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Ultrasounds and insurance

olechkaolechka member
in 1st Trimester

Hi Ladies

I called my insurance co and they said they only cover 1 ultrasound the entire pregnancy unless there is a problem and it's required.   

I already had my first one on Friday, dating me at 8 weeks & 3 days.

Now the doctor wants me to schedule the First trimester scan (I think NT scan is what people on the board refer to it) and they also mentioned they'll do a mini one next time i come into the office.  Then of course there is the 20 week one.

What are you ladies doing about all these ultrasounds?  Are you opting out of some of them?

TIA!

imageNicole Hanna 11-23-2010
Birthday
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Re: Ultrasounds and insurance

  • m&m2006m&m2006 member
    i have a high deductible plan right now (unfortunately), so i will be paying for everything at the discounted insurance rate (but it will still be more than my co-pay would have been).  i'm doing the nt scan at 12w3d, and then my OB will do another ultrasound at 20w.
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  • Toots_popToots_pop member
    I had an u/s at every appt with  DS, and at almost all so far for this one, and I have not paid anything but my $35 copay...maybe somehow my Dr. is coding it as "necessary" for whatever reason.  Can yours do the same?
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  • LLRTLLRT member

    For me the NT scan is coded entirely different and done with the hospital itself since people are specially trained, separate from my OB practice. I called to see whether this scan is covered, you might want to call them and tell them the billing code (given to you from your OB). I found out that mine was covered 100%. I would call and double check for sure.

    As far as other u/s's I plan on getting what is required/suggested. Ultimately I only get one in the 2nd (sex determinination, etc) and then 3rd.

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  • FutureMrsCuoghiFutureMrsCuoghi
    My insurance covers all ultrasounds.  They're all included in the initial maternity co-pay.  The only time I have to pay for an ultrasound is if they send me to the hospital to have it done--but even then I just have to pay my co-pay.  
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  • maramarriemaramarrie
    I think the one your insurance would generally count on is the 20w u/s. Since you've already had one, you will likely need to pay for the 20w one. I would opt out of the NT if you don't need it. If you want to pay for it, go for it, but it's not necessary.
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  • maramarriemaramarrie

    imagem&m2006:
    i have a high deductible plan right now (unfortunately), so i will be paying for everything at the discounted insurance rate (but it will still be more than my co-pay would have been).  i'm doing the nt scan at 12w3d, and then my OB will do another ultrasound at 20w.

    This is what we have, but we know our deductible will be met one way or another this year, so the cost isn't concerning to us. We will have about 12 u/s total, each of them being between $250-400. But along with the other costs, it might be that by the time we get to the hospital in October the bill will only be $600 or something low. Once we reach our max, that's it; so we don't worry about what tests are done. The NT will be my 4th u/s already. We do it because we've had a Downs baby already, so we want to reassess the risk of having another to prepare for complications...not because we would ever terminate.

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