I'm having some (minor) issues with my current OB that makes me feel a little like I don't want to continue my care with him any longer. I'd like to transfer to a midwife but there's a 50 to 60% chance that she won't be covered by my insurance. (There are only 2 other midwives available in my area & I didn't feel excited about them on the phone & they can't deliver me at the hospital I would like to deliver at.) If I were to switch my complete care to the midwife & the insurance doesn't cover it, it would about $3,800 out of pocket, which doesn't sound crazy to me. I'd like to compare costs though before I decide to switch but I need to decide soon as I'm 20 weeks already. Can anyone tell me how to figure how much an uncomplicated, vaginal birth might cost out of pocket?
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I think this depends on so many factors, the area you live in, your deductible (I'm guessing she would just be out of network as opposed to uncovered right?) I think you would be best to call your insurance company and check FOR SURE what would be covered and what would not be, it could add up a lot faster than you expect.
In my area (which is lower cost of living than most) those who I've known that pay out of pocket for birth due to no insurance/no maternal coverage pay close to 10K when all said and done.
Even with insurance coverage and me paying 20%, I still pay 1400 just for the delivery, that doesn't include the additional hospital or baby cost (if baby were to go to NICU again.) last time we paid over 3K out of pocket with insurance when all said and done with delivery/hospital/NICU.
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It really depends on your insurance and what types of things you need in the hospital. For me, the OOP cost for an unmedicated vaginal birth would have been close to $10k. My insurance covered my midwife and hospital birth. If I hadn't met my deductible, it would have been about $2000. Call your insurance, or have the midwife's office call your insurance to make sure you are covered.
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It's most likely going to cost whatever your maximum out of pocket is.
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@LuLu Mom: @avivoca: the midwife called before we spoke & she said that they have trouble with BCBS. Sometimes they cover & sometimes they don't she says she has a current patient that has BCBS & they will only reimburse her, they won't pay the center. She said when she called for me they said that they most likely wouldn't cover it BUT she said the number she called was also in a different state & she wasn't sure if that made a difference. I guess I'll just call myself to double check.
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@lawbee11: haha duhhh....why didn't I think of that? Lol sadly, I don't even know off the top of my head! I need to look that up!
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@Mrs. Sunshine: I had an uncomplicated vaginal birth + epidural, no NICU time, etc. Still cost around $18K I believe...so yeah, we met our OOP max!
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My hospital bill was $17-$18K, then $1500ish for R. No complications, epidural (so another $1K for the anesthesiologist). The OB's bill was $3-$4K. We paid around $3K total.
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That $3800 sounds like the doctor's/midwife's fee for routine maternity care plus routine vaginal delivery. When you factor in hospital room & board, anesthesia (even if you don't plan on it, I made that mistake!), incidentals etc. it's much much higher. Like scary high. Make sure you're looking at your out-of-network maximum, and the family max not individual (assuming there are others on your plan).
Does your midwife's office have a billing department? They should be able to give you more of a straight answer than that. If not, definitely call the insurance company yourself and get the rep's name that you speak with!
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@thismustbetheplace: all I know is what was discussed during a phone consultation as I haven't switched yet. I'm sure I could email and ask but if it's something I can figure out for myself, I'd rather do that so if I don't decide to switch I won't feel like I wasted too much of her time. They also have a labor support option which would run me about 1k but I doubt DH would go for it.
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Are any midwives covered by your insurance? Are there any within 50 miles? In my case I got an exception and my birthing center will be covered as in network because there are no other choices. It is 7k out of pocket and we expect to get about 50% back. So 3k vs the 1500 estimated by the bcbs website for a hospital birth (online through the account they had an estimator). So in paying double but I am so much happier and more relaxed.
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