Transcript: Does Insurance Cover Midwives?
Sunny Gault
You'd like to have a midwife as part of your overall birth plan. But how feasible is that, especially from a monetary perspective? And if you're counting on insurance to cover some of that cost? Well, will they actually do that? I'm Sunny with New Mommy Media. And today I am joined by Cheryl Furer. She is a midwife educator. And she's also the founder of your thriving pregnancy. Hi, Cheryl, thanks for being with us today.
Cheryl Furer
Hi, Sunny. Thanks for having me.
Sunny Gault
So let's talk about the general cost for giving birth. And I know this is gonna vary, there's some factors in here, like where you give birth and things like that. But can you break down for hospital births, you know, if you have a vaginal birth if you have a C-section, and perhaps a home birth, so, so moms have a general idea of how much money they might be spending based on what type of birth they have?
Cheryl Furer
Sure, so like you said, this is gonna be ballpark figures. And it really also depends on where you live, like, if you're giving birth in New York City, compared to Ogden, Utah, they're gonna be quite different numbers. But, you know, in general, insurance and hospital births are insurance and hospital-based practices are pretty intricately combined. And so depending on the type of insurance you have, and where you give birth, you may not even find out the final number of what it costs. So for example, is the cesarean section, which is the costliest of all the birthing options that can range between $35,000 to $45,000. Again, just depending on where in the United States you're giving birth, and what that might look like. And if that is part of your birth plan or winds up being part of your birth plan, then it's better obviously, to have like really good insurance, that's going to take care of most of that and have a smaller deductible fee that, you know, you won't be paying out of pocket for years and years and years to come. So I'm thinking about that. And then if you're going to plan a hospital national birth, those can range anywhere from $15,000. I've seen them as high as $30,000, again, depending on where in the US your first CNET, and you know, depending on when you're watching this video, right, that could change. But even to get these numbers can be really difficult. And so if a mom really wants to know, like, I want to compare the different hospitals in my region, I would suggest calling the hospital and asking their billing department, if you were to pay cash for one of these services, what would the ballpark be for a cash service, that's how I found out what some of the pricing was in my area. Um, I just called him kind of, you know, sort of had to ask around them. So a birth center, which you didn't quite ask about, but I'll transition to there. So the hospital is usually covered by insurance, it's pretty standard, you may go to, you may have like a PPO insurance, where you have to go to a particular type of hospital or particular ran hospital. But essentially, they're all pretty well integrated. A lot of birth centers are also integrated into insurance. And so the average birth center cost between like $6,000, and maybe up to $15,000. So already, we're coming down in cost quite a bit. And the birth centers that are integrated again, what you would see is your deductible, so that would be billed through your insurance, and then you get your deductible at the end after you have your baby. And then the last pricing is home birth midwifery. And, again, this varies by state by state, but some homebirth midwives can take insurance, some of us are covered by Medicaid. And some of us are cash pay only because of the restrictions of our state. So those are ranges are usually between again, all over the country, different pricey but between 20 $506,000 Okay, and sometimes I'm kind of surprised by insurance companies don't like see that savings and be like, oh, obviously we should be covering this homebirth. Right, because they charge like a tiny percentage, you know, 1% or 10% of what, you know, a hospital is covering, right. But, you know, logic escapes. Some companies sometimes it's we just....
Sunny Gault
I know I totally feel you I remember getting the bill. I had a Syrian iPad. He was with my second child. And I remember getting, it wasn't actually a bill, but it was a breakdown of everything because insurance did cover a bunch of it. And I could not believe the numbers. I mean, it was what you were talking about, it was over 35,000, I can't remember the exact number. And it's just, you know, when you're getting ready to have a baby, I don't know, for me that I didn't think about how much it was gonna cost, there was a lot of stuff going on in my head. And that was not one of them. But I was shocked afterward. And you're right, when you compare, you compare it to a homebirth and, you know, midwifery and things like that. I mean, they would be saving a lot of money. If they encourage more of that, how much money does it typically cost? Again, everybody's a little bit different. And every, every location is a little bit different, but specifically to bring on a midwife, what's the ballpark there.
Cheryl Furer
So I know this is a huge range, but between 20 506,000, okay, and sometimes, like, if I'm going to Bill insurance, I might build that higher amount and then ask for a retainer fee at the beginning of the care, so that my clients bill is covered with my care completely before the baby's here. And that works really well for my practice. And for clients that hire me, I totally understand that that doesn't work for everyone, because the way maternity care is set up is that you're so if you're going to see an OB practice, let's say and, you know, maybe they have 50 different or 15 different doctors in that practice. They actually don't bill for your insurance until after you give birth. So they bill all your prenatal care, your birth and the pithily postpartum care that you get. Oh, yes, it's something but they, they charge for all of that, after you give birth. And that's the way our insurance is set up. Okay, which, as a home birth midwife, that doesn't necessarily work for my practice, because my in person practice, because, you know, we do everything we can to support a home birth, but there will be transfers, and we may need to go to the hospital, and nobody wants to Bill when they're holding their new babies in there.
