|Insurance and Payment|
On this page:
Insurance we accept:
If your insurance company is not listed, contact us and we will attempt to obtain a contract with them.
Getting Medicaid to help cover your costs
Medicaid is a government-sponsored health care assistance, paid for by taxpayers. Medicaid (also called "Salud!," which is Spanish for "health") can provide no-cost or low-cost health insurance coverage to New Mexico's uninsured and financially eligible citizens. Even if you didn't qualify before getting pregnant, you still may qualify for maternity coverage.
Click on the links below to contact your local Human Services Division (HSD), apply for assistance, or to learn more:
Insider tip: Seeing a caseworker in person is often the fastest and easiest way to complete the process. Try to arrive just before they open in the morning so you'll be seen first. Later in the day you may wait for hours.
Start the application process immediately if you think you may qualify for Medicaid. It can take 45 days for coverage to begin, and while you wait, your appointments may not be covered by Medicaid. You can start your care at Dar a Luz any time, with or without insurance, but you must be prepared to pay for those visits if Medicaid denies the claims.
If you qualify, then you will be asked to select a Managed Care Organization (MCO) to administer your care. We accept all four MCOs (BCBS, Lovelace, Molina, Presbyterian). However, if you choose Molina Salud, you will pay less out-of-pocket at Dar a Luz, because we are completely in-network with Molina Salud. (See below, "More about insurance networks.") If you're with a different MCO, you can request a change by calling the Insure New Mexico! Solutions Center at (888) 997-2583.
The cost of maternity care at Dar a Luz
We are happy to provide an estimate of your out-of-pocket costs for maternity, birth and newborn care at Dar a Luz after you have attended an orientation. Your estimate will include a non-refundable registration fee (due at your first prenatal visit), and your portion of the professional fees (based on your insurance coverage) and our birth center services fees (you will pay these facility fees directly to us and you may request your insurance company to reimburse you). Sometimes newborn care is a separate fee -- it depends on your insurance.
Remember, we can only provide an estimate, and we will settle your final bill with you several weeks to months after your baby comes. It depends on how much and how quickly your insurance company pays its portion.
We calculate your out-of-pocket expenses based on your insurance coverage. If you sign up with us, we will collect your portion from you by week 36 in your pregnancy. You can make payments or pay it all at once. We are flexible in our payment plans, so email Shelley, Office Manager, if you have a special situation.
More about insurance networks, our fees and your estimate
Below is a brief description of how insurance payments and your payments work together to cover our fees. For detailed and customized information, please come to one of our maternity orientations and request a verification of your insurance benefits.
The first thing to know is that our fees fall into two categories with most insurance companies: In-Network and Out-of-Network.
Our professional fees are in-network with most insurers and your out-of-pocket portion of these fees is determined by your insurance coverage. In most cases, this means you'll receive the same insurance coverage you would receive with other in-network providers such as doctors. Professional fees are one-on-one midwifery fees for obstetric, newborn and gynecology care.
If you are getting gynecology services with us, you can expect to pay the same as you would with any doctor. All of our gynecology services are in-network with the insurance companies listed above in the "Insurance we accept" section.
If you are getting maternity services with us, in many cases you will pay less for the part of your care that is in-network, because our fees are much lower, and all of our services are out-patient, meaning you don't have to pay a special hospital admission copayment and other admission fees. Your baby won't have hospital admission fees or nursery care fees at Dar a Luz, and his or her first month of care is included.
A list of our in-network insurance providers is above, in the section called "Insurance we accept."
Note: Gynecology services are always in-network. This section is for maternity clients only.
We have two fees for prenatal care that usually are considered out-of-network: Registration and Birth Center Service Fees. These two fees together are usually the largest part of your out-of-pocket expense at Dar a Luz.
No matter what insurance coverage you have, at minimum, you will pay our registration fee at your first prenatal visit. The registration fee is a non-refundable fee that goes to pay for the hard costs of running Dar a Luz. It is not an insured cost and cannot submitted to insurance for reimbursement. You may, however, use a health care savings account Visa card to pay this fee if your plan allows it.
Our birth center service fees (also known as Facility Fees) are out-of-network with most insurance carriers. At this time, the only insurers who pay our birth center service fees as if they are in-network are: Aetna, Cigna, Molina Salud, and BCBS Salud. Our birth center service fees are out of network with all other insurance companies.
Because insurance companies ignore, lose, short-pay or deny out-of-network claims so often, we must collect them from our clients directly. This is true even if you have out-of-network benefits. We do not submit out-of-network claims, but we can provide the documentation you may need to seek reimbursement from your insurance company.
Our Birth Center Services fees cover such services as your due-date reservation, the midwives being on-call to support you, birth classes, bonus classes, educational materials, support groups, 24/7 midwife access, administrative research and review, data entry, physician consultations, birth supplies, your RN birth assistant, room & board during labor and birth, and home visit travel. These services are bundled into the birth center service fee.
Come to one of our orientations to find out more about these fees. If you need to know before coming to an orientation, email Shelley, Office Manager.
Contacting your insurance company
There are many reasons to get in touch with your insurance company when you find out that you are pregnant.
First, if you are coming to Dar a Luz for care, it is always helpful to call and write letters to your insurance company telling them why covering our services is important to you, explaining to them how much money Dar a Luz will save them over a hospital, and asking them to bring our facility fees into their network. This is a grass-roots effort we've been working on for several years and we need all the help we can get!
Second, you should know what your insurance does and doesn't cover, what they need from you and what you can expect to pay.
When contacting your insurance company about your coverage at Dar a Luz, keep these important points in mind:
Please contact us with any questions or concerns.
We accept payments by cash, credit card, FSA/HCA spending account card, and check.
Gynecology clients who are self-paying (uninsured) receive a discount if the bill is paid at the time of the visit.
Prenatal care and birth services clients: Full payment is due by the 36th week of pregnancy unless other arrangements have been made with the office manager.
We offer discounted fees to our clients who have been approved for Medicaid maternity care (see "Getting Medicaid" above).
Payment plans are available and we will work with you on an individual basis to the best of our ability. Find out more about our fees by emailing Shelley, Office Manager.