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Pregnant after 35
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NT scan insurance coverage?

mbw410mbw410
in Pregnant after 35
I was just told by my insurance co. this isn't covere. Seems like most people are able to have this done. Did anyone else run into this? If so, is there any recourse?
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Re: NT scan insurance coverage?

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    RockyMtnMamaRockyMtnMama member
    I did one for this pregnancy, but haven't seen the charges or EOB from insurance yet.  I have heard that for a lot of insurance companies that more than one ultrasound is not covered unless by doctor's orders.  Did you have doctor's/midwife's orders to schedule?  Maybe they can recode as ordered and resubmit.  It's worth a try.
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    FyreFlyeRushFyreFlyeRush member
    Mine covered it. I have Aetna, and it sucks. But, they covered the NT scan I didn't get.
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    mbw410mbw410
    Thanks for the responses! I think I am getting this sorted out with my insurance co.
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    AdiAdi

    Mine covered it, but not all companies cover everything, even two people with the same company can have different plans. My DH and I both have Kaiser through our respective employers, he has a lower copayment, but he has copayments for everything, even labs. I have only paid 1 copayment so far for this pregnancy and that was to see the geneticist. (and I've seen the midwife 2x, been to the lab 4x, and had 2 ultrasounds) It's all dependent on what you exact policy says.

    Good luck!

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    m3l0d1m3l0d1

    Like PP said, can you ask your OB to refer you for NT scan?

    It might have a different outcome if it's a referral from your OB. 

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    JKohioJKohio member
    It's not technically covered by our regular insurance plan, but we also are set up with a HRA (health reimbursement account) with DH's company. It means that once we meet the deductible (which is covered to a certain point by the HRA) of the plan, the rest is covered 100%. The company contributes toward the HRA funds. For the year, since we'll max out the deductible for the plan (Blue Cross). we'll have to pay something like $1k out of pocket (for EVERYTHING total), but since I'll be giving birth within the calendar year, and it's $6k or so for a c/s, it's a pretty good deal. I elected to have the NT scan. It's all about the big picture.
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