Sunny Gault
Of course, yeah.
Cheryl Furer
That's, you know, and so when we can have all that taken care of beforehand, it just, like completes that package of care. And then we get into the postpartum and they never only another, you know and we just, it's really lovely, actually.
Sunny Gault
What would your recommendation be for moms out there that are trying to determine what their insurance will and won't cover? I mean, is that as simple as just reaching out to your insurance and saying, Hey, you know, I'm looking at these different options for giving birth, can you give me an idea of what might be covered, and then they can kind of break it down for them?
Cheryl Furer
Maybe it depends on your insurance company. And what I would say is, I would actually suggest hiring an insurance company that builds like, out of hospital practices to do a verification of benefits for you. Because what I found is that learning the language of insurance is like learning a foreign language, some people are great at learning it, I can definitely tell you, I am not one of those people. And so I have an outside billing company that will call the insurance and they know the exact right questions to ask to see what your insurance will cover. Because it's almost like you don't want to give too much away to your insurance company. But you also need to know which questions and how to ask them in order to get the correct information back. And so I have an outside billing company that does that for my clients. And that's what I would actually suggest to everyone. It's the company I use is $25. And they don't have to be contracted with me or anything.
Sunny Gault
So, okay. Source, is that company based on? Like, do you have to hire companies that are based in your area? Or can you give even the name of the company because I'm thinking, I don't even know how moms are going to search for this. Is that a company you would recommend?
Cheryl Furer
Sure, absolutely. So it's three letters, S, l, B, and then the word slb billing. And like I said, you don't have to be contracted with a midwife in order to get a verification of benefits. And it's usually a pretty reasonable cost just to find out what your insurance will and won't cover and that gives moms a great start in their search for using their insurance for midwifery care if that's what they choose. Yeah,
Sunny Gault
Yeah, that's really smart. Thank you so much for that resource. All right. Thank you so much, Cheryl. This has been great. If you want to check out Cheryl's business and little learn a little bit more about what she does. Her website is yourthrivingpregnancy.com and then once you check out Cheryl stuff, head on over to newmommymedia.com. That's our website. You can check out our podcast episodes. Other videos that we've done just like this one, our blog posts- tons of great information. It's where real moms talk about real life.
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Episode Transcript
Sunny Gault
You'd like to have a midwife as part of your overall birth plan. But how feasible is that, especially from a monetary perspective? And if you're counting on insurance to cover some of that cost? Well, will they actually do that? I'm Sunny with New Mommy Media. And today I am joined by Cheryl Furer. She is a midwife educator. And she's also the founder of your thriving pregnancy. Hi, Cheryl, thanks for being with us today.
Cheryl Furer
Hi, Sunny. Thanks for having me.
Sunny Gault
So let's talk about the general cost for giving birth. And I know this is gonna vary, there's some factors in here, like where you give birth and things like that. But can you break down for hospital births, you know, if you have a vaginal birth if you have a C-section, and perhaps a home birth, so, so moms have a general idea of how much money they might be spending based on what type of birth they have?
Cheryl Furer
Sure, so like you said, this is gonna be ballpark figures. And it really also depends on where you live, like, if you're giving birth in New York City, compared to Ogden, Utah, they're gonna be quite different numbers. But, you know, in general, insurance and hospital births are insurance and hospital-based practices are pretty intricately combined. And so depending on the type of insurance you have, and where you give birth, you may not even find out the final number of what it costs. So for example, is the cesarean section, which is the costliest of all the birthing options that can range between $35,000 to $45,000. Again, just depending on where in the United States you're giving birth, and what that might look like. And if that is part of your birth plan or winds up being part of your birth plan, then it's better obviously, to have like really good insurance, that's going to take care of most of that and have a smaller deductible fee that, you know, you won't be paying out of pocket for years and years and years to come. So I'm thinking about that. And then if you're going to plan a hospital national birth, those can range anywhere from $15,000. I've seen them as high as $30,000, again, depending on where in the US your first CNET, and you know, depending on when you're watching this video, right, that could change. But even to get these numbers can be really difficult. And so if a mom really wants to know, like, I want to compare the different hospitals in my region, I would suggest calling the hospital and asking their billing department, if you were to pay cash for one of these services, what would the ballpark be for a cash service, that's how I found out what some of the pricing was in my area. Um, I just called him kind of, you know, sort of had to ask around them. So a birth center, which you didn't quite ask about, but I'll transition to there. So the hospital is usually covered by insurance, it's pretty standard, you may go to, you may have like a PPO insurance, where you have to go to a particular type of hospital or particular ran hospital. But essentially, they're all pretty well integrated. A lot of birth centers are also integrated into insurance. And so the average birth center cost between like $6,000, and maybe up to $15,000. So already, we're coming down in cost quite a bit. And the birth centers that are integrated again, what you would see is your deductible, so that would be billed through your insurance, and then you get your deductible at the end after you have your baby. And then the last pricing is home birth midwifery. And, again, this varies by state by state, but some homebirth midwives can take insurance, some of us are covered by Medicaid. And some of us are cash pay only because of the restrictions of our state. So those are ranges are usually between again, all over the country, different pricey but between 20 $506,000 Okay, and sometimes I'm kind of surprised by insurance companies don't like see that savings and be like, oh, obviously we should be covering this homebirth. Right, because they charge like a tiny percentage, you know, 1% or 10% of what, you know, a hospital is covering, right. But, you know, logic escapes. Some companies sometimes it's we just....
