too. That's what I did, and it worked out from my understanding, usually a midwife would take a number of different health care providers, so you should have a good number of options

Good luck, hope you find a great lady to work with

We don't have insurance just yet but it seems that no individual plan covers pregnancy or maternity. This is just ridiculous. Through my husband's work, the insurance for us would be well over a grand a month with maternity included!! I couldn't believe it. Everything is super pricy and we can't really pay anything over 300 a month. I'm having no luck and have been looking online for a while :/

Hopefully we'll figure something out. Thanks!!

wow, that's insane! Hope you figure something out too! Could you maybe apply for health care that gives lower rates outside of your DH's work? Wish I could offer more advice, but I really don't know very much about health care and coverage or what your options may be. Sorry Hopefully there are other ladies on this board that can suggest a better solution

 

[amjon]

I have BCBS in Florida and they covered a MW (and even a homebirth if I had wanted).

 

[Anjali]

Also in the US, I just got back from my first midwife appointment the other day, but had already had my insurance, so had to find one that would take my coverage. I have Care First Blue Choice and only have to make a small co pay per visit.

Maybe you could get a better idea by doing a Google search for any midwives in your area or nearby. Usually the health insurance they will take is mentioned online, and if not, you could always call to ask too. That's what I did, and it worked out from my understanding, usually a midwife would take a number of different health care providers, so you should have a good number of options

Good luck, hope you find a great lady to work with

We don't have insurance just yet but it seems that no individual plan covers pregnancy or maternity. This is just ridiculous. Through my husband's work, the insurance for us would be well over a grand a month with maternity included!! I couldn't believe it. Everything is super pricy and we can't really pay anything over 300 a month. I'm having no luck and have been looking online for a while :/

Hopefully we'll figure something out. Thanks!!

wow, that's insane! Hope you figure something out too! Could you maybe apply for health care that gives lower rates outside of your DH's work? Wish I could offer more advice, but I really don't know very much about health care and coverage or what your options may be. Sorry Hopefully there are other ladies on this board that can suggest a better solution

Yeah, it is crazy, thanks. With his work it was BCBS and it was 1500 for us both! Outside his work individual plans don't cover maternity at all. I hope so too, thanks a lot!

 

[Anjali]

I have BCBS in Florida and they covered a MW (and even a homebirth if I had wanted).

Through husband's work (btw someone please school me on these DH's and everything else, cause I feel dumb ) BCBS quoted us 1500ish. Crazy.

 

[Guppy051708]

We have health insurance through my husbands work and i am NOT impressed with it. Wicked expensive and we have NO OTHER option since i am SAHM and his work requires him to have it. It's way overpriced but thats bc he works for corporate Liberty Mutual and it's group insurance...i fecking hate it. anyways, they covered quite a few hospital MWs (a lot of CNMs). As for out of hospital MWs there are only two in the entire state that they are willing to cover and they are free standing birth centers, however, they refuse to cover those SAME MWs for a homebirth totally twisted, huh?!
Im with Blue Cross Blue Shield of Massachusetts.

Have you considered applying to the state program for pregnant women? It's usually a pretty high income allowence, much higher than typical Medical Assitance. Many times they cover MWs, actually, bc they are cheaper.

Another option is to not get health insurane. which sounds risky, initially but really its not. Let me explain. Most out of hospital MWs charge extremely less than the hospital anyways (my intervention free hospital birth costed $14,000 my out of hospital, intervention free birth only [would have] costed me $4,000 (if my insurance wouldn't have covered a portion in both situations). Not only that but my MWs offered a discount if i paid in full by certain points of the pregnancy (had i not had insurance). For instance, if i paid in full by 24 weeks, they took the price down to $3,000. If i would have paid in full by 28 weeks it would have been $3,200, etc. Also, many times they offer a sliding scale, so if you let her know your situation it could even be less than what they initially say the charge. And if not, a lot of MWs also accept payment plans.
And if you are worried about needing medical intervention, thus requiring the hospital, hospitals are, by law, not allowed to refuse you care. they have to give it to. Then you end up getting a bill for everything, but nearly all hospitals offer programs to help reduce your bill, so you could end up not paying much at all, even if you need something like say a c-section or NICU for the baby. On top of that they have to, by law, offer you a payment plan, so then you could make affordable monthly payments.
Should your hospital not offer a reduce bill, every state government offers a temporary form of medical assistance. It is different than regular MA. Basically they look at your income, then they look at your hospital bill. Let's say you made $60,000 per year, and didn't qualify for MA, they will then take your hospital bill and subtract that from your annual income. For instance, if you made $60,000 and your hospital bill was $20,000, for this ONE TIME help, they will say you only made $40,000 that year and you can qualify for them to pay your hospital bill for you. (only that hospital bill, it wouldn't be any type of coverage you could keep using, as said its temporary). So that can help reduce or even eliminate your hospital bill, should you need one. Now, those figures are just that, figures, it depends on your state and everything, but its a pretty good example of what happens. And as i said a lot of hospitals offer programs to help cover fees anyways, so you may not even need to go through the state.

