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Paying for care with insurance

We know financial planning is an essential component of preparing for the birth of your baby. We are here to help!

Confirm your Coverage Before Starting Care

  1. Call the Member Services number on the back of your insurance card. Let them know you’re checking coverage for care at Minnesota Birth Center, a freestanding birth center.
  2. Ask if your plan covers out-of-hospital birth and midwifery services, and be sure to provide our Tax ID to help them locate us: 27-1689468.
  3. Also ask if these partner facilities are in-network with your plan:
    • Quest Diagnostics (our primary lab)
    • Abbott Northwestern and United Hospitals (our transferring hospitals)
  4. If you find out that Minnesota Birth Center, the hospitals, or Quest Diagnostics are out-of-network, please reach out to our Billing Team—we’re happy to help you explore next steps.

Our Financial Policy for Insured Clients

Overview

At Minnesota Birth Center (MBC), insured clients are asked to prepay their insurance deductible by 32 weeks of pregnancy as a down payment toward anticipated costs for care.

If you plan to birth at one of our birth centers, MBC will also collect a down payment estimate for your baby’s care, based on your policy details.

If your care spans two calendar years (e.g., care in 2026 but due in 2027), we will collect the full deductible amount based on your due date.

How Prepayment Works

  • Funds are held as a credit in your MBC account
  • Claims are processed and payments drawn from your prepayment
  • Refunds are issued if you’ve overpaid at the end of care
  • Additional charges are billed if you’ve underpaid (e.g., co-insurance, co-pays, or uncovered services)
 
Why we do this
Prepaying the majority of your out-of-pocket costs reduces the burden of dealing with larger medical bills after your baby arrives and helps our small business by ensuring we receive prompt payment for services rendered.

What to Expect When Establishing Care

Financial Contract

Before your visit, you’ll receive a financial contract showing your prepayment amount (deductible only).

Payment Plan

  • Complete your contract no later than your second visit
  • Choose your payment method:
    1. One lump sum
    2. Multiple prepayments
  • All prepayments must be made by 32 weeks

Insurance & Coverage

MBC is contracted with every major insurance company in the state of Minnesota, including:

  • Aetna
  • Blue Cross and Blue Shield
  • Cigna
  • Health Partners
  • Medica
  • Preferred One
  • UCare
  • UMR
  • United Health Care. In addition, MBC is a participating provider with United for the VA Community Care Network program. 

However, every insurance company has many different plans, each of which cover services differently. Therefore, it is important that you call your insurance company to verify that MBC is in-network for your plan. Sometimes it is helpful to provide our Tax ID, which is 27-1689468. In most instances MBC is in-network, but it is still important for you to do this double-check.

MBC is not able to accept out-of-state Medical Assistance plans, Tricare, or Veterans Benefits.

MBC is happy to accept Medical Assistance (MA) plans from the state of Minnesota, as well as managed care plans through HealthPartners, BCBS, Hennepin Health, Medica and UCare. We cannot accept out-of-state MA.

Note that when you apply for MA you are usually put on “straight MA” through the state of Minnesota and later transferred to a managed care MA policy such as BCBS-MA or Health Partners-MA. Please notify MBC when this change takes place so that we do not submit claims for your care to the wrong location.

We will bill both of the policies – one as primary and the other as secondary. There are specific rules about which one is primary:

  • Any policy where you are the policyholder is primary (unless it’s a Medicaid policy). For example, if you have insurance through your employer, but you are also on your spouse’s policy through their employer, yours will be primary, and theirs will be secondary. 
  • If you are a dependent on all policies, the oldest one is primary. For example, if you have been on a parent’s policy since 2020, and then were added to your spouse’s policy in 2022, your parent’s policy would be primary, and your spouse’s will be secondary. 
  • Medicaid policies are always last.

It is important to make sure each insurance company knows about your policy with other insurers and that you clarify with them which one is primary. Not calling them and getting this settled can cause significant delays in claim processing and may result in you owing additional fees to MBC for claim reprocessing. 

If a newborn will be on two policies on which they are a dependent (e.g. one for each parent), and they both go into effect on the newborn’s date of birth, the policy belonging to the policyholder with a birthdate that falls earlier in the year will be primary. For example: if Parent A has a birthdate of April 1, and Parent B has a birthdate of November 15, Parent A’s policy will be primary and Parent B’s policy will be secondary, regardless of which parent is older. 

