Kaiser Permanente Midwife coverage
Hello
I am in the Santa Rosa area in California. I have Kaiser HMO. I decided to hire a midwife (not related to Kaiser).
I called Kaiser customer care and asked about midwife / home birth coverage. I was told that home births are only covered by my HMO insurance IF my OBGYN determines that I must have a home birth instead of a hospital birth. This sounded so ridiculous and absurd! A doctor would never determine that, they want you delivering your baby at their hospital where they can make money.
Has anyone experienced something similar?
Thanks
Dec 1, 2017
Parent Replies
I don't think it is about money, Kaiser and the doctor don't make "extra" money on births. It would be about safety to have the birth at the hospital.
You will likely have to pay out of pocket for any homebirth expenses.
A homebirth midwife will certainly not be covered by Kaiser.
Sometimes PPOs will reimburse you, but be prepared for paperwork.
The home birth will not be covered by Kaiser. However lab work, ultrasounds and etc. can be covered by Kaiser as parallel care. I've given birth at Kaiser twice and never felt that the staff was delivering my children for money. They all were very supportive and seemed delighted to meet my babies! Maybe try giving doctors and nurses the benefit of the doubt here--they cash a paycheck whether you deliver your baby at Kaiser or not.
Actually, a Kaiser doctor makes the exact same amount of money regardless of where you deliver your baby. Recommending you have your baby in the hospital or at home is therefore a genuine medical recommendation. Technically, Kaiser would “make”/keep more money if you had your baby at home, and didn’t incur all the hospital costs. But a hospital is a safer environment for most people.
Hi,
I have Kaiser health insurance (gold plan which is the most coverage possible) and a supplemental Cigna plan to cover anything that is not covered (like acupuncture for any reason and chiropractic) and my care is based in Oakland. I had a home birth with a midwife - none of it was covered, since my plan covered complete pre-natal care and birth, they would not cover any of my midwivery care. Even my supplemental plan did not cover anything. I think Kaiser is great health insurance, but if you want your home birth or midwife care to be covered, it will not happen via Kaiser Health Plan. So basically I paid completely out of pocket to not go to the hospital, but I had concurrent OB visits which were free and all of my lab testing/US was covered, and it was nice to know that if I needed a hospital transfer, it would be covered. My baby is 6 months and has had to have a lot of care since birth (not related to birth though) and it has been so nice to be at Kaiser, as far as getting specialty referrals quickly and getting imaging done. Good luck to you!
Isn't home birth way cheaper, for Kaiser as an HMO? I got an infection when I delivered my first in the hospital and had midwives with home births for the next two.