NT scan and my insurance

chance_encounters

So the perinatologists office called me today. My insurance covers 70% of the NT scan AFTER my $4000.00 deductible!!! UGH. So now I am seriously torn. The scan will roughly run about 2400.00 although we know the Dr. personally so may be able to get a little bit of a deal.....I do not have 2400.00 just laying around right now. I am 36 and will be 37 by the time the baby delivers but I know there is an error ratio with the scan too and many end up with an amnio. Ladies I need your thoughts on this....

Thanks!

(this is also posted on my BMB)

leffe1

Honestly, that's a tough call. I got pg with my 1st at 37 and didn't have any testing done. It wasn't due to money, I just decided not to do any testing.

I did the testing with this pg and ended up having the amnio. I have pretty good insurance but my out of pocket costs (deductable) were close to $1,000 for NT/Amnio and all the bloodwork. 

I'm not sure what to tell you. Obviously there are lots of false positives and I sometimes want to kick myself thinking of the $$$ I could have saved. BUT knowing that everything is fine with this pg has given me a peace of mind I wouldn't have had otherwise.

Good luck with whatever you decide.

jennypasadena

If you only want one test and want to know definitively, you might want to consider just jumping directly to the CVS.  I didn't have one with this pregnancy (but was scheduled for one with the one I lost), and it was going to be covered at 100% because of advanced maternal age.

amandaleigh1

If I were in this situation, I would go straight to a diagnostic test like cvs or amnio or just do maternit21. The thing is is that the nt scan also looks at other things that the genetic tests cannot-- organs, spine, limbs, etc. that is pretty crsppy that they are making you satisfy your deductible first. I find that strange since all my maternity testing, or at least stuff like the nt scan is considered preventative routine care, so it was paid at 100% without making me pay my deductible.

lhcooper

I would also jump to the CVS. One thing is that they do an u/s anyway for the CVS that ends up being like the NT scan -- in fact my u/s tech took the measurements just as they do for the NT when I asked. And I would find out if the CVS was covered at all because you are AMA. If not, it will probably be about the same amount of money, but the results would be definitive.

Adi

I'm so sorry your insurance only covers 70% after the huge deductible. That seems so odd to me since u/s are typically covered 100% I know the NT scan is a "special" one, but it still is basically another u/s... it's just one that requires specialized training for the techs. Can you double check that with your insurance?

I agree with PP that if your insurance will cover the CVS, then maybe that's a more cost efficient route to get you the answers you are looking for.

benoitfan

Can you get the MaterniT21 or verifi blood tests in your area?  Might be a far cheaper alternative and they area  diagnostic test, rather than a probability test.  Also non-evasive, compared to the amnio.

StaceySMC13

Honestly, I wish I would have skipped the NT scan and it was 100% covered.  It just caused way too much stress.  I ended up finding out I had a 1 in 70 chance of delivering a baby with down syndrome so I did the MaterniT21 test and it came back negative.  If I would have just done the blood test to begin with, I'd have had a yes/no answer and not had to worry.  You'd need to ask about the cost but they lab has been accepting $235 payment, up front, and then if insurance doesn't cover it, they eat the cost.  I don't know if that is for all insurance or just PPOs.  

bklynbmp

You might want to call the place that is doing the NT and see if they have an adjusted payment plans when not covered by your insurance.  They may be able to give you a significant cost break on the total.

 I would also suggest checking in to what exactly is covered without meeting your deductable b/c if you are going to have to spend the $4K anyway on something later on, might as well get it out the way now so you do whatever else is necessary throughtout the rest of the pregnancy without worry.

 MaterniT21 is definitely an option as well but I know I slept easier having both.

kirac

We skipped the NT scan since we knew we were going to do the amnio.  So I ditto advice about doing CVS or Amnio instead.  NT is covered by my insurance but since there are a few false positives and we knew we were going to do amnio anyway, the dr. agreed with us about not doing both.

chance_encounters

Ok after hours on the phone with the Dr's office insurance co. I found out my responsibility will be 246.00 so that is not as bad as I thought.  We are personal friends with the perinatologist and she might work something out for us too.... we shall see.  We have decided to go ahead with this.