Don’t worry – insurance changes are common, especially when you have a big life event like the birth of a baby. Just let us know as soon as you have switched. We’ll need to know:

  • The new company name
  • The new ID and Group numbers
  • The effective date of the change. This is extremely important to ensure claims are submitted to the correct company.
 

Once we have updated information from you we will update your financial contract to reflect your new deductible and prepayment amount.

Yes! If you birth at the Minnesota Birth Center your baby will receive care from our team, and we will have claims to submit to the baby’s insurance. It is best to do some research in pregnancy to determine how you will insure your baby, as well as what paperwork the insurance company requires in order to add your baby to the policy. We ask that you give us the details of your baby’s coverage no later than 30 days after the birth so that we can submit his/her claims for care and so that this cost does not fully fall to you.

Working with Insurance

While MBC is contracted with many insurance carriers, we are not in-network for every insurance plan that carrier may offer. The network for a given plan may be determined by the insurance carrier and/or the organization offering the plan.

If you encounter this, please contact us at billing@theminnesotabirthcenter.com right away. This may be an administrative error that can be corrected.

We recommend that you call your insurance and ask. In some cases, an insurance carrier may allow you to be seen at MBC with in-network coverage if you send them a referral from your primary care physician. You may also need a retroactive referral from a pediatrician for your newborn, so make sure to ask about that as well.

Additionally, some clients have found that their out-of-network benefits are sufficient and decide to proceed with care knowing they will have increased costs.

Your insurance collects money to go into a pool of funds. If you have commercial insurance, that money is collected from you and/or your employer and is called a premium. It may be deducted from your paycheck. If you have state insurance, that money comes from tax dollars.

When you receive medical care, the provider charts what type of care you received and how long you were seen. Based on those details, the billing staff creates a claim using standardized procedure and diagnosis codes. That claim is submitted to your insurance company, typically electronically.

When your insurance receives the claim, they determine:

  1. If the service is covered by your policy.
  2. How they will cover the charge. They will first apply any discounts designated by the contract between them and MBC. Then they will determine if the remaining amount will be applied to your deductible or coinsurance (after your deductible is met). In some cases, they may apply a copayment instead of applying the charge to your deductible. For example:
    • MBC bills your insurance $500 for a procedure
    • Your insurance discounts $100 per the contract.
    • Then:
      • Your policy covers 100% of maternity care, so they pay the remaining $400. You have no patient cost. OR
      • Your insurance applies the entire $400 to your deductible (which you haven’t met yet) and pays nothing. You have $400 of patient costs. OR
      • Your insurance applies $100 to your deductible (which you had met all but $100 of), applies 20% coinsurance to the remaining $300, and pays 80% ($240). You have $160 of patient costs. OR
      • Your insurance applies a $25 copay to the visit. They pay $375. You have $25 of patient costs.

The insurance company will communicate the determination of coverage and send any applicable payments to MBC. All the information about how your insurance covered the costs of your care is available in the explanations of benefits (EOBs) sent to you by your insurance.

MBC will apply the insurance discounts and payments to the claim and, if there are patient costs, apply some of your prepayment or send you a bill.

We will bill both of the policies – one as primary and the other as secondary. There are specific rules about which one is primary:

  • Any policy where you are the policyholder is primary (unless it’s a Medicaid policy). For example, if you have insurance through your employer, but you are also on your spouse’s policy through their employer, yours will be primary, and theirs will be secondary.
  • If you are a dependent on all policies, the oldest one is primary. For example, if you have been on a parent’s policy since 2020, and then were added to your spouse’s policy in 2022, your parent’s policy would be primary, and your spouse’s will be secondary.
  • Medicaid policies are always last.

It is important to make sure each insurance company knows about your policy with other insurers and that you clarify with them which one is primary. Not calling them and getting this settled can cause significant delays in claim processing and may result in you owing additional fees to MBC for claim reprocessing.

If a newborn will be on two policies on which they are a dependent (e.g. one for each parent), and they both go into effect on the newborn’s date of birth, the policy belonging to the policyholder with a birthdate that falls earlier in the year will be primary. For example: if Parent A has a birthdate of April 1, and Parent B has a birthdate of November 15, Parent A’s policy will be primary and Parent B’s policy will be secondary, regardless of which parent is older.

No, your insurance does not know what you have or have not paid to MBC. Do not pay the birth center unless you receive a bill from MBC or are prompted by our staff.
Your insurance does not send bills. They will send you an Explanation of Benefits (EOB) or other informational communications. You do not need to pay MBC unless you receive a bill from MBC or are prompted by our staff.
It’s preferable that you wait until you receive a bill from MBC and pay us directly. We can’t guarantee that the amount your insurance says you owe is the most current balance.
There is not currently an approved CPT procedure code for nitrous oxide used during labor. The only existing codes are for dental use. MBC cannot submit a claim without a valid CPT code.

