Under my insurance policy, _______________ a midwifery practice/certified nurse-midwife/certified midwife (choose one) in _____________, is not currently an in-plan provider.  I am writing to request an exception to this and authorization for full coverage for my prenatal, delivery and postpartum care by this practice/midwife. In addition, I would like to request that ______________be included as part of the Plan's network for future obstetric and gynecological care.

Certified nurse-midwives/certified midwives (choose one) are highly trained licensed professionals who are experienced in providing clinical care, health education and follow up for mothers and their families. Midwifery views childbirth as a natural event and therefore uses technological and invasive interventions only when medically necessary. Midwifery care is a safe, cost-effective and patient-responsive health care alternative, and produces good outcomes and high levels of patient satisfaction. A study examining the differences in the practices of family physicians, obstetricians and certified nurse-midwives found that the midwives had lower cesarean section rates and used significantly fewer resources than either group of physicians.*

I would like to obtain your authorization for an exemption to cover my care by_____________ at the rate equivalent to seeing a physician and to request that the practice/my midwife be included in the provider network for the following reasons:

• I believe that I should have the right to choose a certified nurse-midwife to provide my care. The midwifery philosophy of care is consistent with my philosophy about pregnancy, labor and delivery and postpartum care.
• I want a non-interventive childbirth with competent prenatal, labor and delivery assistance and postpartum follow-up. Care by ____________ (midwife=s or practice=s name) and delivery at ___________ hospital provide this option.
• The costs associated with midwifery care are lower, because there are fewer technological     interventions, fewer cesarean sections and other surgical procedures and shorter hospital stays.
• I want to breastfeed my newborn immediately after birth and have total support in assuring breastfeeding is well under way before I go home. _____________ offers this support, as well as continuous breastfeeding advice for my child's first weeks of life.
• I have been a patient of another provider and have not been satisfied with the care.
• For your information, ________________ currently contracts with the following insurers: ________________________________. (List all insurers they contract with including Medicaid, Medicare, etc.)

I am now (   ) months pregnant and would like to transfer as soon as possible to the care of _______________.  I sincerely hope you will grant me an exemption to obtain care from _____________under the plan, so that I can have a well monitored, safe childbirth that is also responsive to my needs. I know that ______________ Health Plan is committed to patients and providing high quality, responsive and cost-effective care.

For further questions about the midwifery by _______, please contact ______, at (xxx) xxx-xxxx. Thank you for your consideration.

(Your name, address, phone number)

Additional Resources

Birth Center Letter

Home Birth Letter