XP: Insurance company trying to dictate where I give birth...

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AmberC727's picture
Joined: 06/05/06
Posts: 226
XP: Insurance company trying to dictate where I give birth...

My husband got a new job last fall (thank God!) but despite the increase in pay and the better working conditions, their health plan is through BCBS. I am grateful to have health insurance, but when it comes to pregnancy, they are horrible.

My other two children were born in free standing birth centers with midwives. The labors went quickly (9 hrs for the first, 11 hrs for the 2nd) and both baby's were nearly 10lb (9lb 12oz and 9lb 15oz). My 2nd child was born in the water in full squat and despite her size, I didn't tear one bit! I highly doubt that would have happened lying flat on my back in a bed.

So the problem is that there is only 1 birth center in the entire state of NC that is in-network with BCBS, and that birth center is 2 hours from me. I don't really want to drive that far for all of my prenatal appts, much less labor! With my other insurance company, all I had to tell them was that they cover birth centers, but there are none in my area that are in-network so they granted an exception and paid the birth center at my in-network rates.

BCBS will not do this. They say that there are hospitals nearby who are in-network and can provide the "same" service, so I should go there. This is not the case. No hospital in my area will provide the same kind of care that the birth center does. I have tried to explain this to them, my midwife has to, but they are sticking to their guns and I feel like I'm being bullied into a hospital birth. I'm not a newbie to this. I know how my body births and how it works best in labor, and that is in the relaxed atmosphere of a birth center where I can get in and out of the water, delivering in the water if I want to.

So, with all of this information, I'm endeavoring to get the policy at BCBS changed. I created a petition and I'm asking you ladies to sign it. It doesn't matter if you agree with birthing in a birth center or not, the point is that a woman should have the freedom to experience the intimate moment of childbirth where she is most comfortable. My state already outlaws homebirth, and now BCBS is trying to tell me I can't go to a birth center either. This isn't right. Please sign my petition and forward it to friends and family that you think might sign it. Together, we can get this policy changed, not just for me, but for other women with BCBS coverage!

http://www.change.org/petitions/blue..._id=nZfTfQibiW

kridda_88's picture
Joined: 01/28/08
Posts: 1798

That is horrible. We actually had the same issue with our insurance and just ended up paying out of pocket because we were tired of fighting them. I hope you can get things figured out! I hate that they tried to say that a BC is the same as a hospital birth, they are complete opposites of each other.

AmberC727's picture
Joined: 06/05/06
Posts: 226

Definitely opposites!

In our case, the difference of in and out of network benefits is $2K, a HUGE amount! I don't really want to be paying for this birth for the next few years (if they'd let me) but I also don't want to go to the hospital either.

kridda_88's picture
Joined: 01/28/08
Posts: 1798

I think our cost by the end was $1900 ish dollars. Basically 2k. But I was determined not to go to a hospital, especially since the closest one is a piece of sh** and the only other one covered by our insurance is an hour away and my labors are fast. So we elected to just pay out of pocket to get the birth we wanted and then used our tax return to pay the midwife off, had we tried to go to the farther hospital I would have had my baby on the side of the road it went so fast. BUT that being said I had an awesome midwife who doesn't do it just for the money, she will barter with you, so if you can't pay she will have you clean at the birth center or do yard work, that sort of stuff.

In the end, though it is a lot of money, I would talk to the midwifes to see if they will work with you and go with what your heart says. If you do do a hospital birth you could always show up pushing. Wink

Sweet Pea Twins's picture
Joined: 09/08/09
Posts: 922

Amber, I tried to click on the link to your petition, but it comes up that it's not found...

Joined: 08/03/07
Posts: 3198

I'm in this battle right now also. I am currently wrapping up an appeal to BCBS (which they will deny since my employer is the one that determines what coverage is allowed) that will then get passed onto my employer to review. We have a birth center that they will cover but I want a homebirth and they won't cover that. It's ridiculous that they wouldn't bat an eye at me saying I want a c-section on a specific day but me letting my body do what it's meant to do and where it's meant to do it isn't allowed.

Thanks for being so proactive!

Cindy

cactuswren's picture
Joined: 10/19/09
Posts: 4658

I would also totally sign this, but the petition isn't there?

Also, :grouphug:

AmberC727's picture
Joined: 06/05/06
Posts: 226
claireCJ's picture
Joined: 04/04/12
Posts: 742

I will sign it! I completely agree that you should be allowed to birth where you want to and they shoudl work with you on that. I'm sorry they are pushing you into something you don't want, but I hate to say I am not surprised. (I am mad at my insurance company for a completely different reason, but I had an annoying phone call with them this morning and decided that they are crooks. ) Anyway, I think it's awesome you are taking step to change the system and help other ladies who might come up against the same thing.

cactuswren's picture
Joined: 10/19/09
Posts: 4658

Works now! Signed and shared.

Spacers's picture
Joined: 12/29/03
Posts: 4100

Check your state laws about this. Many states have a law that requires insurance companies to pay for any licensed caregiver who is licensed by the state to provide that service, so a licensed midwife would *have* to be covered if an OB was covered. It doesn't matter where the service is provided, at home or at a birth center or at a hospital, because the insurance doesn't provide the "where" only the "who." Your state might also have a provision that requires out-of-network coverage to be covered at the in-network rate if an in-network provider isn't available within a certain number of miles, for birth that's generally 50 miles from your home. Call your local state reps and ask them to check into what your state's law says, and if it's not what you want, tell them to start the process to change it! And finally, most states have a medical review board that can review your case & order your insurer to pay, if you make a good case about why they should, so don't let this drop. You've got a great start, keep it up!