hope this helps
The insurance situation in America is truly disgusting and i think its outrageous that insurance companys wont cover more MWs and HBs, especially since it's cheaper and proven just as safe if not safer than hospital births for the low risk mother.-end rant -

 

[Anjali]

We have health insurance through my husbands work and i am NOT impressed with it. Wicked expensive and we have NO OTHER option since i am SAHM and his work requires him to have it. It's way overpriced but thats bc he works for corporate Liberty Mutual and it's group insurance...i fecking hate it. anyways, they covered quite a few hospital MWs (a lot of CNMs). As for out of hospital MWs there are only two in the entire state that they are willing to cover and they are free standing birth centers, however, they refuse to cover those SAME MWs for a homebirth totally twisted, huh?!
Im with Blue Cross Blue Shield of Massachusetts.

Have you considered applying to the state program for pregnant women? It's usually a pretty high income allowence, much higher than typical Medical Assitance. Many times they cover MWs, actually, bc they are cheaper.

Another option is to not get health insurane. which sounds risky, initially but really its not. Let me explain. Most out of hospital MWs charge extremely less than the hospital anyways (my intervention free hospital birth costed $14,000 my out of hospital, intervention free birth only [would have] costed me $4,000 (if my insurance wouldn't have covered a portion in both situations). Not only that but my MWs offered a discount if i paid in full by certain points of the pregnancy (had i not had insurance). For instance, if i paid in full by 24 weeks, they took the price down to $3,000. If i would have paid in full by 28 weeks it would have been $3,200, etc. Also, many times they offer a sliding scale, so if you let her know your situation it could even be less than what they initially say the charge. And if not, a lot of MWs also accept payment plans.
And if you are worried about needing medical intervention, thus requiring the hospital, hospitals are, by law, not allowed to refuse you care. they have to give it to. Then you end up getting a bill for everything, but nearly all hospitals offer programs to help reduce your bill, so you could end up not paying much at all, even if you need something like say a c-section or NICU for the baby. On top of that they have to, by law, offer you a payment plan, so then you could make affordable monthly payments.
Should your hospital not offer a reduce bill, every state government offers a temporary form of medical assistance. It is different than regular MA. Basically they look at your income, then they look at your hospital bill. Let's say you made $60,000 per year, and didn't qualify for MA, they will then take your hospital bill and subtract that from your annual income. For instance, if you made $60,000 and your hospital bill was $20,000, for this ONE TIME help, they will say you only made $40,000 that year and you can qualify for them to pay your hospital bill for you. (only that hospital bill, it wouldn't be any type of coverage you could keep using, as said its temporary). So that can help reduce or even eliminate your hospital bill, should you need one. Now, those figures are just that, figures, it depends on your state and everything, but its a pretty good example of what happens. And as i said a lot of hospitals offer programs to help cover fees anyways, so you may not even need to go through the state.

hope this helps
The insurance situation in America is truly disgusting and i think its outrageous that insurance companys wont cover more MWs and HBs, especially since it's cheaper and proven just as safe if not safer than hospital births for the low risk mother.-end rant -

I totally agree with you, it does suck. Plus next year with ObamaCare, everyone is forced into purchasing insurance or they'll get thrown in jail, even though everyone here known insurance doesn't even cover anything unless you pay an arm and a leg. Ugh.

We thought about it and are going to try to pay it out of pocket within $3k or something. The whole system here is really a perpetual joke.

Thanks so much for the advice!

 

[Guppy051708]

We have health insurance through my husbands work and i am NOT impressed with it. Wicked expensive and we have NO OTHER option since i am SAHM and his work requires him to have it. It's way overpriced but thats bc he works for corporate Liberty Mutual and it's group insurance...i fecking hate it. anyways, they covered quite a few hospital MWs (a lot of CNMs). As for out of hospital MWs there are only two in the entire state that they are willing to cover and they are free standing birth centers, however, they refuse to cover those SAME MWs for a homebirth totally twisted, huh?!
Im with Blue Cross Blue Shield of Massachusetts.

Have you considered applying to the state program for pregnant women? It's usually a pretty high income allowence, much higher than typical Medical Assitance. Many times they cover MWs, actually, bc they are cheaper.

