Insurance & Med-free Birth

With all of the crazy fun going on with Obamacare, I felt like this would be the appropriate time to share my fun insurance story from this morning!

I have BCBS of Louisiana.  It's a high deductible plan, which means that pretty much every single thing you can go to the doctor for is subject to that deductible first.  BCSB won't pay for anything until the deductible is met.  So, I decided to call them with a couple of questions this morning.  I realize that my policy could change for 1/1, but it might also stay the same.  As a former Girl Scout, I try to always be prepared.

So, my questions were regarding coverage/reimbursement for doula services and a breast pump.  Now, I still have my breast pump from Ethan, but on the chance that it craps out on me, I'd like to know that I won't have to come out of pocket another $250-300.  I even had a CPT code ready for them.  The lady was nice enough, although she had obviously never even heard of a doula before.  I explained that I knew this would be something I would pay for and then submit a claim, but I didn't want to waste any one's time if it wasn't going to at least be applied towards my deductible.  She comes back and tells me that the doula services are not covered at all, and that breast pumps are covered under the following:
- maximum $40 reimbursement for a manual pump that can be purchased at your local drugstore
- electric breast pumps must be purchased at a DME facility and will be subject to your deductible
- hospital-grade pumps will only be reimbursed if your physician has called ahead and obtained an authorization

Meh.  I get the breast pump part and can deal with it.  But, the denial of the doula service really annoys me.  The whole point of having a doula is to manage your pain through labor and delivery.  What I am trying to accomplish would save at least a thousand dollars for BCBS.  I had an epidural for Ethan.  The epidural and anesthetist fee that my insurance paid was around $1500-2000.  I'm asking for them to give me credit or pay a portion of $700.  Sounds like a bargain to me!  Yes, I could still end up with an epi, or even a C-section.  But, the doula services are designed to help avoid that.

So, why do I want to (try to) go natural?  A few reasons...
- When I had Ethan, I made it to 8 cm before I got the epidural.  Had I known how far I was (they checked me after), I might have changed my mind.  I was right there.
- The pure euphoria that (according to women who have been there) washes over you immediately following is something I want to experience.  Yes, it was amazing with Ethan; and no, I wouldn't give anything back.  But, I would like to try to experience this birth in a different way.
- The recovery (again, according to women who have been there) is MUCH smoother than with an epi or section.
- I DO NOT want to have another catheter.  I think that was a large part of the reason I felt like my bladder was going to fall out of my urethra for months.

There are downfalls as well.  If I were to be cut this time, there would be no anesthesia down there.  I've heard that is excruciating.  Thankfully, I did not need to be with Ethan, but that doesn't mean jack for this pregnancy.  One thing I am doing to assist in that area is squatting.  That is one of the best ways to prepare your body for childbirth.  Many women who go med-free even give birth in that position.  It opens your hips up and gives the baby plenty of space to squeeze through.  Studies have shown that women are more likely to tear or need to be cut when giving birth on their back.

But, enough of all that.  I am still educating myself and trying to use my time wisely to make sure know all of my options.  Having been through this before is super helpful, though.  I feel like my expectations are set at a more "real" standard because I know how my body acted for the last go 'round.  However, when it comes to pregnancy and childbirth, always expect the unexpected. ;)