Understanding Insurance & Investing in Homebirth Midwifery Care
A gentle, honest guide from my practice to your family
When families begin exploring homebirth, they’re usually drawn in by something deeper than logistics.
They’re seeking care that feels personal, respectful, and rooted in trust. They want to feel seen, heard, and supported throughout their pregnancy, not just during labor. And then… naturally, the conversation turns to cost. Because while this kind of care is incredibly valuable, it’s also different from what most people are used to navigating in the traditional healthcare system. So I want to walk you through this - honestly, clearly, and without overwhelm, so you can make decisions that feel both informed and aligned.
First, a Truth I Hold Close
I’ve walked this road too.
I’ve experienced births that were fully covered by insurance… and births that were not. And what I can say, both as a mother and as a midwife, is this: Choosing out-of-hospital midwifery care is not just a medical decision, it’s an investment in your experience, your autonomy, and your family’s beginning. That doesn’t mean the financial piece isn’t real. It is. And you deserve to understand how to navigate it.
Does Insurance Cover Home Birth?
Sometimes - yes. But it’s rarely straightforward. Each insurance plan is different, and most midwives (myself included) are considered out-of-network providers. This means that while your insurance may reimburse you, it typically doesn’t pay the midwife directly. The best place to begin is with something called a Verification of Benefits (VOB).
This helps you understand:
What your out-of-network benefits are
Your deductible and coinsurance
Whether midwifery care is eligible for reimbursement
You can call your insurance yourself, or work with our billing specialist who understands this process well (which I often recommend - it saves a lot of time and frustration).
A Very Important Piece Most People Miss
Insurance doesn’t base reimbursement on what your midwife charges. They use something called an “allowed amount.” This is the number they decide a service is worth, regardless of the actual fee. So even if your global care fee is higher, your reimbursement is based on their number, not mine. This is why families are sometimes surprised by what they receive back.
What Does Reimbursement Typically Look Like?
While every plan is different, most families I’ve worked with receive somewhere in the range of: $1,000–$3,000 in reimbursement. Some receive more, some less, it truly depends on your specific plan. And I always want to say this gently: Reimbursement is best viewed as a bonus, not something to rely on fully covering your care.
What Is a “Network Exception”—and Why It Matters
Occasionally, insurance companies will approve something called a network exception (or gap exception). This allows your care to be processed at in-network rates, even if your provider is out-of-network. When this is approved, it can significantly increase reimbursement.
However, these are:
Not guaranteed
Increasingly harder to obtain
Often require persistence (and sometimes professional billing support)
If this is something you want to explore, I can guide you in the right direction.
Choosing an Insurance Plan (If You Have the Option)
If you’re planning ahead or evaluating options, here’s what I gently encourage families to consider:
PPO plans tend to offer the most flexibility for out-of-network care
Look closely at:
Out-of-network deductible
Coinsurance percentage
Lower deductibles = higher monthly premiums (it’s always a balance)
And something many families don’t think about:
If you plan to use other supportive services (like pelvic floor therapy, chiropractic care, or lactation support) your insurance structure can impact those costs too.
Using HSA or FSA Funds
This is one of the most practical and empowering tools available.
Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA):
Allow you to use pre-tax dollars
Can often be applied to midwifery care, labs, and birth supplies
For many families, this is a meaningful way to offset costs while still choosing the care they truly want.
Health Shares: An Alternative Path
Some families choose to use health sharing programs instead of traditional insurance.
These can:
Offer more comprehensive coverage for homebirth
Reimburse midwifery care more fully
Each program is different, and they often require:
Membership prior to pregnancy (often specific amount of time where you must be enrolled PRIOR to pregnancy in order to have services covered).
Adherence to specific guidelines
But for the right family, this can be a beautiful fit.
A Gentle Reframe
I never want finances to feel dismissed or minimized—because they matter.
But I also want to offer this perspective:
The value of this care extends far beyond the day your baby is born.
It’s in:
How you feel during your pregnancy
The trust you build in your body
The way your partner is included
The support you receive postpartum
The story your family carries forward
This is care that is continuous, relational, and deeply personal.
And for many families, that becomes something they would choose again—without hesitation.
If You’re Navigating This Right Now
You don’t have to figure it all out alone.
I’m always happy to:
Help you understand your options
Point you toward trusted billing resources
Walk through what this could look like for your specific situation
Because this isn’t just about insurance.
It’s about helping you create a birth experience that feels safe, supported, and truly yours.
Learn More About Your Specific Coverage Now
If you’re desiring a more personalized understanding of what your coverage may look like, we want you to feel fully supported in that process.
We work alongside a trusted billing specialist who offers a complimentary verification of benefits (VOB) prior to the start of care - providing thoughtful, individualized insight into your plan so you can move forward with greater clarity and ease.
If this feels aligned for you, we invite you to reach out at admin@jengrieco.com, and we will guide you through each step with care.