Cost & Payments

At MBC, we ask for a prepayment by 32 weeks. This amount is the lower of these two options:

  • Your remaining individual deductible plus a $750 down payment for baby’s care, OR
  • Your remaining family deductible.

The prepayment won’t exceed $4,000. If your deductible is higher than $4,000, you will likely have more costs after the birth.

How you can pay your prepayment

  • In monthly installments OR
  • In one lump sum payment any time up to 32 weeks

If you have HSA, HRA, or FSA funds that will total (or exceed) your prepayment, please provide documentation of your balance (and contributions if you’re building a balance). You won’t need to make a prepayment. Instead, we’ll bill you directly as costs come up, and you can pay using your funds.

If your HSA/HRA/FSA balance is less than the prepayment, we’ll reduce your prepayment by that amount.

Please do NOT pay your prepayment with HSA/HRA/FSA funds. These accounts require that all payments are tied to specific services and will not accept a prepayment as a qualifying expense.

Your prepayment is held at MBC and used to cover any costs your insurance applies to your deductible, coinsurance, or copays.
Remember, your insurance company doesn’t see how much you pay MBC or when. They apply your costs to your deductible as they happen. Your prepayment doesn’t automatically meet your deductible. Since most of your MBC costs happen during birth, your deductible may not significantly decrease until after your baby is born.

Payments don’t go towards your deductible—costs do. As your insurance applies costs to your deductible, it will decrease. Your insurance doesn’t know what you’ve paid MBC.

While we’d love to give you an exact quote, the amount that you will ultimately pay for your birth is dependent on the specific details of your insurance policy and the care you receive over the course of your pregnancy and birth.

If you have insurance, the best way to determine coverage is to call your insurance company and review with them each CPT Code listed in the Cost of Care Estimate here. Based on this information, your insurance can tell you which services are covered and which would count toward your deductible. Once you meet your deductible, you may have co-insurance, which means that you are responsible for a portion of costs up to an out-of-pocket maximum. This information should help you to calculate an estimate of your costs for care with MBC. In the event that additional care is necessary MBC will submit claims for your care accordingly.

Remember that the Cost of Care Estimate is for routine care at MBC. It does not include the cost of problem visits, non-routine care, labs (typically sent to Quest Diagnostics), or any care received at Abbott or United Hospitals or another facility outside of MBC. These businesses will bill you directly.

MBC’s providers are committed to practicing evidence-based care and will only assess, test, and treat when medically indicated.

Birth centers are usually a more cost-effective option than hospitals. Healthy people giving birth in a birth center avoid the routine use of advanced technology and interventions that may not be necessary for normal physiologic birth. Those giving birth at Minnesota Birth Center receive skilled, continuous care and labor support from our midwives and nurses. Research has shown that continuous labor support and care in a freestanding birth center decrease the need for costly medical interventions like epidural anesthesia and cesarean sections.

Read “Outcomes of Care in Birth Centers: Demonstration of a Durable Model” in the Journal of Midwifery and Women’ Health.

Unfortunately, FSA funds can only be used for services that occur during the year in which they are available. Because a prepayment is not a service for which we can provide information for FSA reimbursement, your funds can’t be used this way. This only applies to FSAs with funds that expire. It does not apply to HSA funds or other types of medical expense accounts that allow you to keep your funds.

Because HSAs and other medical accounts usually need proof you paid for eligible medical expenses, please don’t use them for prepayments. Prepayment funds often aren’t applied to medical services until the birth, and we can’t provide retroactive bills. Instead, please provide documentation of your HSA balance, and then we will bill you. (see above re: The Prepayment)

We are very flexible! Just let us know what your situation is, and we will work with you. If your balance is too low and you don’t anticipate it increasing, we will reduce your prepayment amount by the balance in your FSA/HSA/HRA account. If you are building your balance, you can send us documentation of those deposits. If your employer is going to reload your funds at a later date, you can send us anything that documents that they commit to that deposit. We want to make sure you get to use your hard-earned funds whenever possible.

