So I received a $250 bill from my ob/gyn for ultrasounds... even though pre-natal care is supposed to be completely covered by our insurance. After looking deep into our plan documents, apparently ultrasounds are not considered part of my covered care? I know for a fact that this was NOT the case when I had DD in 2013- I paid exactly $50 for her pre-natal care in it's entirety.
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I had pretty good coverage when I was pregnant with LO and paid quite a bit for ultrasounds.
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The same thing happened to us this year. $375 bill out of pocket for the anatomy scan.
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All testing was outside of my "prenatal care" copay. So I had to pay for ultrasounds and lab work separate. Same for my hospital stay, all on top of the prenatal copay.
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Same as others, we have great coverage and had to pay for all ultrasounds.
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Probably depends on both your insurance coverage AND your specific OB/GYN. Some ob/gyn practices have in-house ultrasound techs/equipment and labs; others outsource it. And insurance coverage can vary greatlyTypically my ultrasounds have been covered but my labs haven't, and I have now had/am having kids with 3 different insurances and 3 different OBs
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My insurance only covers the anatomy scan and any other ultrasounds are out of pocket unless medically indicated.
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My insurance only covered the main 3 ultrasounds. Everything else was a $20 copay, which added up since I saw my high risk Doctor every 3-4 weeks for my previa.
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I had decent insurance when I was pregnant, and anatomy scan was covered, but any other ultrasounds were not. I had to have a dating ultrasound, so we paid out of pocket for that. And I declined an extra growth ultrasound, in part because of the cost.
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My prenatal care only covers the doc visits, labs are considered lab work and ultrasounds are imaging. It really depends on how your plan is set up.
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My Kaiser insurance covers anything ordered by my doctor-- four ultrasounds with DS1 and two with DS2. I think Kaiser routinely covers a transvaginal ultrasound to confirm the pregnancy, as well as one anatomy scan.
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This is exactly what's wrong with healthcare in our country, when such things should be part of routine healthcare. I know for a fast that I didn't pay with DS1, but did with DS2. The change seemed to happen after obamacare kicked in for whatever reason, despite us not making changes to our insurance.
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Any medically necessary scan is covered for us. So it's basically just the anatomy scan Bc that looks at both health of baby and mom (cervix, placenta attachment, fluid levels.) But then other stuff is covered as well if you don't know when your last period was (for dating scan) or any scans to check on baby if an anomaly is found. It might be worth calling to get a specific reason.
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Hmm, I wonder if you can get your OB to bill your insurance for your ultrasounds as something that was necessary as a pose to just "routine". I know it's so stupid, but my mom had some issue awhile back where her insurance wouldn't cover some type of test or scan. And the doctor went ahead and either called or sent a letter saying that it needed to be cover as it was necessary for proper treatment or assessing, which ended with that test being billed under a different category or something, but it did get cover. Just an idea.
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My US are all covered, but I did just get billed over $500 for a fetal non stress test
So I feel your pain. Health care in this country is abysmal.
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Adding to my answer above, my ultrasounds and lab work were "covered", just not included in the prenatal care copay, and subject to deductible. So I paid for most of the first round of labs and 12 week scan then once I met the deductible it was like 10% of the rest.
And yeah health care and insurance sucks. You should be able to fairly easily figure out how much something will cost. I called and tried to figure it all out and finally was like, F it, I'll just wait for the bills. I was already pregnant and my hospital and practice were in network so not much else I could do.
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@Foodnerd81: that is exactly the situation I'm in right now- there isn't anything I can do since I'm already pregnant. My obgyn and hospital are in network so I will hit my deductible soon and then I'll be 70% covered. I just feel like my insurance should not say "all prenatal care is covered" when really they mean that the ten minute visit with the doctor is covered and all the actual necessary medical stuff is extra, plus the lab and the radiologist charge separately so it's really $350 once you factor in paying for the tech. Not cool.
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@caterw: I think what they mean is no matter how many visits you have with your ob or midwife it is covered- so if you have an issue or once you are coming in weekly at the end, you don't have to pay $40 every time. Which is something at least. But it's still ridiculous.
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We're in Germany with the military so we're going to a military hospital and everything is free and included, but they only definitely give ultrasounds at the 8-12 week appointment and at 20 weeks for the anatomy scan. If we changed our insurance a bit to be seen off base with a German doctor then they do ultrasounds at every single visit. It's pretty crazy!
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18 comments