Another option is to not get health insurane. which sounds risky, initially but really its not. Let me explain. Most out of hospital MWs charge extremely less than the hospital anyways (my intervention free hospital birth costed $14,000 my out of hospital, intervention free birth only [would have] costed me $4,000 (if my insurance wouldn't have covered a portion in both situations). Not only that but my MWs offered a discount if i paid in full by certain points of the pregnancy (had i not had insurance). For instance, if i paid in full by 24 weeks, they took the price down to $3,000. If i would have paid in full by 28 weeks it would have been $3,200, etc. Also, many times they offer a sliding scale, so if you let her know your situation it could even be less than what they initially say the charge. And if not, a lot of MWs also accept payment plans.
And if you are worried about needing medical intervention, thus requiring the hospital, hospitals are, by law, not allowed to refuse you care. they have to give it to. Then you end up getting a bill for everything, but nearly all hospitals offer programs to help reduce your bill, so you could end up not paying much at all, even if you need something like say a c-section or NICU for the baby. On top of that they have to, by law, offer you a payment plan, so then you could make affordable monthly payments.
Should your hospital not offer a reduce bill, every state government offers a temporary form of medical assistance. It is different than regular MA. Basically they look at your income, then they look at your hospital bill. Let's say you made $60,000 per year, and didn't qualify for MA, they will then take your hospital bill and subtract that from your annual income. For instance, if you made $60,000 and your hospital bill was $20,000, for this ONE TIME help, they will say you only made $40,000 that year and you can qualify for them to pay your hospital bill for you. (only that hospital bill, it wouldn't be any type of coverage you could keep using, as said its temporary). So that can help reduce or even eliminate your hospital bill, should you need one. Now, those figures are just that, figures, it depends on your state and everything, but its a pretty good example of what happens. And as i said a lot of hospitals offer programs to help cover fees anyways, so you may not even need to go through the state.

hope this helps
The insurance situation in America is truly disgusting and i think its outrageous that insurance companys wont cover more MWs and HBs, especially since it's cheaper and proven just as safe if not safer than hospital births for the low risk mother.-end rant -

I totally agree with you, it does suck. Plus next year with ObamaCare, everyone is forced into purchasing insurance or they'll get thrown in jail, even though everyone here known insurance doesn't even cover anything unless you pay an arm and a leg. Ugh.

We thought about it and are going to try to pay it out of pocket within $3k or something. The whole system here is really a perpetual joke.

Thanks so much for the advice!

yes, the insurance system here is terrible.
With ObamaCare though, you actually dont go to jail if you dont get coverage. you can opt to pay a fee of like $100 or some amount like that. (basically a fine which sucks!) but on the bright side this will force insurance companys to charge you far less than they are now each month. Some states actually already have the fee in place (far before ObamaCare came out). In the state of Mass. you get fined a certain amount each yr you dont have coverage. you either get the insurance and dont pay the fine. or you dont get the insurance and you pay the fine. It blows, but some states alreayd do this. So even though you are forced into getting health care, there will be more affordable options (probably way less than what you are getting quoted at now.) those options can either be private or public. its up to you. Not ideal, at all, but at least it will become affordable and i think that is the goal bc the new health care laws force companys to not screw over people like you and me, especially when it comes to cost. so you will see the premium/deductibles/coinsurance/copayments decrease SIGNIFICANTLY with this bill.
Im not happy with it, but honestly if there is a cheaper option becoming available bc of Obama Care, i may consider that route bc we pay $18,000 per yr on health care right now and it is making us go broke.

At any rate, that doesn't really matter, but i hope you figure someting out. There are more options than you think and when i was faced with your current diliema we were just going to pay out of pocket. It ended up being far cheaper in the long run, especially when you are getting charge insane amounts in premium each month.

 

[Jess137]

It's actually a $95 charge on your taxes. You don't go to jail. There's a lot of misinformation out there about the Affordable Healthcare Act. About insurance, you probably won't find a private insurance that covers maternity that is affordable. My sil is on Medicaid (in Missouri) and it covers a midwife and a birthing center. Which makes sense as it's cheaper than a doctor and a hospital birth.

 

[Guppy051708]

You might consider checking this link out.
I did the program when i was pregnant with my first and living in Pennyslvania. (its called Healthy Beginnings there) Amazingly i actually had more (and better) options on it than i do with private health insurance.
I wont ask you your financial situation, but if you scroll to the bottom it will tell you how much you can make each month to qualify. the limit is MUCH higher than typical MA. This is so that pregnant woman without health care can get what they need and not pay so much money (its usually free)

https://www.hhsc.state.tx.us/Help/healthcare/women.shtml

 

[Jess137]

Also, I have insurance from my employer (which is a freaking hospital system!) and it'll still be at least $2000 out of pocket for me.

 

[Guppy051708]

I live in New Hampshire now, and its state law that government/state medical insurance programs cover MWs AND homebirth, should the mother want that as an option...i wish they could enforce the same law for private insurance!

 

[Jess137]

That would be so amazing! Unfortunately I work for a hospital system so I'm forced to give birth there or pay a ton more money which we can't afford. Also the hospital is an hour away from home

 

[Guppy051708]

that stinks.Of course, if you are already paying $2K for your birth, id be willing to bet there is an out of hospital MW that charges nearly that for her services too, out of pocket. But obviously you should only do what you feel is best for your situation

My MWs are 1 hr from my home too, so i know the feeling It gets irratating near the end of the pregnancy going every other week and every week that far!

 

[Jess137]

I've reasearched and wasn't abler to find any midwives cheaper. But honestly I also am on meds which carry a small chnace of complications for baby so its probably for the best that I be at the hospital They have the only level 3 NICU anywhere in the state and a children's hospital attached so I'd be very confident in the care my baby recieves IF something goes wrong.