San Diego Midwives: Home Birth and Birth Center - Costs & Affordability
How much does it cost?
In San Diego, the range in costs for a Homebirth is between $5,000- $8000. Birth Centers are similar. Each practice sets their own prices. Some practices may have a discount for paying early, or for having their student as your primary midwife. Ask the practices you are interested in. Midwives don't want to publish their prices because we want you to choose based on fit and interest rather than price. It's an intimate connection and we want to nurture that.
Do You Have Payment Plans?
YES! All practices have payment plans. In most cases, You tell the practice what your payment plan will be. For example. "$400 every 2 weeks until paid up." Or, "We will complete payment when we receive our tax refund."
Most practices do require the full fee be paid by 37 weeks.
Some practices offer an extended payment plan after the birth. Inquire with the midwife team you are interested in.
Do You Accept Insurance?
Most home birth and birth center midwife practices accept insurances as follows:
PPO: You pay for care up front, by 37 weeks of pregnancy, and your midwife team submits a claim on your behalf or gives you a Superbill after the birth. See the Get An In Network Exception Section.
Active Duty Military: TriCare Prime will not help you cover the costs of your midwife attended birth.
TriCare Select: Some midwife practices accept TriCare Select. On our listings, only San Diego Midwife and Best Start Birth Center accept TriCare Standard. This is due to TriCare/ Medi-Caid issues at the National Level. if you believe this is unfair, please ADVOCATE with your local legislator and TriCare for them to make this care available to you.
Medi-Cal: Medi-Cal DOES accept Licensed Midwives, Certified Nurse Midwives, home and birth center births! That is good!!! Among our listings, Best Start Birth Center in downtown San Diego and Acorn Birth Center in Fallbrook are the practices currently accepting medi-cal.
The reason home birth midwives don't apply to become Medi-cal providers is because their payment rates for folks with Medi-Cal (but not in a "facility" (aka birth center) are so low (around $1800) home birth midwives cannot accept this rate.
If you are eligible for Medi-Cal, some practices offer an additional discount. Inquire with the practices you are interested in.
HMO: HMOs currently do not help pay for the cost of your home or birth center birth. You would pay the full fee yourselves. In many cases this is still less expensive than paying for hospital birth with your HMO. If you TRANSFER in labor, though, you would likely pay for both the midwife team AND the hospital birth. This is something each family must consider, based on their own finances, insurance plan, and investment in their birth dreams.
What is a typical Insurance Reimbursement?
Let's talk scenarios.
Scenario 1- you get all your prenatal care, birth and postpartum care with your midwife team. (YAY!) How much the insurance co reimburses depends heavily on what they SAY THE ALLOWABLE AMOUNT IS. (which you cannot know until AFTER the services are billed!!!!)
Let's say your midwives bill for $8,000 for all they do. The insurance co can say "oh, that's too high. We only value that care at $5000," and the Member has a 20% share of cost and a $6000 deductible. You would receive nothing back on the amount paid to your midwife team.
Scenario 2: Let's say you have all your prenatal care with your midwife team, transfer for pain relief in labor, and the midwives return to provide their complete care postpartum. The midwives will only be able to bill for the prenatal care, and postpartum care. So the total amount they can bill will be reduced by around $5000.
How Can We Get Our Insurance to Pay For This?
This is a key question. Home and Birth Center midwives typically spend 3x the amount of time compared with an OB or Hospital Midwife while charging 1/3 the price. Insurance companies should be banging down our doors. For more resources on how to get your insurance co to pay for your midwife care, we like: Mind Body Baby OC.com Ultimate Guide To Home Birth Insurance Reimbursement. Get An In Network Exception Once you decide on your incredible midwife team, have their biller run a Verification of Benefits to see where your insurance company draws their lines for In- and Out-of- Network providers. Once you've established what needs to happen next, you'll want to apply for a Gap Exception or an In Network Exception. If you get this your insurance company will treat your midwife team as In- Network - which is a huge benefit to you as they will then be part of your in network deductible and be paid at in-network rates and share of costs.