March 2016 Moms

Nuchal Test NOT Covered by Insurance

Did anyone else have this issue?  I heard that everyone gets this test and then uses the positive results as a green light to tell everyone, but my insurance is saying they won't cover ANY chromosomal testing.  very stressed out!

Re: Nuchal Test NOT Covered by Insurance

  • oceanchildoceanchild member
    edited August 2015
    Are you "at risk" (advanced maternal age, history of genetic anomalies, etc)?
    My understanding is that it's only covered if you have some sort of risk factor like that, or if you're over 35? And even then it's not *ALways* covered.

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  • Not everyone gets this test, we turned it down last time, but will be doing it this time.  You don't have to see the baby to know everything is alright, they will listen for a heartbeat at your appointments.
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  • I didn't get this test with my first and I'm not getting it with this pregnancy either. I'm youngish and not considered high risk. I personally find it unnecessary but I will get the quad test since it's just a blood draw. 
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  • I qualify for the age-risk, but we will be skipping this test also.

    March 2016 siggy: babies - expectation vs reality

    Brian's Whovian wife (5/'09) 
    AP, BF, BW, CD, CLW, CS, ERF, Catholic mama 
    to Evan (7/'10), Clare (8/'11), Dean (3/'14), ^F(12/'15)^, Rose (3/'16)
    *no longer a Timelord ~ WibblyWobbly BabyWaby is here!*
    <3 but i still feel bigger on the inside <3
     Autism mama! 
  • I haven't talked about this with my doctor yet, but if it's not covered and I'm not considered at-risk, then I won't opt in. I'm 24, this is my first pregnancy so no history of complications, I'd be surprised if my doctor pushed for it. We'll do the blood test screening and stop there unless something indicates we should do further testing.
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    TTC #2 in April 2017
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  • IMHO if you are not high risk (with advanced maternal age, history of issues), these tests cause way more stress than it's worth.  They only tell you if there is a chance that there are chromosomal issues, not that there are.  If it comes back positive, how stressed out would that make you?
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  • If you would terminate if you found out your baby had a trisomy, then it might be worth paying out of pocket.  If not, it's not worth it.
  • I didn't get it last time and won't this time either
  • I'm under 35 and not considered high risk.  I was "told" my insurance would cover it (though I've heard my type of insurance is notorious for not covering ultrasounds.)  I'm getting the NT scan along with accompanying blood work on Thursday.  I agree that hearing the results can be stressful, especially when they say there may be a "chance" there is something wrong with the baby, but can't actually confirm it.  My husband is against us finding out if the baby has Down's syndrome because he thinks it doesn't matter since we will be keeping the baby regardless.  I, on the other hand, would like to know in advance so that I could start preparing.  It's a personal choice based on your desire to know now instead of once the baby is born.
  • I am 36 so it was a I brainer for me but I agree 110% with finding out. Had a friend who didn't cause the result wasn't changing decesion and it was a huge shock. Big adjustment after the baby was born.! Knowledge is power I think it also gives all opportunity to prepare friends and family and give them an adjustment time. All my test came back fine but if not I planned on telling everyone so it wasn't so shocking and everyone could adjust.
    I am located in CT and with the blood test materniT21 I was told it would cost no more then $140 even if insurance didn't cover. However the whole appointment with US, genetic counselor, and blood test was almost $5000 insurance paid for all but $70 but remember I am over 35. Also might want to find out about amino or cvs cost and coverage as they are more definitive and paying for a false positive seems silly.
  • katy0990katy0990 member
    edited September 2015
    We opted not to do it since it can't give you a definate answer. All it can tell you is your chances. I would not have done an amino to find out for sure (too risky imho) even if my odds were high, so we would have just spent the rest of the pregnancy worrying, which I did not want to do.
  • Call the doctor's office and get the specific code and name for the procedure (there might be a more official or code name for it that the doc/insurance company uses on their paperwork). Then call the insurance company, give them the procedure code, name, and doctor/location where you would have the NT scan and ask if it's covered. The NT scan should be considered a prenatal screening test instead of a chromosomal/genetic diagnostic test.

    I've had that situation before where my insurance says broadly we don't cover X types of procedures but then when I give them the specifics for them to enter and check in their system it turns out it is covered (maybe because for the insurance company X doesn't technically fall into the category that you first think it does). I know my insurance company covered the NT scan, I think as part of prenatal testing, but requires high-risk or other preauthorizations for genetic testing so we only did the NT scan. Good luck!
  • I am surprised it isn't covered. I can see the Harmony, Panorama, etc. not being covered (if you're under 35), but like @ddjay315 said, the NT scan is a screening. I see this is a month old post, so perhaps you've already gotten it figured out. Hope it worked out the way you wanted it to.
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  • My insurance wasn't going to cover any testing because I am only 25 with no risk factors!
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