The best/worse insurance to have while pregnant

tattoobabe

I will be having a nt scan on monday. I was under the assumption the procedure would be covered because i had this same procedure 2 years ago while covered under bcbs. I just had a feeling i should call my insurance and check and to my surprise its not covered unless its medically necessary.  Luckily my husband's insurance that im covered under will cover it so if its denied under mine they will pay it.  It just got me to thinking what is the best/worse insurance to have while pregnant?  I think the best is blue cross blue shield. Another is HealthPlus based out of michigan.   The worse and this is based solely on this nt scan experience is aetna.  Sadly my company no longer offers bcbs as an insurance choice  and only offers aetna.

 

 

hillbillysunshine

I'm sorry you're just finding that out now. Kind of a bummer!

I have United Health Care Choice Plus. It is a PPO plan. It covers both major hospitals here in Cleveland (Cleveland Clinic and University Hospitals/Rainbow Babies) plus a ton of private physician offices.

Th eonly thing I have is a co-pay for my first office visit ($15). Then, nothing else. No deductible b/c I'm in network.

 They cover all ultrasounds, NT scans, Quadmarker screens and any further testing necessary based on those tests.

$15 for my entire pregnancy is pretty darn good. So I think it is WONDERFUL coverage! 

Temp700366562504480

For coverage, Insurance companies vary widely depending on the plan.  You just can't compare without knowing specifics.  That being said, I know a lot of doctors in our area won't take Aetna HMO's...probably has more to do about reimbursement, though.

tattoobabe

Yeah its a total bummer i have aetna ppo coverage..this nt scan issue makes me wonder what other stuff they will be denying outright. I'm just thankful for my hubby's insurance which is an offshoot of blue cross blue shield. Its called bluecare and they appear to cover way more than what aetna covers so if anything or any procedure i have done is deemed not medically necessary by aetna and is denied i can resubmit it through my secondary and it will more than likely be covered.

 

IncognitoWifey

I have a PPO through Guardian, which is awesome. My doc and the hospital are in-network, luckily. Not only do I get "free" coverage (as in, nothing comes out of my paycheck for myself, DH, or our future dependents at all), but I only pay $20 copay - and for pregnancy, I believe they create a package so that you only pay the copay at the 1st visit and that's it.  Then hospital charges are a copay of $250 and that's it, unless you have to have some kind of insane surgical procedure.  That covers L&D, 48 hrs stay (or 96 hrs for C-section), and all the care provided.

 

tomkat35728

I am not sure what others have experienced, but I am throroughly convinced that CIGNA has to have about the worst health care.  I know that it varies by policy and what your company opts for, but I have heard nothing but horror stories regarding health insurance with CIGNA.

I have been covered through one of their plans and ended up refusing (not pg related) treatment on several occasions because I couldn't afford all of the costs that would be incurred.  I also paid a significant amount per pay just to keep the poor coverage.  I couldn't even imagine what the out of pocket costs would be for pregnancy.

I am covered through PPO Blue right now, which is a part of Highmark.  So far, I have been very happy with their coverage for this pregnancy. 

 

AMG06

I have great coverage through BCBS - Excellus. It's a PPO so as long as my doc is in-network (she is) then everything is covered. I only have a $10 copay and meds are $6 - brand name and $3 - generic. It also helps that I work for a school district, so we have really good benefits.

And Ketch

AMG06:

I have great coverage through BCBS - Excellus. It's a PPO so as long as my doc is in-network (she is) then everything is covered. I only have a $10 copay and meds are $6 - brand name and $3 - generic. It also helps that I work for a school district, so we have really good benefits.

 

I have a BCBS PPO through my school as well.  One of the very few perks of being in education is definitely the benefits!

KRISTA555

My hubby is military so I'm under the military insurance Tricare, and we opted for the best option under it... so I am Tricare-Prime.   Literally everything is covered for my pregnancy,  and I don't pay a dime including co-pays for appts and prescriptions.  As long as the Dr. recommends I get something done,  Tricare will cover it 100%.  Pretty awesome.  

Some people don't like military insurance because if you live near a military hospital, they make you go there for your care (and sometimes military hospitals aren't as nice),  but lucky for me we are stationed where there aren't any military hospitals, so I go to all civilian docs (and one that I chose myself) .   I get the best of both worlds.

jlthompson19

The best is to be covered under two plans.

We have our own insurance at the Union I work for (DH is a member as well) but it's a subsidiary of CMR/GHP.  Since I am double covered, I will pay $0 for this baby.  I never pay any copays for any doctor or medicine and we have $0 premiums as our employers pay 100%.

We, no doubt, have the best deal around.

Mrs.Handy

I'm switching from Aetna to BCBS at the first of the year.

From all the research I did it seemed to be the best one to have while pregnant. I'm happy to be getting rid of Aetna. I've heard bad things about them and have not had the best experience.

