We just got a bill for the first and second trimester prenatal screening (down's syndrome, etc.) blood tests. We are in the U.S. with PPO. Is it normal that we have to pay for this? If you paid, how much did you have to pay? I truly have no idea what do/don't pay for so I'm going to call the insurance company tomorrow. TIA!
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It depends on your plan. We have a high deductible plan - and we pay a certain percentage on everything up until 4500$ and then everything is covered 100%. I never thought about it, honestly, so I'm glad we're doing it all in one calendar year so we will hit our deductible for sure. They cover even less if we're not going somewhere "In network" (which we are).
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Ours would not have been covered because it wasn't medically necessary. We chose not to do it, but I think it would have been around $250?
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Ours was covered under insurance. I had to pay $50 for bloodwork but only because I haven't met my deductible for the yr
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Ours was completely covered under our insurance. At that time we had awesome insurance (I worked for the gov't) and I had met my $250 deductible so we didn't have to pay for anything. I saw the bill though, and it was like $16K for the ultrasound, screening, & meeting with genetic counselor to go over the results... yikes.
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I was originally billed $162, but after submission to insurance, it was $32.90. I had expected it to be entirely covered, but I guess not! We also have a PPO.
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Thanks ladies for your input!
@scgoo387 - I think we have a $5000 deductible - but I wonder if all my medical care will be billed for 2012 separately when baby is born in 2013? Yikes! I do think the office told us they bill everything at the end in one payment...
@cranberryapple - Our bill was close to that too - $165 I think. I'm going to call tomorrow and hopefully get ours knocked down too!
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Mine was $162 which I thought was covered by insurance. I got a bill in the mail. Then my insurance sent me a check, so I sent that to the State then they sent me another bill for $32. I have to call my secondary insurance b/c they should pay for the remaining balance. It's been a pain in my butt and they keep sending me bills and I keep putting it off!
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@shopaholic - Definitely don't want to scare you since I didn't research it very much (no way is this baby coming in 2013 LOL!) but it's worth asking. We have received bills for each ultrasound, the initial blood test, and for my GD testing. Hopefully you'll have an easy breezy pregnancy and not have to pay very much until the end when you hit your deductible!
I called our insurance ahead of time to try and wrap my head around what they covered vs. we covered and they were 100% unhelpful. Wish I had better advice!
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OB wanted pre payment for his services so we were on a payment plan until we met our $500 deductible. We got billed separately for the screening tests you are talking about because we saw a perinatologist for those.We got a bill after services were rendered and we paid it until we met our deductible and then the out of pocket maximum kicked in, so some of the billing went to that ($1500). I have a PPO also.
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Ah! SO much to find out about the billing stuff.
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