Didn't know my anatomy scan wouldn't be covered. :(

Onelovelyginger · January 2014

I heard you guys talking about them so much on here that I never thought to see if it was optional. I just thought it was something you did. My doctors office never asked if I wanted it, they just set me up the appointment at the hospital. No one even mentioned it. Got a bill from the hospital. $1,600 that we have to pay out of pocket because our insurance said it was a routine ultrasound. I'm so bummed. I really wasn't expecting this.

avidkeo · January 2014

Thats a freaking expensive US! I dont know much about insurance (don't need it here) but i would say your 20 week scan was necessary! I would be surprised if any OB said it wouldn't! Maybe talk to your drs office? I hope you get it sorted!

MamaFantastic · January 2014

whaaaaat?! that's crazy. an anatomy scan is standard protocol for a prenatal care program. i would make some calls and be firm about demanding an answer as to why this isn't covered.

that's not right - not right at all!!

Twirple · January 2014

Ouch. Our insurance covered our AS. I would never thought it wouldn't be covered either. I'm sorry you have to pay that much out of pocket.

Ashleypixie · January 2014

I think something got billed incorrectly. At least I hope so. At least one US is considered routine and medically necessary. I don't even know how you can even get an elective scan. I'd call your insurance company and get that straightened out!

RedDawnsRevenge · January 2014

Yeah, I didn't want to do the A/S this time, and didn't have one done with DD for that reason. The cost of the A/S almost completely covers my deductable...

Edit: your glucose labs usually aren't covered either, just a heads up.

KatieGummow · January 2014

Ours wasn't covered either.. but it was only $880 for twins. Our insurance "gave" us a discounted rate...

irisheyez7 · January 2014

They might have coded it incorrectly. I would talk to your Dr's office about it. Either way that is REALLY high for an U/S. The MFM only billed my insurance about $800 for our A/S...

scarles · January 2014

It is also always more expensive when you have things like this done at a hospital vs your doctors office or another outpatient facility.

snmetz7 · January 2014

Yikes. Things like this really make me realize I take my amazing insurance for granted. They will cover anything that the dr seems medically necessary that has so far included 2 one hr gtt, 2 three hr gtt, and 6 us to date.

JessieAlbin · January 2014

That sucks. I can't believe having it done at the hospital costs roughly double what most private practices are charging (mine was $835 I believe and 100% covered since we already met our deductible). Definitely look into how your care is being coded and what is covered in your maternity care-if any of this out of pocket cost is in error it is worth you being your own advocate and figuring out exactly what you are supposed to owe! Makes me appreciate DH's insurance even if it might be the only good thing about his job.

Rrrrrachel · January 2014

Damn! Even before insurance mine didn't cost half that!

AcaAwkward · January 2014

. I would double check that something didn't get coded incorrectly with your insurance, but Level II u/s can definitely be that $$$ when not covered. We have to pay a % for every one we have done with our peri, and it's around $500 OOP each time (I had 12 with DD...4 so far this time...sucks).

ETA: all our Level II u/s are with the perinatologist so our insurance treats them as a specialist visit, not normal prenatal care.

lilmama412 · January 2014

Sometimes insurances will only pay for 1 ultrasound, I ran into this last time as well. Since my periods are so irregular they normally have to do a dating one initially and then my second one isn't covered

I would definitely call and make sure first before paying it though

Serenla · January 2014

@MamaFantastic said:
whaaaaat?! that's crazy. an anatomy scan is standard protocol for a prenatal care program. i would make some calls and be firm about demanding an answer as to why this isn't covered.

that's not right - not right at all!!

Ours actually wasn't going to be covered, unless it was "medically nessacary" because we had early scans due to a loss history. Luckily, well kind of, we have a history of hydrocephalus in our families so we only had to pay 200 oop. I hate to say it but because it is routine doesn't mean insurance will cover it.

