Totally OOP

lovebug33 · December 2011

I'm just so upset about this. I think the insurance should count this as prenatal care, but they are still counting it as IF. They won't even give me anything back as out of network. DH actually cried last night because we had totally forgotten that we would have to pay so much after the IVF, which we still don't know how we are going to pay back. Each ultrasound is 500 dollars and they want to do 4 before we graduate. We don't even know what they are going to charge for the bloodwork. It really puts a damper on the whole being pg. thing, especially because it is looking more and more certain that neither of us is going to get paid in January. It's just incredibly frustrating. DH actually wants to go try the gambling machines but I managed to stop him on that account!

KaliChick · December 2011

I would talk to your RE and see if a) they discount for cash customers or b) if he will refer you to the OB at this point.

Mine had a plan if you were OOP, but he was actually covered (partially) under my insurance once I was pregnant.

missjul61 · December 2011

I'm sorry. I feel your pain about still having to pay 100% OOP until graduating to the OB. It stinks but it's of course worth it and is a drop in the bucket in the grand scheme of what we've paid so far for treatments. Are you willing to talk to your Dr about seeing if they're willing to do more of a packaged deal to save on some costs? $500 is really steep for an u/s

. Regardless, I hope you and your DH do get paid in January!

lovebug33 · December 2011

He has done some things, like my new meds, he "found" them somewhere (don't ask me), which saved us 700 dollars, but I just don't feel that they care if we have the money or not. Where we live, this is the only place to go, so I think they can kind of charge whatever and they know we'll pay because we need it. I think it's just the thought of losing all that pay in January and not knowing how we will ever make up everything we need to pay because we wiped out our savings with IVF. It just makes me feel hopeless.

missjul61 · December 2011

lovebug33:
He has done some things, like my new meds, he "found" them somewhere (don't ask me), which saved us 700 dollars, but I just don't feel that they care if we have the money or not. Where we live, this is the only place to go, so I think they can kind of charge whatever and they know we'll pay because we need it. I think it's just the thought of losing all that pay in January and not knowing how we will ever make up everything we need to pay because we wiped out our savings with IVF. It just makes me feel hopeless.

Gotcha. I agree with PP that you should ask to graduate from the RE sooner. Maybe see if you can get 2 u/s in and start seeing your OB?

STL34 · December 2011

missjul61:

lovebug33:
He has done some things, like my new meds, he "found" them somewhere (don't ask me), which saved us 700 dollars, but I just don't feel that they care if we have the money or not. Where we live, this is the only place to go, so I think they can kind of charge whatever and they know we'll pay because we need it. I think it's just the thought of losing all that pay in January and not knowing how we will ever make up everything we need to pay because we wiped out our savings with IVF. It just makes me feel hopeless.

Gotcha. I agree with PP that you should ask to graduate from the RE sooner. Maybe see if you can get 2 u/s in and start seeing your OB?

Seriously, this. There is no reason that they can't let you graduate sooner. My RE does checks for a heartbeat and then graduates you. This required two ultrasounds for me. Good luck and I hope you end up getting paid in January!!

labbylover03 · December 2011

I agree with others...try moving on to OB sooner. I only had one u/s to check for heartbeat and then moved on. I had u/s #2 with OB today. I still have one more blood draw tomorrow with RE but then I should be done. I'm so sorry you're dealing with this.

wordslikeswords · December 2011

That's definitely one part of IF that no one tells you about. Once you're finally pregnant you still have to stay with the RE at full price! Could the RE refer you to another center for the ultrasounds, and then have it sent over on a DVD? That way he'd still get to see everything, but you could charge insurance?

naybird · December 2011

Sorry.. Bump burp

naybird · December 2011

Ask your RE to release you earlier. I was released after the second u/s.

My OB filled out the paperwork at my 12 week u/s to make me an official pregnant women with the insurance company. I don't know if all insurances are like that. But when looking over my claims they were all labeled preventative care, and not pregnancy or maternity. That could be why your insurance isn't covering this as pregnancy.

Good luck!

ELF4321 · December 2011

Many REs are comfortable releasing you to the OB as soon as confirming a heartbeat, which you should be able to get if you wait until 7w to do another u/s. I would talk to the RE about the situation and see if they are on board with that approach. Good luck!

JennPierog · December 2011

Once you are pregnant you should no longer be OOP. You need to talk to your RE's office about how they are coding your ultrasounds. My first ultrasound was coded 1st tri US high risk due to IF. So see if they can change the way they code it. RE's are OB they are providing you OB care not IF care at this point.

My IMO I would ask to be released to an OB and if you have some other kind of issues then just hook up with a MFM md. I had one ultrasound and was sent on my way.

Best of luck! Review you options your RE did a great job to get you pregnant but he or she is not the only one that can keep you pregnant. Look at all your options and do whats best for your family. You shouldn't need to go broke.

lovebug33 · December 2011

Thanks! I am going to talk to them on Wednesday when I have the next u/s. We just got a letter from the union that is basically conceding to the district, so we are getting more and more worried about no pay in January. It would be a lot less stressful if we didn't have to worry about 500 dollar u/s!

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