Does Insurance Cover Home Birth?
Home births are more likely to be covered by health insurance than they used to be, but you still likely have to meet strict requirements.
A home birth tends to be cheaper than a hospital birth, but it also has additional risks. That's why insurance companies have rules about who qualifies for coverage, if the company covers home birth at all. Insurance companies that cover home birth commonly require that you have a Certified Nurse Midwife (CNM) with you, haven't had any complications and are a certain distance from a hospital.
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Does insurance cover home birth?
Your health insurance might cover a home birth, but it depends on your plan and overall health.
The best way to know if your health insurance covers home birth is to call your company. Home births are becoming more common, although they still make up only about 1% of all births. Health insurance companies are now more likely to cover home births. But coverage still varies depending on your company and plan.
For example, some Cigna plans cover home birth as long as you're accompanied by a medical professional who is licensed to provide home birth care. Kaiser Permanente plans might cover home birth if you don't have any pregnancy complications, are between 37 and 42 weeks pregnant, and can quickly get to a hospital if there are complications. And Excellus Blue Cross Blue Shield plans, which are available in New York only, have similar requirements.
But many health insurance companies and plans still don't cover home birth. If you are considering giving birth at home, talk to your insurance company early in your pregnancy to give yourself as much time as possible to find out what your options are.
If your plan doesn't cover a home birth, that doesn't mean you can't have one. It just means you will have to pay for the midwife and medical care yourself. Knowing your plan's coverage early gives you time to prepare and save if you will have out-of-pocket costs.
Is home birth just as safe as hospital birth?
Both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) advise against planned home births. Although the overall risk is still low, it's more than twice as likely that a baby will die because of complications during a home birth compared to a hospital birth. It's also more likely that a baby will have seizures. The increased risk is why health insurance companies are hesitant to cover home births.
However, both organizations recognize that women have the right to choose how and where to give birth. The American College of Obstetricians and Gynecologists also acknowledges that home births have perks, including a lower risk of tears during birth and a higher chance of not needing medical interventions like pain medication.
How much does a home birth cost?
Home births cost an average of $4,650.
But the cost can be higher or lower, depending on where you live and what type of medical care you need. For example, the cheapest cost for a home birth is about $2,000 and the most expensive is about $10,000.
Home births are usually cheaper than hospital births. The average cost of childbirth in a hospital is about $13,000 for a vaginal birth, while a cesarean section (C-section) costs $22,646 on average.
But hospital births are far more likely to be covered by health insurance. It may end up being cheaper to give birth in a hospital, especially if your health insurance doesn't cover home birth. To figure out which option is cheapest, you'll need to talk to your preferred hospital about pricing and your insurance company about coverage.
Are midwives covered by insurance?
Just like with home birth, midwife coverage depends on your specific insurance plan.
In general, though, it's more likely that insurance will cover you to see a midwife for your prenatal care. You may have to see a Certified Nurse Midwife (CNM) or Certified Midwife (CM), depending on your insurance company's rules and your state's laws. These types of midwives have the highest level of training and accreditation.
Are birth centers covered by insurance?
Birth center coverage depends on your health insurance plan.
If coverage is included, make sure the birth center you choose is in your plan's network. Your plan may also have qualifications for birth center coverage that are similar to the requirements for home birth coverage. You may have to show that your pregnancy is low-risk and that you're within a certain distance from a hospital.
What is a birth center?
A birth center is designed to give you a home-like atmosphere for labor and delivery. Birth centers are usually staffed by nurses, midwives and doulas. They aren't inside hospitals, but they do usually have an agreement with a hospital so that you can be transferred if you need medical care.
Frequently asked questions
How much does a home birth cost?
A home birth costs an average of $4,650. But costs range between $2,000 and $10,000, and you may pay more if you need more in-depth care during labor or delivery. If you need to be transported to a hospital, you will also have to pay the charges for the care you receive there. However, insurance is more likely to pay for some of the cost of a hospital birth compared to a home birth.
Is it cheaper to give birth at home with a midwife?
Home births, which typically include a midwife, are usually cheaper than hospital births. But the final price you pay will depend on whether or not your insurance covers home births. If it doesn't, it may be cheaper to give birth in a hospital. Even though the total cost would be higher, insurance could significantly lower the amount you have to pay.
Does Medicaid cover home birth?
Medicaid covers home birth in at least 25 states. Additionally, nurse midwife services and birth centers are always covered by Medicaid, no matter what state you live in.
Sources
Sources about the cost and risks of home birth, as well as insurance coverage, are from:
Statistics about the percentage of home births in the United States and the rate at which they are increasing come from the Centers for Disease Control and Prevention (CDC) and research on where women give birth in America.
Medicaid coverage information is from Medicaid.gov and KFF.
Editorial note: The content of this article is based on the author's opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.