WiscoMom67

I have a BCBS plan and it SUCKS!  I have to pay a $75 copay every time I have any labs done, including peeing in a cup to test proteins and sugars, because the hospital (not the doctor) does the labs and they consider it a "hospital visit" (even though I didn't step foot in the hospital)!!!  That said, I have been on OTHER BCBS plans that have been pretty good, and when my husband becomes eligible for insurance at his new job (thankfully soon), I will go onto his plan...  Which, by the way, is BCBS!  BUT, it's a different BCBS plan with much better coverage.  SO, as others have mentioned, you can't simply compare the companies, as each company has plans ranging from terrible to terrific.

I was on a Cigna plan with the last school I worked for, and coverage was actually pretty darn good!  I had a co-pay for my office visits, but that was it!  Nice and simple; never any surprises.  Right now, I'm wishing I had that back...

jodi_p

I have United Healthcare and so far they've been great. Although, they always caution you to check their Web site for doctors that are or are not covered. Thankfully, the NT Scan was covered.

BelhurstBride

It's not the insuracne company, but the plan your employer chooses through the company. Someone's employer could have picked an awesome BCBS (for example) package and someone else's employer could have picked a terrible one.

LoveBeingAWife33008

The worst is to have none, yet not qualify for any state assistance (like me)!  Good luck.

Garnetbaby09

Tricare for sure but you can't just sign up for it.  I paid nothing my entire pg and my total for the labor/delivery/hospital stay with DD was $25 for the hopsital copay.  LOVE that.

KellyGreen

This does not just depend on insurance company, but also the particular plan you have.  Also, "covered" is a vague term.

We have United and pay very little each month for premiums.  However, we are responsible for paying a large portion of our medical bills out of pocket until we reach the OOP (out-of-pocket) max.

All in all, having my son cost us about $5000.

But, I'd guess that we pay about that much less than some people who have their entire pregnancy "covered".

I'd rather pay less every year for premuims and more in the rare years where we have a lot of medical bills, I guess.

SerenaGrace

The BCBS federal standard plan is AWESOME - I will be paying $0 for this pregnancy and delivery.  I had a different BCBS plan under my old company which wasn't as good but still paid for almost everything.

cheex090

I'm somewhat annoyed with insurance related issues right now! I work for the State and have a version of BCBS for State/School employees in Misssissippi. I went to my first Dr. appointment this past Monday expecting the majority to be covered. I had all my bloodwork done, urine test, ultra-sound, etc. My bill was $270! When I looked at my plan online I was under the impression that the bloodwork/lab stuff would be covered, but the doctor's office claimed otherwise. I do get 2 ultrasounds, so I wasn't charged for that.

 I paid it, but I'm now having to request an itemized bill...because I have a feeling they charged me for things that they should file w/my insurance co. I'll def. be getting it cleared up. It's just annoying! I do have a decuctable I need to meet before they cover 80%, but w/their maternity benefits most are covered 100%, not subject to the deductable.

 The delivery will be covered 100%, luckily...so I guess I can't complain too much if I have to pay more in the beginning...it's just frustrating.

lidda

As other have said, this will vary widely based on the plan your employer chose and the plan design they negotiate.  In addition, some employers are self-insured and pretty much decide exactly what they want to cover. So, saying that your CIGNA PPO I have is awesome and covers this or that means absolutely nothing to someone else who probably does not have a choice of that same plan.  (I work in ee benefits.)

julybaby23

I have Harvard Pilgrim and it seems pretty good. I don't even pay co-pays. Unless there is some secret bill headed my way, I think the cost will be $0 as long as, knocking on wood, it is a normal healthy pregnancy and delivery.

Temp200154562509288

KRISTA555:

My hubby is military so I'm under the military insurance Tricare, and we opted for the best option under it... so I am Tricare-Prime.   Literally everything is covered for my pregnancy,  and I don't pay a dime including co-pays for appts and prescriptions.  As long as the Dr. recommends I get something done,  Tricare will cover it 100%.  Pretty awesome.  

Some people don't like military insurance because if you live near a military hospital, they make you go there for your care (and sometimes military hospitals aren't as nice),  but lucky for me we are stationed where there aren't any military hospitals, so I go to all civilian docs (and one that I chose myself) .   I get the best of both worlds.

This exactly, I had my daughter using the same insurance and I had a csection and the only thing I paid for my entire pregnancy was my 3D u/s which was $100

WaitingOnAMiracle

tattoobabe:

I will be having a nt scan on monday. I was under the assumption the procedure would be covered because i had this same procedure 2 years ago while covered under bcbs. I just had a feeling i should call my insurance and check and to my surprise its not covered unless its medically necessary.  Luckily my husband's insurance that im covered under will cover it so if its denied under mine they will pay it.  It just got me to thinking what is the best/worse insurance to have while pregnant?  I think the best is blue cross blue shield. Another is HealthPlus based out of michigan.   The worse and this is based solely on this nt scan experience is aetna.  Sadly my company no longer offers bcbs as an insurance choice  and only offers aetna.

 

Its not Aetna, its what custom plan your employer has chosen. 

 I have BCBS under my DH but my employer has Aetna (I am not covered under my employer). Aetna does cover NT scans under my employer's plan.

preppynewlywed

BCBS.

Everything is covered 100%.

bretsgirl

I have BCBS Excellus but they pay 80% and I have an of pocket max of $1500. I guess $1500 total isnt much to pay, but it sounds like some other plans are better.