Frequently Asked...

Why Off the Grid Midwifery and Women's Health?

Off the Grid is a private practice that intentionally accepts a limited number of women for childbirth each month, helping to foster intimacy between you and your midwives, while providing the best individual care possible.

Kay Jackson, CNM, ARNP, and Tiffani Hoffman, LM, CPM, are experienced, compassionate professionals with a range of expertise between them. They both offer their services at The Birthing Inn for low-risk women who would like out-of-hospital birth. 

If the need arises, Kay can admit to St. Joseph's Hospital and continue midwifery support there. She has developed a reputation for safely providing hospital care to women who  desire a VBAC, and others who need or want hospital birth.

How do I make an appointment?

If you're not already registered with Off the Grid and desire midwifery services, make a complimentary Meet & Greet Appointment by clicking HERE.

Not having a baby, but looking for women's health care? Schedule an annual exam HERE.

Does Off the Grid take insurance?

Off the Grid Midwifery & Women's Health can accept BCBS, Regence, Premera, Group Health/Kaiser Options (non-Core plans), KPS, FirstChoice, LifeWise, Bridgespan, and Tricare Standard (we accept assignment, decreasing your responsibility by 15%). 

Keep in touch. 2017 is the year Off the Grid will finalize contracts with state and community health networks.

Insurance-speak. What does it all mean?

Insurance Plan: A contract between you and an insurance company. Choice of plans influences how women experience health care, so when you're able to make a choice between plans, please read the fine print and know your chosen plan's details.

Deductible: An amount the insured person pays before the plan pays its portion. A deductible can be tiny or huge, ranging from $300 to $10,000 depending on your plan.

Co-insurance: The percentage of an "allowed amount" insurance accepts as payable after your deductible is met. This is sometimes called a co-pay. It's basically a cost-share between the insurance company and the insurance customer. Traditionally this cost-share was an 80/20% split, with you paying the 20%, but many plans now have their customers paying much higher shares.

Patient responsibility: Deductible + co-insurance + any office visit co-pays = your responsibility.

Professional provider: A midwife, physician, or other type of practitioner. Individual plans differ regarding inclusion of chiropractic, naturopathy, and acupuncture and massage in coverage. Look for a plan that does!

Out-of-Network: If a desired provider is not within a plan's network, check your plan for these benefits or apply for an Out of Network Exception.

Facility Fee: The amount charged by a birth center, or hospital. X-ray and ultrasound services may also include a facility fee. A first choice of facility is not always part of a plan network--another matter to check on.

Open Enrollment: November to January of each year when you can change insurance plans based on preference, finances, and upcoming needs. Don't let it pass you by!

Global Maternity Care: If a single provider or provider-group handles pregnancy, birth, and post-birth care, insurance companies treat the pregnancy as one event and pay in a lump at the end of pregnancy. But if a woman changes providers, or has need for ultrasound, fetal monitoring, admission to hospital, or anesthesia, these and other items are treated as "extra" events billed and reimbursed separately. 

Self Pay: Individuals who opt to pay Off the Grid out of their savings account. Families who have no insurance contract, one that Off the Grid can't participate, or who have high deductibles and co-insurance/co-pay amounts can find it beneficial to use Off the Grid's prompt-pay discount for childbirth care. If you register for care with Off the Grid you'll be able to have our billing service help you compare options. If you'd like Off the Grid's billing service to do an evaluation of your options prior to registering, you can do so for a small fee.

What about safety?

The Birthing Inn is a 5 ½  mile drive to St. Joseph's Hospital, where Kay can continue your care. Kay and Tiffani partner with Dr. Tarek Baghdadi, Tacoma obstetrician who serves as back-up for many community midwives when help is needed.

Can I keep coming back?

Yes, please! See the section below on continuing women's health care Off the Grid.

Women's Health

Family Planning/Annual Exam/Preconception Advice

When she's not catching babies, Kay enjoys her role as a nurse practitioner (ARNP) who sees women for their usual annual gynecologic exam. This may or may not include a Pap smear and breast exam, or deciding how best to treat problems like painful periods, too much bleeding, too little bleeding, pain with sex, desire to get pregnant, and the desire to prevent pregnancy. 

Preconception counseling deserves its own appointment, as this is where we make sure you're taking enough folate before pregnancy, as well as look into any family history that might make genetic testing worth considering.

Kay: "One of the aspects of my work I've become ever more interested in is helping women figure out how to manage symptoms that come with life...as a woman."

  • depression
  • PMS/PMDD
  • pelvic pain
  • hot flashes
  • vaginal discomfort/infections/pain
  • polycystic ovarian syndrome (PCOS)
  • and a LOT of other stuff.

Make a Family Planning appointment with insurance or pay-as-I-go

Make a Preconception appointment with insurance or pay-as-I-go

Peri-Menopause and Menopause

The transition from one stage in life to another is a powerful one. Women's needs change from preventing or planning pregnancy to learning what an always changing body means to accomplish this time. A women's health appointment can include:

Evaluation of symptoms

Evaluation of hormone status as it relates to age 

Evaluation of family history

Creation of your healthy treatment plan for the year, and in years to come:

  • Continued PAP smears (or not)
  • Plan for breast health surveillance and when this will include mammograms
  • Plan for bone health surveillance
  • Information about hormone replacement 
  • Supplements/prescription hormones
  • Cholesterol and thyroid screening, as well as other screenings that can be reported to each member of your health team

Make a Women's Health Appointment:

Annual well-woman exam with insurance or pay-as-I-go

Evaluate hormones/menopause with insurance or pay-as-I-go