Financing a Homebirth vs. Hospital Birth

This is a Guest Post by Scott. 

According to a recent study in Nurse Midwifery, the average homebirth that doesn’t have any complications costs about 68% less than a comparable hospital birth! When you add this to the fact that a homebirth with an excellent midwife is much less likely to land you with an unnecessary cesarean delivery, and the savings of a homebirth can be quite significant.

However, financing a homebirth is quite different, often times, from financing a hospital birth. Here’s what you need to know:

Average costs

If you didn’t have insurance, a hospital birth – uncomplicated and vaginal – would cost around $7,600. With insurance, most people pay about $1,500 to $2,300 out of pocket. This, of course, depends on your actual insurance coverage. It also depends on what area of the country you’re giving birth in, which medications you end up using, how long you stay in the hospital, and many other factors.

The average midwife-based home birth costs about $2,000 to $3,000. For some midwives, this fee covers all of the pre-birth consultations, as well, which can present significant savings. With a hospital birth, keep in mind that you must pay not only the hospital but also your practitioner for services the day of the birth as well as services in the months leading up to the birth.

Insurance coverage

One of the many reasons some couples choose not to go with a home birth is that they assume insurance will not cover it. This isn’t always true, though! Some insurance providers – including major providers like United Healthcare – now provide at least some coverage for midwives. Your insurance provider may pay part of the pre-birth fees, even if the actual home birth itself isn’t paid for.

However, never assume that your insurance won’t pay simply because homebirth is still rather unorthodox. Many insurance companies are coming to grips with the fact that midwives tend to offer more cost-effective care than traditional obstetricians! If it’s more cost-effective for you, then it’s more cost-effective for them, too.

Payment plans

When your insurance covers a hospital birth, you may be required to pay the fees up front before your due date. Many hospitals these days will check the insurance coverage of the pregnant woman and provide her with a payment plan leading up to the birth, and they’ll require that the fees for a regular vaginal birth be paid in full in the last month or two of pregnancy. If a c-section is required, the patient will have to pay even more out of pocket afterwards.

Midwives who work in homebirth may do something similar. It depends on the practice, though. Some will give you a monthly payment plan so that all your fees will be paid by the time the baby is born. Others will offer a discount if you pay in full up front, and still others will allow you to pay after the baby is born. This is definitely something to think about when you’re talking about financing homebirth, and you may want to compare midwives in your area for how they require patients to pay.

If you have to be transferred

One more thing to think about when financing a homebirth is what happens if you need to be transferred to the hospital. With top-rate midwives dealing with low-risk pregnancies, transfers rates are very low, but you still need to consider the possibility. Chances are likely that your insurance will kick in if you do need to transfer to the hospital, but then you’ll have to pay both the midwife and the hospital. Talk to your midwife about what will happen financially in a situation like this, just so that you can be prepared.

Figuring out how to finance it

If you don’t have enough money in savings at the moment to pay for a homebirth (or even a hospital co-pay for an in-hospital birth!), you may be able to finance your homebirth with a credit card. Consider applying for a low-interest credit card, or one with a limited-time no-interest option. Pay your fees in full up front, especially if this will score you a discount, and then pay off the credit card a little at a time. If you can pay off the card before it starts accruing interest, you’ve basically got a way to finance your homebirth without paying any extra fees.

Costs are only part of it

Many people who don’t have good insurance coverage choose a homebirth in part because it’s just so much more affordable than an uninsured or underinsured hospital birth. However, make sure that cost isn’t the only reason you’re choosing a homebirth. Instead, Jamie Scott from CreditDonkey recommends you get as much information as you can about homebirth, and make your choice based on what’s best for you and your family.

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12 thoughts on “Financing a Homebirth vs. Hospital Birth”

  1. I live in Kansas, we are planning a home birth and have a wonderful midwife that is going to cost us just over 2000. I called the local hospital just for fun and asked what an UNCOMPLICATED standard birth would cost and they said upward of 40k. No Joke. And they said that did not include the doctor, pre or post natal care and once the baby was born it was extra. Very scary numbers.

  2. For my vbac I looked at both the cost of a home birth and a hosptial birth, and the hospital was a lot cheaper but only because of insurance. It stinks that insurance will pay a higher percentage on a high cost hospital birth, and a much lower percentage on a low cost home birth. We paid $500-$600 total for everything including my midwife and pediatrician in the hospital. A home birth would have been a lot more. Obviously you can’t put a price on a good birth experience though.

  3. With my 2nd, I had no insurance. I had to pay my OB $3000 before 36 weeks. I had a vaginal birth, an epidural (so I had to pay the anesthesiologist, too), and a 24 hour hospital stay, with a total cost of just under $10,000. So just about $13,000 for pre and post natal care.

    I’m pregnant w/my 3rd and have private insurance (Blue Cross/Blue Shield) and I have a midwife and planning a home birth. The total for pre and post natal care (HOME visits by the midwife), plus the home birth is $4000. Insurance covered half of the initial payment ($2000), and will cover half of additional visits.

    While I had a relatively decent experience in the hospital w/#2, I’m looking forward to not having nurses in and out of my room after giving birth, and not having to pack myself and newborn up to go to a post natal appointment!

