PRIVATE HEALTH INSURERS COVERING MIDWIFERY AND HOMEBIRTH
...
@ September 2007
Compiled for Homebirth Network SA, Birth Matters
(SA), and the Maternity Coalition
by Lareen Newman
Here is the latest information we have collected
since August 2005 via mothers and midwives in Australian birth and
midwifery networks about private insurance companies who have reimbursed
for the services of an independent/private midwife covering homebirth
or other midwifery services. Do send advice if you find more recent
information, or can add information about other insurers, to matcoalitionsa@yahoo.com.au
Women are advised to check their individual situations
with the individual insurer and what level of cover is required for
which services; also to check whether smaller amounts may be eligible
for rebate (ie prenatal education/care and postnatal care). In some
instances it seems that only one staff member in a company is aware
of the company’s stance on reimbursement for homebirth or midwifery
services. Birth Matters (SA) or the Maternity Coalition may be able
to put you in touch with such individuals who have had previously
had contact with women seeking or obtaining reimbursement for homebirth
or midwifery care. Email matcoalitionsa@yahoo.com.au for contact details
or to provide us with updated information.
SUMMARY (See below for more detailed information.)
Company
- Maximum Homebirth Reimbursement - Date latest
Info Recieved.
Australian Unity - Up to $2,000
- August 2007.
Defence Forces Health - Up to
$790 - Sept 2007.
Grand United - $2,000 in the past,
but in 2006 would not cover homebirth or independent midwifery - October
2006.
HBA - $1,200 (Were having a pilot
program on homebirth but current status of this is unknown.) - Sept
2007.
HCF
- Unknown.
Mutual Community
- $1,500 (down from $2,000) - March 2006.
Manchester
Unity - Small amount in the past.
MBF - $3,000 to $4,000 in the
past, but currently unclear if reimbursing - August 2007.
Medibank Private - Unknown. Appear to reimburse nothing.
Mt Isa Mines - Unknown re homebirth,
have paid for midwifery care.
NIB - Small amount in the past.
NRMA
- Partial reimbursement before taken over by another company.
Queensland Country Health - Only if midwife has indemnity
insurance.
SGIC - Have covered in the past, but latest news
is that it is withdrawn - September 2005.
Teacher’s Federation Health
- $1,500 - July 2006.
WA Hospital Benefit Fund (HBF)
- Have reimbursed in the past, amounts unknown.
AUSTRALIAN UNITY
May pay $2,000 to $3,000 per birth. The most recent
information we have is for reimbursement in August 2007. A mum says
she: “wrote to AU to “apply" for approval for homebirth
coverage. The letter outlined our midwife’s schedule of visits,
payment schedule, her AU provider number, etc. We got a letter back
from them saying that the usual benefit for midwifery services under
our private health insurance level of cover (hospital only, no extras)
is $400 plus pre and post natal services, which would generally add
up to approx $600 in benefits. But they have the discretion to fund
additional costs associated with homebirths. As such, they agreed
to fund us up to a maximum of $2,000 for midwifery services for pre
and post natal care and attendance at the birth. Our midwife can invoice
them directly, or we can pay her and send a receipt to them. The contact
is Jane Boag, Manager, Claims Analysis. Ph: 03 8682 4228”.
Another mum, from SA, said that in 2002 she received 100% rebate for
a homebirth from AU: the midwife charged $1,200 and AU would have
reimbursed up to $1,500 at that time. She needed a certain level of
cover – but not the top level. They would also have paid the
full fee for an independent midwife to attend at a hospital. She had
to apply in writing to be approved the same funding for a homebirth,
but she said they were quite happy and there were absolutely no disputes.
This mother says that this occurred right at the time of the indemnity
insurance dilemmas, and the company was not concerned about that.
MUTUAL COMMUNITY
Two SA mothers have received reimbursement for
midwifery services for planned homebirth, one in Dec 2005, and another
(for $2,000) in March 2006. After March 2006 it seems they dropped
to $1,500 reimbursement. The bill may need to be sent to a particular
staff member in the policy section.
TEACHERS FEDERATION HEALTH
For teachers, or people who have been in the fund
since a child and their parents are teachers. 9 month waiting period.
