Thinking about a home birth? One of the biggest questions parents face is how to cover the costs. Unlike hospital births, home births are often seen as out-of-network by many insurance companies, which can make paying for a midwife feel complicated. However, there’s a little-known but powerful tool called an “out-of-network exception” that may help you get insurance coverage for your home birth midwife, potentially saving you thousands. In this guide, we’ll dive into how to navigate insurance, what to ask for, and how BeHerVillage can help make home birth more affordable.
Understanding the Costs of Home Birth Midwifery Care
Home birth costs vary based on location, midwife fees, and additional items like birth pools or special supplies. Here’s a breakdown of what you can expect to pay:
- Midwife Retainer Fee: Often between $3,000 and $8,000. This includes prenatal, birth, and postpartum care.
- Birth Pool (if desired): Renting or buying a birth pool can cost $100 to $300, including liners and accessories.
- Supplies and Birth Kits: General supplies, including “chux” pads, towels, and postpartum essentials, typically range from $50 to $150.
With the right preparation, these costs don’t have to be out of reach. Let’s look at how to secure an out-of-network exception and explore other resources that can help.
Getting an Out-of-Network Exception: A Game Changer for Home Births
Many families are unaware of an insurance option called an “out-of-network exception.” If your insurance company doesn’t offer in-network home birth midwives, they may be required to cover an out-of-network midwife at in-network rates.
What Is an Out-of-Network Exception?
An out-of-network exception is a request you can make to your insurance company. If they don’t have in-network providers for the type of care you’re seeking (like a home birth midwife), you can request coverage for an out-of-network provider, treating them as if they’re in-network.
Steps to Get an Out-of-Network Exception
Here’s how to pursue an out-of-network exception for your home birth midwife:
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1. Start with Your Midwife: Before calling your insurance company, consult with your midwife. Many midwives work with billers experienced in securing insurance coverage and can guide you.
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2. Request a Referral or “Gap Exception”: When speaking with your insurance, ask for a “gap exception.” Explain that you want to use an out-of-network midwife because they have no in-network providers for home birth in your area.
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3. Use the Right Codes: Midwives’ billers often know the exact codes needed to present to insurance, which can improve your chances of approval.
- 4. Confirm Your Coverage: If approved, ensure that you receive documentation in writing confirming that your midwife’s services will be covered at in-network rates.
This approach takes patience and persistence, but it can make home birth far more affordable.
Why Some Insurance Companies Will Cover Out-of-Network Midwives
Insurance companies are sometimes required to provide out-of-network exceptions for specialized care not available in-network. This rule can apply to home birth midwives if your insurance company doesn’t contract with any in-network providers who offer similar services.
Key Points to Communicate to Your Insurance Company
- Limited In-Network Access: If your insurance plan doesn’t offer an in-network midwife, you’re allowed to request coverage for an out-of-network one.
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Comparable Care: Emphasize that the midwife provides a comprehensive package including prenatal care, birth, and postpartum support, comparable to an OB-GYN but for a home birth setting.
How BeHerVillage Can Help Cover Midwife Retainer Fees
BeHerVillage is a powerful resource for families choosing home birth. Through BeHerVillage, you can set up a registry specifically for your home birth costs, inviting friends and family to contribute to your home birth fund. Contributions can help cover midwife retainers, supplies, and additional support you may need.
Benefits of Using BeHerVillage
- Easy Setup: Start your home birth registry in just a few steps, selecting the type of support you need.
- Flexibility: Funds raised can cover a variety of costs, including midwife fees, birth supplies, and postpartum services.
- Personalized Support: BeHerVillage allows you to build a registry tailored to your birth and postpartum needs.
BeHerVillage offers families a new way to approach birth financing, making it easier to prioritize home birth with the support of loved ones.
Additional Tips for Navigating Home Birth Insurance and Costs
Here are some additional steps that can help make paying for your home birth more manageable:
- Talk to Other Home Birth Parents: Join local or online groups to find advice on insurance coverage and strategies that worked for others.
- Consider a Health Savings Account (HSA): If you have an HSA, you may be able to use it to cover some midwifery and birth-related expenses.
- Keep Detailed Records: Save all receipts and communications with your insurance company in case you need to dispute claims or reapply for an exception.
Making Home Birth Affordable and Accessible
While paying for a home birth can seem daunting, tools like out-of-network exceptions and resources like BeHerVillage make it possible to have the birth experience you envision. By understanding your insurance options and exploring community support, you can approach your home birth with confidence and peace of mind. With the right preparation, you can make your home birth a reality without facing unnecessary financial strain.
BeHerVillage is helping parents like you get the funds they need for the support they deserve! Are you having a baby and are looking for support? Create a registry for support today and get gifted funds directly into your bank account to pay for your support team. You deserve this.
Are you a birthworker who supports new moms? Use BeHerVillage to help your clients pay for your support. Create your free profile here and you can be the best baby shower gift a mom will ever get!