New Beginnings Birth Center does accept and bill for healthcare insurance. For out of network insurance we have a truly unique process of billing insurance providers. Making birth at our birth center affordable was at the center of our billing process. Therefore we are happy to say 99.9% off all our clients pay less with our billing process then the hospital and even other birth centers. Our out of network insurance clients pay their family deductible for the baby birth year to the birth center and that’s it! If you’re unsure what your maternal deductibles are, we will have them verified for you. If we find your insurance deductible is higher than the cash price we will revert to the cash price of $4,000.00. To simplify the process, our out of network clients DO NOT PAY Co-Pays, or Co-Insurances which can be very costly. Simply put, you are only going to pay out of pocket your insurance maternal family deductible.
We are happy to discuss further the approach we take with healthcare insurance in person, before or after your next prenatal visit! If you like, you may schedule an appointment solely for instruction on our approach with your healthcare insurance.
We are now IN-Network Providers for Blue Cross Idaho, and Aetna(including Aetna Subsidiaries)!
For more information on the complex use of maternity terminology please see below.
Common Insurance Terminology
- Do you have maternal coverage in your policy or just medical coverage?
- Does your deductible include your newborn?
- Do you have out of pocket maximums?
- What is your maternity co-pay? (co-pay is defined as “The cost after insurance has paid it’s portion”)
- Is it a personal or family policy?
We will help to enlighten you as to why these are critical components to have intimate knowledge about when it comes time for payment. Knowing this information will help you budget your finances based on the birth that is right for you.
Maternity vs Medical Only coverage:
If you do not have maternity coverage in your policy none of the expenses related to birth or you prenatal care will be covered. The coverage you have is for what the insurance community calls Medical only.
Does your deductible include your newborn?
If you aren’t familiar with what a deductible is, it is the cost you must pay BEFORE your insurance will cover ANYTHING. From our experience, it is common to have a $2,000 or higher deductible. In fact, as time has went on we are seeing more and more $5,000 maternal deductibles. Now, where this gets tricky is the deductible is almost always for each person covered under the policy. This would include MOM AND BABY. That means you have to meet the deductible for both mom and baby prior to insurance paying out a single cent. Using the low-end example deductibles above you would be looking at $4,000 out of pocket before your required to pay the co-pay.
Out of Pocket Maximums:
Out of pocket maximums are very rare, and very high, but it is good news if you are having triplets or more. If your policy includes these maximums and you are having twins or triplets your birth won’t cost you more than your house!
Family or Personal Policy:
If you have a personal or individual policy you will not be able to add the newborn to your policy and thus will be out of pocket the newborn costs. In most cases the newborn cost is about 30% of the overall cost. However, if there are emergency situations that arise (N.I.C.U.) the newborn cost’s could be 95%. If you have a family policy than you will be required to add the newborn within 30 days of birth. DO NOT MISS THE CUTOFF, if you miss the 30 day window you will be required to wait until the next open enrollment period which is done annually. If you miss the cutoff, you will then have to pay the newborn cost out of pocket plus all the other expenses.
All too often families forget about the co-pay portion of the coverage and are than left with thousands of dollars of unforeseen debt. In many cases we see an 80/20 split. What that means is, your insurance covers 80% of the bill and you must pay 20%. This is on top of the deductibles and any other non covered costs. Co-pay’s are the insurance company “sleepers”, they are not discussed much and than your hit with them unexpectedly after services are performed.
Thank you for the opportunity to allow us to serve your birth!