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                                                    How to Pay

                                                    While health insurance routinely covers most expenses for prenatal care with any provider and for hospital birth, some expecting parents have had difficulty in securing coverage for home or birth center births. The challenges of paying for childbirth can affect decisions about where to birth and can cause stress during pregnancy. However, there are several approaches that others have found successful in getting coverage for the birth location and provider they want.   
                                                    • Check with your human resources department: if you have employer-based insurance, the employer HR department may be able to negotiate birth center or home birth coverage for you with the insurance company. For an example, see this article from www.gentlebirth.org- "100% Coverage: My Struggle Having a Homebirth Paid for by the Insurance Company"
                                                    • Simply submit the bill: While you may get a negative response if you ask your insurance company if they cover home or birth center birth, some parents and midwives will simply submit the bill for payment and have success.
                                                    • Talk to the midwife you have hired, or (if you haven't hired a midwife yet) talk to a few midwives you are considering.  The midwife might have a billing company that she uses, and she could work with them to explore your payment options.   The midwife and/or billing company may have worked with others who have your insurance and may know how to increase the chance of reimbursement.  
                                                    • Convince the insurance company to cover your birth: Covering home and birth center births is in the best interests of insurance companies because they typically cost less than hospital births. Communicating the efficiency and safety of home and birth center births can be effective in winning over insurance company representatives. For examples, see "How To Get Insurance Reimbursement for Homebirth" from www.gentlebirth.org.
                                                    • Often, midwives practicing in hospitals are not listed in insurance plan lists of covered providers because the OBs they work with are the ones listed.  For women interested in hospital based midwives, it may be wise to call the midwife to see if they accept the insurance, rather than calling the insurance to see if they accept the midwife.
                                                    • The community on the Birth Options Alliance Yahoo group is a good source of information about specific insurance companies or different approaches to obtaining insurance reimbursement or other methods of financing an out-of-hospital birth, or a birth with a provider or in a location that isn't covered on your insurance plan.

                                                    Other sources of information about financing your preferred birth option and insurance coverage include:

                                                    Talking to Your Insurance Company about Midwifery Coverage by the Northern Virginia Homebirth Community

                                                    Sample letters of appeal insurance companies for homebirth coverage at Mothering.com