OP, contact both your insurance and medical provider. Your OB might have to submit a letter or paperwork claiming this to be a medically nessacary proceedure.

snowclouds · January 2014

I'm sorry, but the 20wk a/s in NOT a routine u/s. Contest that. It's the u/s that lets doctors know that there are not problems with baby's major organs and so on.

alysemci · January 2014

My insurance hasn't covered any u/s. Good thing is, I already hit my 2500 deductible with all the shit for this pregnancy so the rest should be covered. I didn't even think it was legal to not cover any but apparently they do what they want

spano41 · January 2014

Our insurance wasn't going to cover ours either (I had called them in advance to check) unless it was medically necessary and we normally would get it done at the hospital which said it would be $1800. Our Dr. was being kind of annoying saying we didn't really NEED one even though kidney problems run in my family which has been picked up at the AS for all of my cousins. So i felt pretty strongly we should get one done and found a place that did them for around $300 OOP. Low and behold, my daughter is missing a kidney, has a cleft lip/palate, and heart issue. At that point insurance decided the ultrasound was necessary so they paid for that one and to redo the AS at the hospital because that's where my Dr. preferred I get it done. Insurance companies are so stupid Sometimes, it just drives me crazy. I would say to read your policy and see if they will cover medically necessary ultrasounds and your Dr. may be able to write a letter stating it was medically necessaey.

mrsflamingo · January 2014

Definitely make some calls. We don't have insurance, so we've paid OOP for all our ultrasounds and none of them has been more than $400.

Mustardseed2007 · January 2014

That's ridiculous. Maybe because it's at a hospital rather than in a doctor's office, but that's freakin ridiculous. My doctor's office had me sign something that disclosed how much my anatomy scan would be if it wasn't covered and it was 200 dollars, not 1600! At the very least I would call and see if you can pay your insurance's standard reimbursement rate (BCBS reimbursement rate is 50% so when stuff isn't covered I've talked some places into just charging that). Also sometimes you can get an upfront "cash" price for paying it all at once. I know someone else on this board was lucky enough to get her doctor's office to help her negotiate with the hospital over an uncovered cost and got it substantially reduced as well.

cfthoct292011 · January 2014

I got a letter before i had mine and it said if insurance didnt cover it to call the hospital and they would give me a cheap flat rate. Maybe you should call and see if they have a payment plan or something.

MadBloom · January 2014

omg that is insane....

So happy to be Canadian.

And yes I realize that we pay for it through our taxes etc but it still feels like I pay nothing because we are so use to it that we're not even phased by all the deductions on our paycheques.

I really feel for you ladies who have to deal with shitty insurance companies and high hospital bills

Cecilbear · February 2014

Okay...don't want to hijack, but I also received a $1,500 bill for my anatomy scan and I paid it without thinking there might be anything funky going on. Do you ladies think this one's a lost cause for me? Feeling stupid over here.

eta: I just realized that this bill was for my sequential screening ultrasounds, not a/s. Think that makes a difference?

mrsB68 · February 2014

I agree to fight it if they won't cover ask the place of there's a no-insurance price. Sometimes the rates are different for oop vs insurances!

Bagnell11 · February 2014

one of my ultrasounds was not approved at first by my insurance company. i called my insurance company they suggested asking the doctors office if there was a different code they could use to bill them. So next time i went to the doctor i asked about it and they said the insurance probably denied it because it was not medically necessary but they would send a letter to explain that it was. And it must have worked because the claim was reprocessed and approved.

So its def worth a few phone calls just to check for other options.

Airynn Chica · February 2014

So sorry! That's awful! I guess of all the 'lack' of technology we have (or don't have) here in Botswana, I am so thankful for the price of hospital procedures. They seem high to me here weighted against my pay but no where near those prices.

nicole mackenzie · February 2014

Pretty sure mine went towards my deductible. But they were 300 a pop.

My doctor tried to make me get three dating ultrasounds!? I declined the third because I was afraid it wouldn't be covered, despite them telling me oh you have good insurance they should cover it.

They refused to send them back to insurance to be reprocessed.

Try calling your insurance company.

fourthnlast · February 2014

What?! That's crazy talk, I can't believe it wasn't covered. Our insurance fully covers all medically needed ultrasounds and the anatomy scan / 20 week ultrasound is the big one that they always cover. I'm so sorry

JessieAlbin · February 2014

Cecilbear said:
Okay...don't want to hijack, but I also received a $1,500 bill for my anatomy scan and I paid it without thinking there might be anything funky going on. Do you ladies think this one's a lost cause for me? Feeling stupid over here.

eta: I just realized that this bill was for my sequential screening ultrasounds, not a/s. Think that makes a difference?

Depends on how they coded it, I mean, it can't hurt to find out if there is anything you can do to change it. At the very least they tell you no, at the best you might get a credit toward the next crazy maternity care bill!

katiedidthat · February 2014

We had to pay for mine because we hadn't met our deductible yet and nothing at all is covered until we pay that. The good thing is between the dating us, the a/s and my bloodwork- we're now done with the deductible.

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Didn't know my anatomy scan wouldn't be covered. :(

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