Wednesday, July 21, 2010

Flags of Our Mothers

It should come as no surprise to anyone on the planet that approximately 24 seconds after taking my home test I was already compiling a list of things I needed to get started with. The top of the list was finding the midwife, but equally imperative were figuring out the insurance coverage. Despite the fact that on average the total cost for a home birth midwife are around $4,000, and despite the fact that their fees usually include ALL of the prenatal and postpartum care in addition the the actual birth, insurance companies are not exactly on board with it. You're right in thinking this makes absolutely no sense. Isn't the whole goal of insurance companies to try to pay as little as possible for your care? Well I went onto my insurance website and submitted an online inquiry about covering homebirth costs. Their response was of course "this is not covered by your policy". Good thing I am my mother's daughter and won't be taking that shit.
See back in 2000 when my mom was diagnosed with Stage 4 breast cancer, which is basically the stage where it is everywhere and there is little hope, it was determined that a stem cell transplant was her only chance. For those unfamiliar with the procedure, a stem cell transplant is very similar to a bone marrow transplant, only you are your own donor. They pump you full of stimulants that make you overproduce stem cells, then they go in and harvest your cells. You are put in isolation and given high dose chemotherapy to kill off everything. They give you your stem cells back and you start growing new cells. It is kind of crazy really. Anyway when the doctor's recommended this treatment for my mom, she was quickly denied by her insurance company. I am not sure the total cost for the treatment, but the hospital portion alone was estimated at $300,000. Since it was a new technology, insurance companies considered stem cell transplants highly experimental and they refused to cover anything that didn't have survival results 20 years after treatment. There were no 20 year survivors because it was maybe a 5 year old procedure. Mom couldn't be stopped though. She petitioned the insurance company, got support from all of her doctors, found survival information and compiled all this into a hefty defense. She spent several sessions in front of a panel of doctors making her case and she won. I will be forever grateful for her persistence because it gave us 5 more years together. Obviously not as long as we all would have liked, but that little extra time was worth millions.
So here I am 10 years later gearing up to do the same thing. Only in my case it doesn't make any sense. We're talking about something that will save the insurance company money. This would be around 1/3 of the cost of a regular healthy birth at a hospital. It is ridiculous for them to deny this, but of course they are going to try. After receiving the denial I contacted my H.R. rep and let her know I wanted to petition the insurance company and how should I do that. All of a sudden amazing things started to happen. She responded that not only could I fight my insurance company, but that she would help me. Good news, right. Wait for it, it gets better.
So I found a midwife, thanks to Katie, who will do a homebirth. Her and I set up an appointment (more to come on this soon) and exchanged a few e-mails. A few days before our appointment my HR rep e-mailed me to see if the midwife would be able to provide some service codes as examples of things she would provide. Wanting to give the midwife ample time to put something together, if it was something that takes a long time, I sent her an e-mail. Then the next amazing thing happened! The midwife responded that she works with a billing company who is the shiznit. Okay my words not hers. And they can take care of all this stuff for me. Say What? The billing company will do a verification of benefits where they talk directly with your insurance company and figure out what is covered under their "out of network" services. They bill the insurance company directly using all the fancy dancey service codes and then I get reimbursed. She said the insurance company doesn't even recognize it as a "homebirth" because the bill looks pretty much identical to that of a doctor. The only indication is that it is significantly smaller. Here I was ready to go Annie Oakley on the insurance company's ass and it turns out I can just sit my sleepy pregnant ass down and relax.
I thought back to my mom's fight and how much anguish and worry that process caused us all. I thought about all the un-named women who came before me and pushed for home births. These women made this possible for me. Before 1993, in Colorado, it was illegal for a midwife or anyone other than a doctor to assist in the delivery of a baby. My friend Pickles was born at home in 1983 and his older brother was born in 1980. His mom, assisted illegally by a midwife, muffled all her screams for fear that the neighbors would call the police. After Pickles was born, their midwife was arrested when another mother was forced by authorities to report her. The police threatened to take the woman's children if she didn't reveal who had assisted in her birth. What was she to do? You and I wouldn't have had a choice in the matter either. Isn't it amazing how different the world is now? We have a choice. Not only can we decide for ourselves what we would like from our births (at least when safe and medically feasible), but now there are ways to get coverage from your insurance company. I just can't help looking around and thinking 'someone out there is looking out for me'.

Blue skies, smiling at me, nothing but blue skies, do I see.


  1. Wow - that is AWESOME Natalie. I'm glad it's working out and you're getting it covered. It just makes so much more sense!!!

  2. HOLY CRAP!!! WOW, the world is juat a crazy crab cake,.. I never had a midwife to many med comp-s for me to,.. nor am I all about that but I think It is awesome that you are going to rock it!@