  4. It’s really interesting to read all of the different experiences with insurance.
    I live in Ontario, Canada so I knew that a hospital birth would be covered – I think the biggest charge would be if you want a private hospital room.
    When I first started to research homeburth my heart kind of sank because I reall didn’t know if the provincial healthcare would include homeburth and midwives as part of the healthcare picture. Boy, was I wrong.
    Once I started researching, I realized we actually have an established association for midwives and that if you would like a homebirth, it’s also an option and covered by the province of Ontario.
    I can only imagine how heartbreaking it is to want something as seemingly simple as a homebirth and not be able to get it. Especially when you look at how expensive hospital births can get.

  5. I can only speak from my own experience, but I am having absolutely no luck having midwife costs covered by my insurance company. I have Anthem Blue Cross HMO and from what they have told my husband and I, they will not cover out-of-network providers under any circumstances. It absolutely baffles me that they are willing to pay the astronomical prices for a hospital birth but will not even consider covering home birth expenses. They won’t even cover birth center costs! Every midwife in my area (Riverside County, California) has told me that I can pay their fees and HOPE to be reimbursed at a later date. Unfortunately, I don’t have an extra five thousand dollars (the cheapest in my area was $4500 total). This is my second pregnancy. My first was healthy and absolutely normal (no meds, other than an induction with prostaglandin at 41weeks which I highly regret) and so far this pregnancy has been totally healthy too. The payment plans mentioned in the post sound nice but aren’t realistic for all families. I didn’t find out I was pregnant until I was almost into my second trimester due to a light period the first month of my pregnancy and costs have to be paid by 36 weeks which means that my family would have to come up with an extra $960 dollars a month in order to pay a midwife. I keep reading all of these blogs and websites about the benefits of home birth but it seems that nobody is willing to address the fact that it’s really only for those of high income. Every midwife website I find says that “most insurance companies cover home birth these days” while nobody can tell me WHICH insurance companies they are referring to! I have several girlfriends who have had home births… none of which were covered by insurance companies. So while the cost comparison to hospital births is great, it’s not particularly relevant to most people (at least from my experience). I would love to hear from someone who has had luck with their insurance company covering a home birth and information on the insurance provider.

  6. I am paying for individual health insurance through LifeWise of WA, my current plan does not cover maternity care. I am planning to use a midwife but am looking into whether my current insurance coverage would cover the birth if I had to go to the hospital for an “emergency” delivery in the event my midwife was unable to deliver the baby.

    In the meantime, what I have discovered in terms of cost comparison is that by upgrading my insurance coverage to include maternity care for 9 months would be $5013. This is a gross figure of my monthly premium and annual deductible. This does not include the $30 copays for office visits ($100 for ER visits) and the 35% coinsurance payments due after the deductible is met. If I add up prenatal visits, ultrasounds, bloodwork,etc. I can easily add another $1000 to that $5013. Then, there are costs associated with the delivery…anesthesia, delivery, hospital stay, etc. which in my area, ranges from $10-15,000 for an “uncomplicated” labor and delivery. If I have to pay 35% of the labor and delivery costs, that would add an additional $3500-5250. So now I would be looking at paying roughly $9,513-11,263 through this individual health insurance covering maternity care. And, this is just a rough estimate for an “uncomplicated” pregnancy!!!

    A local midwife will charge me $5000 for everything…prenatal care, ultrasounds, bloodwork, labor and delivery…everything!!! She offers a discount for up-front payment and monthly payment plans that can extend after the delivery if you choose. There is an option for an extended payment plan that would cost me $350 per month with no interest or additional fees. This is still less that the basic monthly premium of $357 through LifeWise and there are no deductibles, copays or 35% coinsurance payments! If you have great coverage with your existing insurance and want a hospital birth I would say go for it but if you are looking for an alternate birthing experience or have to pay for your health insurance on your own you really need to do the math because having a baby is wonderful but expensive even if you are not directly paying for it. I have spoken to many mothers about their birthing costs and even with the best medical coverage, many people end up paying a few thousand dollars in copays/coinsurance after everything is said and done.

    Because of our current financial situation, we have decided to try to get pregnant in 2014. We hope that the Afforrdable Care Act (starting in 2014) will make additional health benefits such as pregnancy, prenatal and newborn care more affordable or us. According to the act, health plans must cover certain preventive services without cost sharing. Some people may be able to get tax credits to help pay for health insurance if their employer doesn’t offer affordable coverage. In my quest to learn more about the costs and experiences of pregnancy, prenatal care, labor and delivery, and newborn care, midwifery is gaining my vote. I am not against traditional pregnancy care and hospital births, I have just chosen an alternate route…which happens to be less expensive!

  7. In response to Amy, I am currently pregnant with number 2 in Riverside County. My midwife’s fee is $4400. I think the major distinction between insurance covering fees for a CPM is whether you have an HMO or a PPO. Because we have a PPO we have out of network coverage. It isn’t full coverage, but they are paying a portion of prenatal visits. The other factor is your specific plan and what it provides. We have a BCBS plan, but it is out of state and specific to my husband’s employer.

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