Homebirth Costs
Homebirth is an Excellent Financial Investment
Having your own midwife has many benefits, and the quality of care per dollar spent may be the best investment you can make in ensuring a mother and baby are cared for well.
Birth fees 101: Division of OB costs in US healthcare
Global Provider Fee
Covers prenatal care and birth attendance by a midwife or OB doctor. It's a flat fee for the midwife & OB clinic and their attendance at birth.
Birth Facility Fee
Hospital or Birth Center facility fee. Covers the building, nursing care, equipment, food, meds, supplies. Anesthesia would be extra.
Newborn Care
Newborn care would include pediatrician exam, tests and medications (vitamin K)
How do fees work with homebirth?
The global midwifery fee covers all three. The homebirth midwife provides prenatal care, birth care and newborn care. All clinical supplies are included. You're paying for a midwife and birth assistant to be on-call for you 24/7 x 5 weeks (37-42w) and to travel to your home 3 times (37w, birth, 48hr PP)
What's not included?
- Lab fees (I draw them- insurance or you pays the bill) ~$250
- Anatomic ultrasound (I only ultrasound for 1st tri "dating" view and 3rd tri "position" view) ~$250
- Birth room supplies (you buy plastic, chux pads, birth pool, etc) ~$50-$250
- Postpartum supplies (you buy pads, sitz herbs, supplements) ~$100
- Optional newborn meds/tests (vitamin K $30, newborn screen $100)
Moonlight Midwifery financial info...
Details
- $500 deposit
- Monthly payments required
- Pay in full by 37 weeks
- Option to defer higher amounts to third trimester
- Itemized refunds for care ended before 36wks
Transferring in the middle of pregnancy?
Global fee is set for care. Transferring care can actually take us more time than establishing early in pregnancy.
HSA and Credit Cards accepted
There is an additional service fee of 3% for invoicing of cards, including HSA cards.
If your HSA allows you to request a check, I'd suggest that option.
Financing option available through:
If you have insurance...
- Homebirth may or may not be a specific policy in your insurance plan.
- The midwife's credentials may determine whether insurance will cover your expenses. Certified Nurse Midwives should be covered by your insurance since we are licensed in every state. This is an advantage to hiring a CNM vs a CPM (not currently licensed in GA).
- A few policies EXCLUDE any payment for the birth portion of homebirth.
- Some policies have NO out-of-network reimbursement (you cannot file claims for Medicaid, for example)
- Your homebirth will be an out-of-network expense. You will pay in full for services, then submit for reimbursement through insurance after birth services are completed.
- Using a professional biller will ensure the best reimbursement. I recommend Napier Midwifery Billing to help you get reimbursed. She can help you to apply for in-network exemptions if that looks possible on your insurance.
- You need to consider your deductible. It may or may not be worth even filing a claim.
- If you have a high deductible, you may even want to consider lower-cost ultrasounds (cash pay options)
- You can't anticipate what claim amount insurance will honor. They may consider a prenatal and birth claim to be worth $2000 - $4000. They'll apply that to your deductible and send you a check for the amount over the deductible.
- Your labs, ultrasounds, perinatal consultations and co-care with any OB practice will usually go toward your deductible since you often use in-network insurance for those.
- If you do co-care with an OB practice, they may also have you paying toward their global fee. However, if you do not birth with them, they will finalize their claim as "prenatal only" and refund you the excess amount you paid toward their global fee.
Moonlight midwifery is out-of-network.
About 1/4 of my clients obtain in-network Gap exceptions because there is no in-network homebirth provider. When they submit (after birth) the amount is honored toward their in-network deductible.
I can issue you a superbill after the birth. You can submit it. However, during this time period of postpartum bliss and fog it's better to have a professional biller working for you because of the game insurance plays with rejections.
UPDATE
Steps of using biller:
- Start care
- By 28wks, have Maggie at Napier Billing run a VOB (verification of benefits, $30) for you.
- Apply for a gap exception, if possible
- After the birth, I communicate to Maggie
- Maggie completes a coded form for the claim
- Pay the biller ($225 )
- You upload to member services
- Maggie helps to follow the trail of the claim and often has to appeal things
- Insurance applies their honored amount (ex. $4000) to deductible and sends you a check if refund is due
If you have a health share...
- Homebirth is usually a generously covered benefit.
- You pay your homebirth payment plan just like every client.
- Your healthshare will want you to send in the estimated fee invoice I give you after you start care.
- They often send you a check in third trimester, so you may choose to make smaller monthly payments until then.
- I add your cash-discount lab prices and the birth kit fee to the invoice so it's easy for them to cover these required things.
- Ultrasounds are around $250 and those places will give you a superbill you can send in
- The may not pay for dual prenatal care if you are using an OB backup practice.
If you are self-pay...
- Homebirth is going to be your least expensive option for OB care.
- I have a contract with Quest Labs that will offer you deeply discounted labwork (around $250 total for pregnancy) and the required anatomic ultrasound is $250
- Midwife support during labor is proven to help you avoid the most costly things- hospital admission and cesareans. In some low-income cases, you can qualify for emergency medicaid for these expenses.
I hope this answered your questions!
After years of having different discount schemes, I have dropped them in honor of the impossibility of judging what is worth discounting, and honoring the on-call commitment and clinical responsibility midwifery requires asks of me.
My heart is open to hearing your story of how I can help make homebirth possible for you if finances are an obstacle. Also know that many slightly cheaper homebirth midwifery options exist locally that are still wonderful... and some not... and part of the higher value of my practice is how easy it is for you to know the quality you are getting... from the transparency of this website to the credentials that back me to the reviews that highlight my birth presence and skills in midwifing. I honor your financial investment seriously.
-Crystal
Disclaimers
Moonlight Midwifery is not in-network with any insurance policies. WE DO NOT TAKE INSURANCE or negotiate our rates with insurers.
If your insurance provider finds my name, Crystal Bailey, on any in-network contract, it is not related to the care provided by Moonlight Midwifery LLC. I have been on policies for prior employers, and there are other 'Crystal Bailey' practitioners in GA.