The most common question we get is, "Will my insurance cover my birth?"
The question is simple and complex at the same time!
To start, it depends on the type of insurance policy you have.
To make this easy lets eliminate those that do not cover; Kaiser, MediCal, any HMO or EPO policy, TriCare or any of the Covered California policies. What's left?
Most PPO policies cover APM's services at the out-of-network rates as we are not contracted with any insurance companies. Most often a GAP exception is available to be requested by either the insured (you) or the provider (us). See below for GAP exception.
A Gap exception (also referred to as a network deficiency, In-Network exception, out-of Network Exception, etc) is a request to honor a patient's in-network benefits, even though they are seeing an out-of-network provider because there is a GAP in the available providers. If there are no contracted birth centers or midwives, typically within a 30-mile radius of your home, most PPO's will allow you to apply for a Gap exception and will pay the in-network rates for your care which typically include lower deductibles and higher percentage of payments.
Ancient Paths Midwifery uses an outside Insurance Billing Service that specializes in holistic practitioners. Only those utilizing insurance billing will pay for this service and there additional fees for this service. If your very first pregnancy visit is at APM, we can do a test bill for that service. Because maternity services are billed globally (meaning they are bundled with prenatal care, birth and postpartum care) we cannot bill insurance until the 6 week postpartum visit is completed.
When dealing with insurance of any kind, know that our birth package is priced to be paid in full before your birth and then we will bill your insurance after your 6 week postpartum visit. The insurance company will reimburse you for any covered expenses.