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United approved my Gap Exception...so excited I just wanted to share.....

Posted by on Jul. 16, 2013 at 2:28 PM
  • 9 Replies

I applied for a Gap Exception for the birth center I will be using since they are out of network and just found out United approved it at in network level.  I had to ask the lady three times to confirm it.  I am so excited and got all teary and emotional just hearing this.  Now i just need to wait for the confirmation letter in the mail.

by on Jul. 16, 2013 at 2:28 PM
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Replies (1-9):
MorningValley
by on Jul. 16, 2013 at 3:00 PM

Congrats!  I hope I can get my stuff worked out I can have my home birth.

sm12
by on Jul. 16, 2013 at 3:10 PM

 Good luck to you too.  We are planning a homebirth too so that is next i hope happens.  Our birth center was full but made an exception but they are not sure about a homebirth since they only take two patients a month for a homebirth. 

Have you requested yoru appeal already?  if you need any help let me know, i have a lot of links to gap exceptions, etc saved.

Quoting MorningValley:

Congrats!  I hope I can get my stuff worked out I can have my home birth.

 

MorningValley
by on Jul. 16, 2013 at 3:16 PM

Oh I don't have that.  I'm on Medicaid which doesn't cover home births,  but the next coverage up is called CHP and they might cover it.

Azure
by Representative on Jul. 16, 2013 at 3:36 PM

That's great news! Congrats!

sm12
by on Jul. 16, 2013 at 3:43 PM

 Thank you!

NatyRod
by nataly on Jul. 16, 2013 at 9:36 PM
1 mom liked this
That's is great to hear... Yay! :)
Pappi
by on Jul. 16, 2013 at 10:05 PM

Yay! We're still trying to fight our insurance to cover my midwife as in-network as local in-network options don't attend homebirths and it's silly to ask me to go into SF for prenatal care, but even if she stays out-of-network she'll still be covered for 70%.

sm12
by on Jul. 17, 2013 at 10:02 AM

 So the in network providers the insurance company does provide does not do homebirths?   Well we have two providers that are in network but one was more than 30 miles from my home and the other was full so then they approved the birthing center that is out of network  at in network rates.  They were also full but because I am a repeat client they made an exception.    I wish you the best of luck, at least out of network pays at 70%, mine pays out of network at 50% but the out of pocket for out of network is $7500!  So this is definitely going to help.

Quoting Pappi:

Yay! We're still trying to fight our insurance to cover my midwife as in-network as local in-network options don't attend homebirths and it's silly to ask me to go into SF for prenatal care, but even if she stays out-of-network she'll still be covered for 70%.

 

Pappi
by on Jul. 17, 2013 at 9:13 PM

Something like that, they're in-network midwives nearby but don't attend homebirths. I live in the Bay Area so there are lots of options, but driving around (especially into SF) for appointments isn't exactly convenient and we're hoping our insurance will just make an exception since we're sticking with this midwife no matter what. Our in-network coverage is 90% and our midwife's fee is $4000, so the 20% difference is still a good chunk of change. That's a crazy out of network deductible you have :(


Quoting sm12:

 So the in network providers the insurance company does provide does not do homebirths?   Well we have two providers that are in network but one was more than 30 miles from my home and the other was full so then they approved the birthing center that is out of network  at in network rates.  They were also full but because I am a repeat client they made an exception.    I wish you the best of luck, at least out of network pays at 70%, mine pays out of network at 50% but the out of pocket for out of network is $7500!  So this is definitely going to help.

Quoting Pappi:

Yay! We're still trying to fight our insurance to cover my midwife as in-network as local in-network options don't attend homebirths and it's silly to ask me to go into SF for prenatal care, but even if she stays out-of-network she'll still be covered for 70%.

 



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