https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Mon, 06 Apr 2026 13:38:57 +0000 https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-936354 Tue, 16 Jul 2013 15:57:05 +0000 daniellemybelle 936354@https://boards.hellobee.com/ <p>UPDATE: I found out the OB practice that would perform my C-section, if I had to have one. I called and confirmed they are in-network. Yay! I also called the anesthesiology department at the hospital and left a message. We'll see what they say. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935993 Tue, 16 Jul 2013 14:06:37 +0000 buffalove 935993@https://boards.hellobee.com/ <p>@daniellemybelle: agreed! it was a pain in the butt with all the phone calls, but i will say that no one (BCBS or Dr) ever gave me grief about it. it clearly happens all. the. time. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935973 Tue, 16 Jul 2013 14:01:57 +0000 daniellemybelle 935973@https://boards.hellobee.com/ <p>@buffalove: I'm so glad to hear you were able to work it out with BCBS! That gives me hope in case that happens... though it still sucks that anyone has to do that level of runaround after the fact to get it taken care of! </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935966 Tue, 16 Jul 2013 14:00:35 +0000 buffalove 935966@https://boards.hellobee.com/ <p>@daniellemybelle: this is exactly what happened to me! the anesthesiologist was out of network. I received his entire bill but after a few phone calls, I worked it out. BCBS WILL cover it b/c they realize you did not have a choice in the matter, but it'll take some phone calls to both BCBS and the doctor's office - the claim has to be submitted in a certain way. BCBS sent the check directly to me, and I remitted it to the doctor's office. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935807 Tue, 16 Jul 2013 13:15:47 +0000 daniellemybelle 935807@https://boards.hellobee.com/ <p>@sarbear: You would think that would be the case across the board! But since they were intentional to warn me about it, I'm pretty sure that's not how its going to work. :( I am going to call them back though to clarify. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935736 Tue, 16 Jul 2013 13:01:56 +0000 GrapeCrush 935736@https://boards.hellobee.com/ <p>I would think your insurance would have an 'out of control' clause for instances like this. you aren't going to sit around waiting for an in-network anesthesiologist/OB if you do end up needing either an epidural or C-section. I work in insurance(not BCBS) and so long as the hospital is in-network, we pay all claims for out-of network providers seen by a member(anesthesiologist, ER doc, other docs) as in-network, because you have no choice(control) over who sees/treats you. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935670 Tue, 16 Jul 2013 12:46:53 +0000 Adira 935670@https://boards.hellobee.com/ <p>@daniellemybelle: You're being smart. It never even occurred to me to check this! I hope you get it all figured out so you won't have to be stressing when you're in labor! </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935654 Tue, 16 Jul 2013 12:43:52 +0000 daniellemybelle 935654@https://boards.hellobee.com/ <p>@Adira: I'm planning to not have an epidural or C-section either but you never know! We don't have the money to pay large hospital bills, so I am trying to have my ducks in a row. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935651 Tue, 16 Jul 2013 12:42:55 +0000 daniellemybelle 935651@https://boards.hellobee.com/ <p>@MrsCB: That's a good idea about the anesthesiologists. Seems unnecessary but maybe it will give me peace of mind! There are no OBs in my practice - I see midwives. If I need a C-section or any other emergency treatment that requires an OB, it will just be whoever is on call for them.</p> <p>@joyjoy: @MamaG: Glad to hear that I'm not the only one who has gone through this! I will definitely ask my midwife's office about all of that. I have a feeling they might be more helpful than the hospital main line I was sent to. Thanks! </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935650 Tue, 16 Jul 2013 12:42:52 +0000 Adira 935650@https://boards.hellobee.com/ <p>@daniellemybelle: Yeah, the whole thing seems sketchy. I didn't even check at all - I just assumed everything would be fine, and it was! But I also didn't end up getting an epidural or having a c-section, so that probably helped. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935624 Tue, 16 Jul 2013 12:36:14 +0000 daniellemybelle 935624@https://boards.hellobee.com/ <p>@Adira: I know BCBS covers a lot of folks but it freaks me out a little to think, what if they don't and we are stuck with the bill afterward? And what if we check while I'm at the hospital and about to get a C-section, and they are like, "Oh, no, this guy's not covered" - what do I do then, haha?</p> <p>@Cara M. 17: @TheReelDeal: I am going to call BCBS back and see what they say. I also tried calling my midwives' office because they might be more helpful than the hospital, but they didn't pick up. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935622 Tue, 16 Jul 2013 12:35:56 +0000 MamaG 935622@https://boards.hellobee.com/ <p>The anesthesioligist and OB (if used) will be seperately from the hospital. They could be out of network. I tried to research the anesthesiologist part before going to the hospital and failed. I couldn't find any that were in network in my area. I got my epidural and hoped for the best. He was ultimately in network but I simply gave up (I knew I would want an epidural and knew that I would be willing to pay whatever was necessary if I was in pain).</p> <p>You might ask the hospital more specific questions like who the oncall anesthesiologist is (or what company they are contracted with) and same for the OB. That is unless your midwife will call for a specific OB if needed. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935617 Tue, 16 Jul 2013 12:34:39 +0000 joyjoy 935617@https://boards.hellobee.com/ <p>I had Anthem (BC of California), and my policy stated the same thing - I had to verify that not only the hospital was in network, but the physicians as well. My OB practice was really great, though, in making sure they only sent me to specialists (u/s, etc) that were in network. If you used a midwife from the practice, you would just pair up with an OB to be called in an emergency so that everything remained in network. Maybe you could do something similar? Find an OB in-network that would be willing to be your emergency back-up doctor? </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935616 Tue, 16 Jul 2013 12:34:37 +0000 ShootingStar 935616@https://boards.hellobee.com/ <p>Your hospital probably has a set of anesthesiologists they work with. You can find out who they are and check to see if they accept BCBS. Also, if you needed a c-section, wouldn't it be with the on-call OB from your practice? If so, the whole practice should be in-network for your insurance.</p> <p>BCBS is such a huge carrier, it's highly unlikely that any of the providers don't accept it. But on the off chance that someone doesn't, than you would just be responsible for what they charge you, not the entire bill. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935612 Tue, 16 Jul 2013 12:31:58 +0000 Adira 935612@https://boards.hellobee.com/ <p>@daniellemybelle: Honestly, I would try not to worry about it. BCBS covers soooooooo many providers, it seems unlikely you'd get someone out of network. But maybe you can put your husband in charge of checking when you're actually in labor so you can just focus on birthing your baby. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935611 Tue, 16 Jul 2013 12:31:30 +0000 regberadaisy 935611@https://boards.hellobee.com/ <p>@mediagirl: Ditto. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935610 Tue, 16 Jul 2013 12:31:27 +0000 TheReelDeal 935610@https://boards.hellobee.com/ <p>@daniellemybelle: You would, that's why I have to wonder if there is another system in place for births? Where do you live? </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935609 Tue, 16 Jul 2013 12:30:43 +0000 Cara M. 17 935609@https://boards.hellobee.com/ <p>@daniellemybelle: I would call back the insurance, ask to speak with a supervisor, and explain what the hospital has told you. Ask what others have done previously as it's not realistic for you to ask every doctor, nurse, surgeon, etc that walks into your room whether they are in network with BCBS. I imagine they don't even know off hand. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935601 Tue, 16 Jul 2013 12:26:24 +0000 daniellemybelle 935601@https://boards.hellobee.com/ <p>@TheReelDeal: I tried doing that but it stressed me out. :( If I have an epidural, won't I just have to take whoever is on call? And same for a C-section? </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935594 Tue, 16 Jul 2013 12:24:46 +0000 TheReelDeal 935594@https://boards.hellobee.com/ <p>That's really weird. I've never heard of that before and I worked in health insurance for a number of years. You should still be able to look up physicians that are considered in network online and I guess make sure those are the only ones you see??? It seems really odd to task a woman giving birth with that burden. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935590 Tue, 16 Jul 2013 12:23:17 +0000 daniellemybelle 935590@https://boards.hellobee.com/ <p>@TheReelDeal: @MamaMoose: @Cara M. 17: That's not the case apparently. See above. :( </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935589 Tue, 16 Jul 2013 12:22:42 +0000 daniellemybelle 935589@https://boards.hellobee.com/ <p>I just called the hospital, and they verified what BCBS said. The hospital is not in-network per se. All of their providers are individually contracted and may or may not be in-network with BCBS. The lady said specifically, "It's not up to us, it's up to your insurance company." </p> <p>So essentially, I could be treated by someone who is out-of-network at the hospital and it will not be covered. Sigh. What to do now? </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935587 Tue, 16 Jul 2013 12:22:35 +0000 TheReelDeal 935587@https://boards.hellobee.com/ <p>Don't worry. If the hospital is in network so are all the physicians. I think she was just letting you know that if you have any other visits planned, not sure what, to make sure to go in network. Birth is basically one big insurance event. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935562 Tue, 16 Jul 2013 12:13:09 +0000 Adira 935562@https://boards.hellobee.com/ <p>I also have BCBS and didn't do ANY checking, haha. Everything turned out fine. I think as long as your hospital is in-network, you're good to go! Try not to worry about it too much. :) </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935561 Tue, 16 Jul 2013 12:11:55 +0000 honeybear 935561@https://boards.hellobee.com/ <p>Is your hospital in-network? I would call back and ask for another person to answer your questions. Sounds to me like this lady didn't know what she was talking about.</p> <p>ETA: You should be able to determine online whether the hospital is in or out. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935559 Tue, 16 Jul 2013 12:11:52 +0000 daniellemybelle 935559@https://boards.hellobee.com/ <p>@mediagirl: Haha, I am pretty grateful for it! I like that it is straightforward - as long as I stay in-network, everything is pretty cheap. It's this out-of-network stuff that is scaring me, because that is NOT covered at all!</p> <p>I will call the hospital but I'm worried that I am going to get conflicting stories... </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935556 Tue, 16 Jul 2013 12:10:51 +0000 MamaMoose 935556@https://boards.hellobee.com/ <p>I agree with @mediagirl:. As long as the hospital is in network all of the practitioners working there should be considered in network as well. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935553 Tue, 16 Jul 2013 12:10:23 +0000 Cara M. 17 935553@https://boards.hellobee.com/ <p>I think it is normally the hospital or institution that is considered in or out of network rather than individual healthcare professionals. </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935547 Tue, 16 Jul 2013 12:08:43 +0000 mediagirl 935547@https://boards.hellobee.com/ <p>Check with your hospital. If they are in your network, you should not have any problems. Ps...your health insurance is amazing. :) </p> https://boards.hellobee.com/topic/health-insurance-questions-im-confused#post-935537 Tue, 16 Jul 2013 12:05:38 +0000 daniellemybelle 935537@https://boards.hellobee.com/ <p>I called my insurance company (Blue Cross Blue Shield) this morning to make sure I understand my coverage through the birth of the baby completely. </p> <p>It seems pretty straightforward - I have the EPO plan, so anything out-of-network except emergencies is not covered. I am covered 90% in-network after I meet my deductible, which I have, until a $1500 limit after which I do not have to pay anything. My midwife practice is in-network.</p> <p>However, the woman I spoke to said to make sure that everyone who treats me is in-network or I may be on the line for the full bill. This is scaring me a bit. What if I end up having an epidural, and the only anesthesiologist on call is out-of-network? Or what if I need a C-section, and the OB that performs it is out-of-network? Am I really supposed to figure all of that out ahead of time? I guess the C-section could constitute as an emergency but I'm not sure. Now I am confused and a little worried! </p>