An SA midwife had a client (July 2006) who received $1,500 to cover
her homebirth ($650 for the home birth, which must be with a registered
midwife; rest of money covers pre- and postnatal care. Birth amount
not reimbursed if mum transfers to hospital). The midwife had to give
the mother an invoice with her ABN on it, detailing amounts charged
for antenatal, birth/labour & postnatal, as they were specific
about how much they would reimburse for each 'part'. A second mum
confirmed that this is what she received – also that services
must have been provided by a registered midwife; she also believes
that if complications arise and hospital birth is required then they
will pay benefits for hospital according to your cover level, and
any ambulance transfers required as well as the pre/postnatal care
provided by the midwife. This mum had to ask about her care and got
sent a personal letter outlining what they would cover/pay.
DEFENCE HEALTH
Most recent info Sept 2007. Provides private health
insurance for family members of defence personnel; defence personnel
themselves are provided with “free” medical care under
Dept of Defence policy. Confinement and delivery: Up to $550 if provided
by a registered midwife in private practice, whether the confinement
and delivery is at home or in a hospital, unless a doctor is required
to intervene. Ante/post natal care: $20 per pre-natal visit and $40
per post-natal visit, subject to a $240 limit per person per financial
year, if provided by a registered midwife in private practice recognised
by Defence Health. We know of military women who have been covered
for midwifery care or homebirth and were employed in the AIRFORCE
and the ARMY. However, anecdotally each area health service deals
with approvals for military women to use medical specialists who are
or are not on their “approved list” and women may need
to argue their case if they want to have care from a midwife who is
not on this approved list.
HBA
Has notified some members that they will be rebating
on homebirth. One Maternity Coalition member contacted them and they
say they will cover up to $1,200 for homebirth. A pilot program covering
homebirth was being undertaken - contact re this pilot program was
Jenni Doherty (Customer Relations Manager), (03) 9937 4074. Current
status of this program is unknown at Aug 2007.
MBF
Most recent info August 2007 is that one mum is
having considerable difficulties with MBF in finding out whether or
not she is covered for homebirth and who to speak to at this company.
At one point in time we believed that MBF covered the full amount
for homebirth/independent midwifery, but that women need to make an
individual agreement with them. Many women in the past have reported
having $3,000 to $4,000 reimbursed for a homebirth through MBF. One
SA mum who had planned a homebirth had to transfer to hospital where
she had private care with an obstetrician and so didn’t receive
any reimbursement. Had she stayed at home they would have refunded
for the homebirth. Ante-natal appointments can be claimed for as part
of the alternative services which includes osteopathy etc so if other
services in that bracket have already been claimed for the year, there
may not be enough money left to claim for midwifery services as well.
Women who have held a policy for some time might like to consider
switching to MBF if their current fund gives little or nothing back
because as an existing policy holder the waiting times are waived
and so they should be able to go to MBF, do a deal and get all the
costs back - cover is for homebirths only and MBF cover nothing for
the fees of the independent midwife if women transfer to hospital,
as they then cover the obstetrician fees instead.
GRAND UNITED
In 2005/06 GU announced around $2,000 reimbursement
and featured Jan Robinson (a NSW independent midwife) in their brochure.
However, in late 2006 one SA woman found they would no longer cover
independent midwifery or homebirth.
HCF
Nothing so far.
MANCHESTER UNITY
Apparently pay something.
MEDIBANK PRIVATE
Nothing so far.
MIM (Mt Isa Mining)
Have paid rebates for midwifery care.
NIB
Rebate a small amount.
NRMA
Before being taken over paid part – need
to check with the company who took them over if this continues.
QUEENSLAND COUNTRY HEALTH
Say that they cover homebirth and have this on
their website, but their Customer Service Manager says they do not
reimburse for any midwife without the midwife having indemnity insurance
to cover her for birth (so in effect they do not at present cover
homebirth, or any ante- or postnatal care or other care by an independent
midwife as there are insufficient numbers of independent midwives
in Australia at present to form a group to buy group indemnity).
SGIC
Used to cover, now withdrawn.
WA HOSPITAL BENEFIT FUND (HBF)
Cover independent midwifery. The WA govt insurance
office also had a rebate system for midwives. One midwife had a client
commence care in WA and then transfer to NT midway thru and they paid
for the midwifery care.