Great question. Remember that the money prepaid to MBC is held in your MBC account as a credit (sort of like putting money in a “piggy bank for birth”). MBC makes withdrawals from that “bank” as we process your claims for care. It’s only when a claim is processed that you’ll see it reflected on your insurance website. If you are set up with a pre-payment plan at MBC, you shouldn’t receive statements (bills) from us, but you may receive Explanation of Benefits statements (EOBs) from your insurance company, explaining how claims are being processed and how much you owe thus far. EOBs are not bills, so do not pay them! At the end of care, we’ll submit a final claim for your birth – any excess you’ve prepaid to us will be refunded to you. For any amount still owed we will send you a bill.

It is important to confirm that your insurance covers genetic testing as the out-of-pocket cost can be very high. Your insurance may not cover the test at all, or may cover it only if you have a family history risk factor or are above a certain age.

MBC most commonly uses Quest Diagnostics for genetic testing. If you plan to opt for this testing you should confirm that Quest is in-network with your insurance policy. We also recommend using Quest’s QNatal Cost Estimator to estimate what your out-of-pocket costs might be for the most common Quest genetic test.

On occasion Progenity may alternatively be used if Quest is out-of-network. Progenity will often accept a “prompt pay” discount if the test is not covered by your insurance. Contact the number on your Progenity bill for details.

Receiving a Bill

Your prepayment, as per your contract, isn’t your total bill. It’s based on your remaining deductible and/or a down payment for your baby’s care. Your costs might be more than your prepayment if:

  • Your insurance added coinsurance or copays for you or your baby, on top of your deductible.
  • Your deductible was over the $4,000 prepayment cap.
  • Your baby’s costs for care exceeded the $750 down payment amount (if that’s how your prepayment was calculated – see above).
  • Your pregnancy crossed your policy renewal date, so you had charges applied to two years’ deductibles.
MBC bills you only after your insurance finishes processing your claims. If your coverage isn’t what you expected, you’ll need to reach out to your insurance to find out why. MBC billing staff can provide claim details, if needed. We can’t resubmit a claim unless it’s determined we made a billing mistake. If your insurance determines they made a mistake, they will reprocess it, and MBC will receive a correction. Ask your insurance about their reprocessing time and let us know.

You may not have received a bill yet for a variety of reasons:

  • Your insurance may have paid for your cost of care in full.
  • Your claims may still be pending with your insurance.
  • You made a prepayment, and it has not been exhausted yet.
  • You have not completed care yet. (see below)

If you prepaid, MBC will hold your billing until your estimated due date. After that, if your prepayment is used up and you still owe a balance, we’ll start billing you. If you have prepayment funds left, we’ll wait until after your six-week postpartum visit, and your claims are processed. Then we’ll contact you about a refund. Because submitting claims and processing by insurance takes time, this might not happen until 4-8 weeks after your final visit.

Each procedure and service is billed to your insurance as it occurs, with the exception of routine prenatal visits. When your insurance assigns patient responsibility to the charges, it will depend on how you handled your prepayment as to whether or not we bill you right away. (see above re: The Prepayment) Your routine prenatal visits may get bundled with the global maternity charge (see top of this document for explanation). In all cases, the bulk of the costs for your care will not get billed to your insurance until after the birth.

Transfers & Changes in Care

Once we receive confirmation of your transfer, and all your care at MBC is complete, we will audit your account and make sure your care has been appropriately billed to your insurance. If you haven’t made a prepayment, you will start to receive bills from MBC if/when your insurance applies costs to patient responsibility. If you have made a prepayment and have a credit with MBC, we will recheck your deductible and the status of your claims to determine if a refund is appropriate and contact you accordingly.

Generally speaking, there are 4 major components to billing on the date you give birth:

  • professional fees for attending your birth (billed in your name)
  • facility fees for you (billed in your name)
  • professional fees for caring for your baby (billed in baby’s name)
  • facility fees for your baby (billed in baby’s name)

If you transfer during labor and MBC midwives continue to care for you at the hospital, the professional fees for you will be billed by MBC.

If you transfer into the care of providers at the hospital, the professional fees will be billed by the hospital provider group, not MBC.

In either of these cases, the facility fees for you may be split between MBC and the hospital, or billed entirely by the hospital, depending on how much time you spent laboring at MBC prior to the transfer.

In both cases, none of your baby’s care will be billed by MBC.

We try to keep track of hospital births to expedite refunds of prepayments, but it never hurts to give us a call or email to get that going.

Please email billing@theminnesotabirthcenter.com if you haven’t heard from us yet. We will expedite the process of getting your refund to you.

Still Have Questions?

Not to worry – the MBC Billing Team is happy to help. Send us an email at billing@theminnesotabirthcenter.com.