Alice Beard of Bethesda is one of many women who prefer to have their babies at home. And home is exactly where her daughter, Sabrina, made her maiden appearance 15 months ago.
The bill for that memorable event was $1,200 -- $1,000 for midwife Jan Epstein, $200 for attending nurse Ann Borobaby. Alice routinely submitted the two bills to Blue Cross and Blue Shield of the National Capital Area, through her husband Robert Dowlut's group health policy. And Blue Cross routinely paid up.
But a few weeks ago, more than a year after Sabrina's birth, Blue Cross asked the parents for a refund of $160 (80 percent of Ann's fee). Its explanation: nurse's fees for home births are not covered under Robert's insurance policy.
Blue Cross acknowledges that it made a mistake in paying Ann's fee in the first place. It says it paid the claim originally because Ann was erroneously logged into the computer as a doctor, not as a nurse.
"I hope you will appreciate our position," said James J. Stroker, assistant to the manager of the Blue Cross public relations department. "While the error was ours, we feel it is our responsibility to rectify it by requesting a refund for the incorrect payment made."
Alice and Robert are still trying to decide what to do. On the one hand, they feel that asking for a refund more than a year after a mistake was made shows a lot of gall. On the other hand, they realize that Blue Cross could cancel their policy if they refuse to cooperate.
Alice says the couple is "leaning toward not paying, just because this whole thing is so outrageous."
I'm a little surprised at Blue Cross -- for two reasons.
First of all, they can't seriously expect Alice and Robert to return the $160 after all this time. Yes, it's regrettable that a mistake was made. But $160 is no king's ransom, especially for a company as big as Blue Cross. B.C. should just chalk the loss up to experience and let it go.
But I'm especially surprised that nursing care for home births isn't covered.
Of course, Blue Cross sells all sorts of group plans to all sorts of employers, and not every plan offers every benefit.
But nursing care during a hospital birth is covered under every plan Blue Cross offers. If Blue Cross doesn't cover nursing at home births, there's going to be one surefire result. Mothers like Alice will be much more reluctant to have a nurse present when the big moment arrives.
If trouble occurs during the birth, or shortly afterward, a nurse on the scene could prevent it from getting worse. But without a nurse present, the odds of mother or baby needing emergency care go up sharply. So do medical bills.
Blue Cross may be technically correct in seeking the return of its $160. But in the long run, the company's position would assure larger medical bills and poorer medical care for home-birth mothers and babies. And that's no bargain at all.