Sunny Gault
I know I totally feel you I remember getting the bill. I had a Syrian iPad. He was with my second child. And I remember getting, it wasn't actually a bill, but it was a breakdown of everything because insurance did cover a bunch of it. And I could not believe the numbers. I mean, it was what you were talking about, it was over 35,000, I can't remember the exact number. And it's just, you know, when you're getting ready to have a baby, I don't know, for me that I didn't think about how much it was gonna cost, there was a lot of stuff going on in my head. And that was not one of them. But I was shocked afterward. And you're right, when you compare, you compare it to a homebirth and, you know, midwifery and things like that. I mean, they would be saving a lot of money. If they encourage more of that, how much money does it typically cost? Again, everybody's a little bit different. And every, every location is a little bit different, but specifically to bring on a midwife, what's the ballpark there.
Cheryl Furer
So I know this is a huge range, but between 20 506,000, okay, and sometimes, like, if I'm going to Bill insurance, I might build that higher amount and then ask for a retainer fee at the beginning of the care, so that my clients bill is covered with my care completely before the baby's here. And that works really well for my practice. And for clients that hire me, I totally understand that that doesn't work for everyone, because the way maternity care is set up is that you're so if you're going to see an OB practice, let's say and, you know, maybe they have 50 different or 15 different doctors in that practice. They actually don't bill for your insurance until after you give birth. So they bill all your prenatal care, your birth and the pithily postpartum care that you get. Oh, yes, it's something but they, they charge for all of that, after you give birth. And that's the way our insurance is set up. Okay, which, as a home birth midwife, that doesn't necessarily work for my practice, because my in person practice, because, you know, we do everything we can to support a home birth, but there will be transfers, and we may need to go to the hospital, and nobody wants to Bill when they're holding their new babies in there.
Sunny Gault
Of course, yeah.
Cheryl Furer
That's, you know, and so when we can have all that taken care of beforehand, it just, like completes that package of care. And then we get into the postpartum and they never only another, you know and we just, it's really lovely, actually.
Sunny Gault
What would your recommendation be for moms out there that are trying to determine what their insurance will and won't cover? I mean, is that as simple as just reaching out to your insurance and saying, Hey, you know, I'm looking at these different options for giving birth, can you give me an idea of what might be covered, and then they can kind of break it down for them?
Cheryl Furer
Maybe it depends on your insurance company. And what I would say is, I would actually suggest hiring an insurance company that builds like, out of hospital practices to do a verification of benefits for you. Because what I found is that learning the language of insurance is like learning a foreign language, some people are great at learning it, I can definitely tell you, I am not one of those people. And so I have an outside billing company that will call the insurance and they know the exact right questions to ask to see what your insurance will cover. Because it's almost like you don't want to give too much away to your insurance company. But you also need to know which questions and how to ask them in order to get the correct information back. And so I have an outside billing company that does that for my clients. And that's what I would actually suggest to everyone. It's the company I use is $25. And they don't have to be contracted with me or anything.
Sunny Gault
So, okay. Source, is that company based on? Like, do you have to hire companies that are based in your area? Or can you give even the name of the company because I'm thinking, I don't even know how moms are going to search for this. Is that a company you would recommend?
Cheryl Furer
Sure, absolutely. So it's three letters, S, l, B, and then the word slb billing. And like I said, you don't have to be contracted with a midwife in order to get a verification of benefits. And it's usually a pretty reasonable cost just to find out what your insurance will and won't cover and that gives moms a great start in their search for using their insurance for midwifery care if that's what they choose. Yeah,
Sunny Gault
Yeah, that's really smart. Thank you so much for that resource. All right. Thank you so much, Cheryl. This has been great. If you want to check out Cheryl's business and little learn a little bit more about what she does. Her website is yourthrivingpregnancy.com and then once you check out Cheryl stuff, head on over to newmommymedia.com. That's our website. You can check out our podcast episodes. Other videos that we've done just like this one, our blog posts- tons of great information. It's where real moms talk about real life.
