FAQ Paying for Care

Midwifery services
Appointments
Safety and Outcomes
Paying for Care
Set up and Clean up

Sunrise Midwifery offers a competitively priced, cost-effective, and reasonable fee.

We believe that quality of care, access, and choice do matter in health care.

Cost of care

The global midwifery package fee is

$3500

This includes: all prenatal, birth, and postpartum care, plus direct access to your midwife.  Additional fees include: billing services, some medications, and your birth kit.

A financial hardship discount is applied to client with Medicaid as their primary insurance.

Fee schedule

Payments can be made as:

Three payments:
$1000 at intake
$1250 at 20 weeks
$1250 at 36 weeks

One payment:
$3325 (5% discount) at intake

Clients with DSHS as primary insurance:
$500 at intake
$500 at 20 weeks
$500 at 36 weeks

The complete Financial Agreement is available at a consultation.

Payment methods

We accept cash, check, money orders, credit cards, HSA cards, and PayPal.

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More detailed explanations and information

Care from Licensed Midwives is covered by private insurance.

Washington law requires insurance companies to reimburse for midwifery services from a Licensed Midwife.  Your policy and deductible determine how much your insurance will cover.

Sunrise Midwifery is NOT a contracted or preferred providers with ANY insurance.

We choose to not contract with insurances simply because insurance reimbursement rates are so incredibly LOW with onerous paperwork requirements.   Our care is based on a low-volume, high-attention style of care that does not allow for the quantity of patients to make up for the time spent.

You can request an out-of-network exception for midwifery services.  There are NO licensed midwives in the Tri-Cities, Yakima Valley, and Yakima areas that are in-network with any insurance company.

You will be reimbursed for the fees paid to Sunrise Midwifery according to your insurance plan.

Since you have pre-paid the package fee directly to the midwife, you will be reimbursed by your insurance after the birth and the normal 10-16 week billing cycle.  The amount you are paid is what the midwife would have been paid.

Maternity billing is done after the baby is born because insurances like to be billed only once.  That is, all the care provided during pregnancy, labor, and the first 24 hours after birth get bundled together and one bill for all that is sent.  So your pregnancy care will be applied to your deductible during the month/year that you deliver the baby, NOT during pregnancy or when you start care.  All labwork and ultrasounds are billed at the time of service by the lab or office.

An excellent billing service is available.

Especially Births Medical Billing will process all claims, make all necessary pre-authorization requests, estimate your insurance reimbursement, and answer your questions via phone or email. Within a month of starting care with Sunrise Midwifery, you will have an estimate of the amount your insurance will end up paying so you can plan your finances accordingly.  The $275 fee is paid directly to the billing service. It must be paid before the claims will be submitted to your insurance company.

Medicaid/DSHS/ACA does cover homebirth.

Medicaid DOES cover homebirth and midwifery care with contracted providers.  Most doctors and CNMs are contracted providers but Sunrise Midwifery is NOT a Medicaid provider.   Please read the larger discussion below.

Sunrise Midwifery charges a $1500 package fee to clients with Medicaid as their primary insurance.

All labs, ultrasounds, and medical consultations are covered by Medicaid.  We can also provide a Confirmation of Pregnancy for free in order for you to apply for coverage.

TriCare/Military/federal plans do not cover Licensed Midwifery care.

TriCare does not cover Licensed Midwives but does cover Certified Nurse Midwives. It would require a change to federal law in order for your LM to be paid.  As a supporter of our troops and veterans, a payment plan that works for you can be reached.

Why is Medicaid unsustainable?

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Contact your legislators

Unfortunately, we are not able to accept Medicaid as we had been planning for 2016 and do not foresee changing this policy.  We have reviewed our insurance and billing policies and have determined that we cannot begin contracting with any Medicaid HMO.  If you have Medicaid as your primary insurance and you are desperately seeking midwifery care, please talk with the midwife about discounted fees.

We recognize that this reduces access to midwifery care.  Unfortunately, access to midwifery care is even more limited when midwives cannot practice due to excessive overhead costs and time associated with insurance billing.  The amount that your Medicaid HMO pays to the midwife is always much less than the cost of care, in our case, approximately $1800 (out of the $3500 midwifery fee) is paid for a course of care, then we have to pay $200 to the biller.  A small practice based on low-volume of clients with high-time involvement cannot survive on that rate.

There is more to the story.  The state pays each HMO to supervise the insurance care for each pregnant mother.  This amount is several times the cost of midwifery care package fees.  But the full midwifery fee is NEVER paid by that HMO.  Where do those thousands of dollars go??  Not to the providers.  Not to more maternity care for more mothers.

This problem exists for birth centers also.  At this point, the HMO payments for the birth center fee does not cover the operating costs.  Not only does the birth center not make any money, it actually ends up paying for the birth to occur there!  This is not sustainable and will reduce access to care.

If you are upset by the lack of access to midwifery or maternity care, please contact your HMO and your legislators.  Tell them this situation is unacceptable.  Tell your friends and family to tell them this situation is unacceptable.  Have them call me to find out why YOU do not have the benefit of midwifery care via Medicaid!

The DOH has studied the cost benefits of midwifery care by licensed midwives…and it is significant, millions of dollars annually.  If more midwives provided care more often to more mothers, the state would save huge amounts of money.