Long story short, it depends! Compared to a hospital birth, a birth center birth can be about a third of the cost. But, your budget depends on several factors.
Do you have insurance to help pay for your birth center or home birth?
Insurance coverage varies from carrier to carrier. Doing some homework up front will help reduce the surprises and frustrations along the way. You may believe you have “great insurance,” but when it comes to an out-of-hospital birth, your “great” insurance may not be so “great” after all. Here are some tips:
- Get a verification of benefits through your midwife’s professional insurance billing company. You’ll need a provider PIN to start that process. For NOVA Natural Birth Center, our provider PIN is 18277. The billing company will contact your insurance provider and get answers to the most important questions. Bonus — by having the billing company do this, you’re not the one playing phone tag and being on hold waiting to speak to someone at your insurance company! Totally worth it!
- Place of Birth
Some insurance companies only cover hospital births. Some may pay part of the cost of having your baby at a birth center, but will not cover a home birth, and vice versa.
- Provider’s Credentials
Your coverage may also depend upon your provider’s credential. Most plans cover midwives. However, some will only pay CNMs (certified nurse midwives), and not CPMs (certified professional midwives). CPMs are the “new kids on the block” when it comes to insurance. More and more insurance companies are covering CPMs now, but there are a few holdouts.
- In-Network vs. Out-of-Network
Ask your midwife if her practice is in-network, and which plans she’s contracted with. Most CPMs are not contracted with insurance, so your reimbursement would be at the out-of-network rate.
- Deductibles & Co-pays
You’ll be responsible to pay all of your deductibles and co-pays before your insurance will kick in. Most insurance companies have separate deductibles for out-of-network vs. in-network providers. Once your deductibles and co-pays have been satisfied, your insurance will reimburse a percentage of the cost.
- In-Network Exceptions
Some plans have an option for an in-network exception. If you’re able to get an in-network exception, your insurance company will reimburse at the in-network, rather than out-of-network rate. You’ll have to meet certain criteria to be eligible for an in-network exception. Usually, if there are no contracted providers within a certain radius of your home, you may be granted an in-network exception.
Some midwives are Medicaid providers. If you qualify for Medicaid, there will likely be some extra hoops to jump through, but you may be covered. Medicaid doesn’t cover all of the expenses for your birth though, so ask your midwife for details.
2. No matter how much you think you know about your insurance coverage, be prepared for some surprises.
- Your insurance provider may deny your claim
This happens a lot, but your insurance billing company will usually handle the appeals process. Having a billing company takes a lot of stress off of you, which is great, because you’ll have much more important things on your mind — like your baby!
- It can take a long time for the claims to be paid
Once your baby is born, your midwife will usually bill for the global fee. This fee covers your prenatal care, birth, and immediate postpartum. After your 6 week postpartum visit, your midwife will bill for the postpartum and baby care. Sometimes, it can take up to a year for all of the dust to settle. This is especially true if the billing company had to appeal denied claims.
- Your midwife’s fee is what she bills insurance
Your midwife will usually expect a deposit towards what she bills towards your insurance. This amount varies from midwife to midwife, but is generally around $4000 to $5000. She usually expects to receive that deposit by the time you reach the 36th week of your pregnancy. If the total payments (what you pay plus what your insurance pays) exceed what she bills insurance, you may receive reimbursement for part of what you paid.
- Your reimbursement will probably not be as much as you expect it will be
Remember, your midwife’s fee is what she bills your insurance. Your insurance company pays a percentage of what they consider to be “usual and customary” for the codes your midwife bills. The “usual and customary” amount varies from insurance company to insurance company, and they will not tell your midwife up-front what their usual and customary is. So, while you might have 70% coverage for an out-of-network provider, that’s 70% of the usual and customary, after the deductibles and copays have been satisfied.
3. Talk with your midwife about your financial situation
Your midwife will do everything she can to help you find a way to pay for the care she gives you. She really wants to make it work for you.
4. Explore creative financing options
Many midwives will accept credit cards, and even PayPal payments. Some midwives offer loan programs, payment plans, and discounts for early payment.
Are you uninsured? Does your insurance not cover your midwife’s services?
Many midwives have payment options for uninsured clients, or for people with high deductible insurance plans. Ask your midwife if she offers a self-pay discount if you don’t have insurance coverage.
What other costs should I expect?
Additional costs can be minimal, or can be even more than what your midwife charges! It all depends upon your needs and preferences. Some additional expenses to consider are:
- Hiring a Doula – Sometimes, insurance will cover part of this cost, but if you hire a doula, you should expect to pay anywhere from $300 to $1800 for your doula’s services, depending upon where you live and what her experience level is.
- Childbirth Education – Having a baby naturally can be very challenging, and you don’t want to be unprepared for it. Childbirth education is absolutely critical. Birth can be very challenging, and some people say preparing for birth is like preparing for a marathon. You wouldn’t show up to run a marathon without having at least gone jogging a few times. A comprehensive childbirth education class is absolutely essential. Expect to pay several hundred dollars for it.
- Birth Photographer – This is optional, of course, but it is important to many people. Having a professional birth photographer at your birth will help capture memories of your experience and the first moments with your new baby.
- Birth Supplies – If you’re planning a home birth, you may need to purchase a birth kit. The birth kit contains all of the disposable supplies your midwife needs for your birth. These vary in cost from midwife to midwife, but are generally less than $100. You’ll also need to gather other supplies, like sheets, towels, washcloths, etc. Some of these things you’ll already have around your house.
So, how much does it cost to have a homebirth or a birth center birth? The answer is different for everyone, but the investment is usually within your reach. It is good to keep in mind that the service your midwife is giving you is unique and valuable. You have to want this out-of-hospital birth so much that you’ll still be happy even if the cost is totally out-of-pocket. Then, if and when you do receive some reimbursement, you’ll be happy with whatever it is, even if it is much less than you thought it would be. After all, many people spend thousands of dollars on vacations and HD televisions. This birth is a once-in-a-lifetime experience, one that you will remember for the rest of your life. It is worth the investment. Will it really matter to you 10 years from now that your insurance reimbursement wasn’t all that great?