Insurers Reimbursing for Midwifery or Homebirth Services
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 in Australia. Please email additions or updates to sa@maternitycoalition.org.au
We advise that you check your individual situation with your 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). You may need to confirm arrangements and reimbursement amounts in writing with the insurer before the birth. 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 (info@sabirthmatters.org.au) may be able to put you in touch with such individuals who have previously had contact with women seeking or obtaining reimbursement for homebirth or midwifery care.
ALPHABETICAL LISTING BY COMPANY NAME
AHM Australian Health Management provides $600 cover for a homebirth assisted by a midwife. Their website says "As some members choose to have a home birth, Top Hospital and Family Hospital will pay a benefit towards midwife assisted deliveries with a registered midwife. This benefit is $600 for each home birth. The benefit doesn’t apply if there’s a hospitalisation related to the birth". We hear there is a 12 month wait period, but that this can also lead to further rebates on home care (info @ April 2008).
Australian Unity - Reimburse up to $3,000 for homebirth. Website states "Home birth benefits available subject to prior application". Also includes 100% ambulance cover. http://www.australianunity.com.au/au/hins/pdfs/HospEssentials_JE.pdf Send letter applying for approval for homebirth coverage, and outlining midwife's schedule of visits, payment schedule, her AU provider number, etc. Check level of cover required; qualifying period 12 months for new members unless transferring from another fund where you already have 12 months membership. Contact: Jane Boag, Manager, Claims Analysis. Phone (03) 8682 4228 (info @ April 2008).
Defence Forces Health - Reimburse $790 for homebirth. 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. Provides private health insurance for family members of defence personnel; defence personnel themselves are provided with "free" medical care under Dept of Defence policy. From their website: www.defencehealth.com.au > Health cover > cover options > Top hospital and extras > midwifery "a benefit is paid for ante/post natal care, confinement and delivery at home or in hospital where the service is provided by a registered midwife in private practice recognised by Defence Health. If a doctor is required to intervene in the delivery, this benefit is not payable". 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 (info @ September 2007).
Grand United - Have paid up to $2,000 in the past. Contact them directly to ask if still reimbursing. Merged with Australian Unity October 2005. (see above info for Australian Unity who DO reimburse homebirth) (info @ April 2008).
HBA - supposed to be paying $1,500 but not easy to get. Contact Jenni Doherty (Customer Relations Manager) (03) 9937 4315 for further information. HBA had a pilot program on homebirth but are currently supposedly putting together a committee to work out whether they will cover homebirth as a service over the next 12 months (info @ May 2008)
HBF (WA Hospital Benefit Fund) - Commercial decision to stop reimbursement for homebirth ($1,400) in April 2008. Read more here.
Manchester Unity - Reimbursed small amount in the past, may pay something still. Contact them for further details. Website says covers for "Maternity and Home Nursing". (info @ April 2008).
MBF - Reimbursed $3,000 to $4,000 in the past for homebirths. Website currently details information including homebirth - contact them for details. (However used to cover nothing for the fees of the independent midwife if woman transferred to hospital, as they then covered the obstetrician fees instead) (info @ April 2008).
Medibank Private - Unclear - contact them via http://www.medibank.com.au/About-Us/Contact-Us.aspx
MIM Mt Isa Mines - Unclear re homebirth. Have paid for midwifery care in the past.
Mutual Community - Have reimbursed up to $1,500 (down from $2,000) for homebirth. The bill may need to be sent to a particular staff member in the policy section. Contact them for further details (info @ July 2008).
NIB - Reimburse small amount: 10 ante-natal visits and 10 postnatal - $13 back per visit; $220 back for the birth.
NRMA - Partial reimbursement before taken over by another company.
Queensland Country Health - say they cover homebirth and have this on their website, but Customer Service Manager says they do not reimburse for any midwife services without the midwife having indemnity insurance to cover her for birth.
SGIC - Have covered in the past; current status unclear. Their website says "SGIC Health Insurance Extras Cover Benefits help with day-to-day extras such as dental, optical and physiotherapy, which are not covered by Medicare and are rendered by a recognised provider of the Fund in Australia. SGIC Health Insurance Extras also helps cover alternative therapies and Wellness Programs (http://www.sgic.com.au/pub/sgic/health/extras_cover.shtml). You may like to inquire if this covers homebirth/midwifery by emailing them at https://www.sgic.com.au/Form/healthenquiry (info @ April 2008).
Teachers Federation Health - Have reimbursed up to $1,500 for homebirth. Benefits for home birth by a registered midwife payable under the Top Extra's cover, 9 month waiting period. Fund is only for teachers, or people who have been in the fund since a child and their parents are teachers. Covers birth, pre- and postnatal care. Birth amount not reimbursed if mum transfers to hospital. Email: TFH customer service office on info@TeachersHealth.com.au (info @ December 2007).
WA Government insurance office. - had a rebate system for midwives. One midwife had a client commence care in WA and then transfer to NT midway through and they paid for the midwifery care.
Updated by Birth Matters and Maternity Coalition SA, 10 October 2008