I just found out that my insurance doesn't cover my anatomy scan ultrasound since it isn't a "medical reason". Did anyone experience this or was your anatomy scan covered?
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@WALLAROO: A deductible applied to all of my ultrasounds.
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When I spoke with my insurance company (BCBSMA) they said the same thing, that it's 'routine' and not covered. We opted to get it anyway, and it ended up being covered ...kind of strange.
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Wow, I am surprised to hear this. Ours was covered because they had to check for many things such as spine development, kidneys, measure all the bones, check the brain, etc..
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Ours was covered as well. They said they only covered 2 ultrasounds the duration of a pregnancy and that was one of them. I've never heard of it not being covered as it is used to make sure baby is healthy and growing properly.
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Agree with @Mrsbells: even though we all call it the anatomy scan the scan done within those few weeks are actually to check for proper development not just for gender.
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@regberadaisy: @Mrsbells: I'm hoping that is the case and the insurance customer service representative misunderstood my question. Either way, we are definitely having the anatomy scan done
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We had everything covered. Maybe it's cuz my hubby was hospital employed and everything done at the hospital was free?
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My doctor's office actually refers to the 20 week ultrasound as an "anomaly scan" rather than an "anatomy scan". I wonder if they have to code it that way for billing so it would be covered as medically needed? I would call your doctor and ask for the exact billing code and then call your insurance again to check if it's covered.
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When I went over our maternity/prenatal coverage (we're still TTC) with BCBS, they said one ultrasound is automatically covered, when I told them my office normally does 2, she said not to worry about it as long as they were ones the dr said were needed, that they'd cover those too.
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I have bcbsnc. They covered the first vaginal ultrasound and the second ultrasound which was our anatomy scan. They paid for a portion of the third one we had done. I should add our insurance is pretty crappy so I was surprised it was covered!
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Ours was covered, since the purpose of the ultrasound was to check to make sure all the organs are developing properly, not to determine gender.
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Not sure. I have a deductible I have to meet but I've had four ultrasounds already at 14 weeks (I had early unexplained bleeding) and everything has been covered so far, so I guess we'll see! There was some talk at the office that they didn't think my NT scan would be covered, but I'll find out in a couple of weeks at my next visit, if I owe anything for that. Good thing is if I do, it counts toward my deductible.
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Check with your doctor on how they code it for billing purposes, often times it can be coded one way and wouldn't be covered versus being covered if coded a different way.
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13 comments