How to understand health insurance

This page is for informational use only. It is ultimately your responsibility to understand your benefits.

The best place to start is to call your insurance company (the Member Services phone number on the back of your insurance card) and ask them the following questions:


Insurance FAQ's

Is Willow Midwives in network provider with my plan? How are birth and facility fees covered at their clinic, hospital and birth center?

Sometimes they will ask for our address and/or NPI number. Our address is 3033 Excelsior Blvd, Suite 585, Minneapolis, MN 55416. Our Facility NPI # is 1750771143.

Please explain my eligibility and benefits for pregnancy and birth. What is my deductible? What is my co-insurance percentage?

The amount you pay for your pregnancy and birth is determined by these two amounts. Your deductible is the amount you will pay out of your pocket before your insurance starts paying for anything. Your co-insurance amount is the percent AFTER THAT, that you will be responsible for. If your plan is not in-network with us, be sure to ask what your out-of-network benefits are. SOMETIMES THIS IS STILL A GOOD DEAL DUE TO OUR OVERALL COST BEING LOWER THAN AT THE HOSPITAL.

Are pregnancy labs, ultrasounds, and other pregnancy procedures covered under my plan? Are they subject to my deductible?

MN law requires health plans to cover routine prenatal labs.      

How does the deductible work?

The typical billing for prenatal care includes one bill for your initial visit, then from your 2nd visit until your postpartum visit you will get a "global bill" which is like a package of care.  Your baby's care will be billed separately and as another person with their own deductible.  This is true regardless of where you have your baby.


Frequently
Used Terms

EOB:

Explanation of benefits. Not a bill, but an explanation to you about what was billed by us and what they plan to cover.  After insurance processes, we will send you a bill.  If you have your baby at our birth center, there will be an EOB for your care, for your baby’s care and for the facility in which the baby was born. (Birth Center OR hospital).

Deductible:

The amount that you will pay out of your own pocket, each year, for your care before the insurance company will start paying for services.  Covered services are usually reimbursed at a reduced and contracted rate which affects the use of your deductible.

Co-insurance:

The percentage of your bill that you will be charged after you pay the deductible.

Out of Pocket Maximum:

The amount you are obligated to pay for services rendered. This includes your deductible and co-insurance payments. Each amount is different for in-network and out-of-network services.

In or out-of-network?

We have IN-network contracts with all major insurance plans.  If you have an employer-based plan, please check with your employer requesting the inclusion of the Birth Center (sometimes they will grant an “in-network exception for out-of-network care” or a “waiver exception”).