Doctor only ordered NIPT.....what about NT scan?

happygal5 · December 2015

Hi I am 41 years old and my doctor only ordered the harmony test....I called and the nurse said the harmony test covered everything but if I really wanted a NT scan she would ask the doctor....do you think it's worth skipping the NT scan?

splsmama2016 · December 2015

My dr didn't order the NT. She asked if I was interested in any prenatal screenings and tests, which I was, and gave me the information to set up an appointment to have it done.

Atlast111 · December 2015

The harmony is much more accurate than the NT as it looks at the free DNA of the baby in the blood. Having the harmony will make the NT redundant as it is less accurate.

PressLove · December 2015

I agree with PP. My OB says that many MFM specialists still do the NT scan out of habit. While not necessary with the harmony test, the scan gave me another chance to see my LO.

Lilwatz · December 2015

My OB has stopped doing the NT scan entirely and refuses to order it. Despite me calling their office repeatedly and trying to demand it. I would think it doesn't add any benefit over the Harmony test as it looks for the same things and is more accurate. But seeing the little baby is always worthwhile!

ETA: This has me so angry I am considering a new OB.

goldie987 · December 2015

Agreed with PP, at this point the NT isn't going to tell you anything that the NIPT didn't.

nicolesmith0624 · December 2015

Lilwatz said:
My OB has stopped doing the NT scan entirely and refuses to order it. Despite me calling their office repeatedly and trying to demand it. I would think it doesn't add any benefit over the Harmony test as it looks for the same things and is more accurate. But seeing the little baby is always worthwhile!

ETA: This has me so angry I am considering a new OB.

I'm curious why it makes you so angry. The NT has a very high rate of false positives, so why wouldn't you just opt for the much more accurate testing?

Lilwatz · December 2015

nicolesmith0624 said:

My OB has stopped doing the NT scan entirely and refuses to order it. Despite me calling their office repeatedly and trying to demand it. I would think it doesn't add any benefit over the Harmony test as it looks for the same things and is more accurate. But seeing the little baby is always worthwhile!

ETA: This has me so angry I am considering a new OB.
I'm curious why it makes you so angry. The NT has a very high rate of false positives, so why wouldn't you just opt for the much more accurate testing?

Because it's not covered by insurance and is $349.00. That's ridiculous and pretty classist. What my OB's office is effectively saying is you can only know about potential risks to your child if you have enough money. That's wrong and makes me angry.

ETA: This testing is typically only covered if you are Advanced Maternal Age (over 35), I am 34. Or if you have a known risk for a genetic issue. Many, many, many of their patients do not meet those requirements.

nicolesmith0624 · December 2015

Ohhhhh. That makes total sense then!

catherinekate · December 2015

NIPT doesn't check for neural tube defects, iirc. So that would be one argument for getting the NT scan.

MsBeachNJ · December 2015

@lilwatz - I'm under 35 with no known risks and my insurance is covering the test. When I spoke to the doctor she said that historically the test hasn't been covered without those factors but many insurance companies now cover it. Have you checked with your provider to be certain? Could be worth the call if you haven't already done so! Stinks how many variations there are in coverage for pregnant women... we should all be able to get the best coverage/care available.

purplefan1 · December 2015

My insurance company said the Panorama is covered but in order for Harmony to be covered the doc would have to call and present medical info on why he is requesting the Harmony. That still isn't a guarantee that it will be approved. Definitely frustrating. Will you be 35 when the baby is delivered? That's apparently another way they will approve some of this testing is if you are turning 35 at any point before the baby comes out.

Lilwatz · December 2015

MsBeachNJ said:

@lilwatz - I'm under 35 with no known risks and my insurance is covering the test. When I spoke to the doctor she said that historically the test hasn't been covered without those factors but many insurance companies now cover it. Have you checked with your provider to be certain? Could be worth the call if you haven't already done so! Stinks how many variations there are in coverage for pregnant women... we should all be able to get the best coverage/care available.

Yes, I have. The test gives me an info screen for payment. They claim the test costs $750.00. With my insurance they say it is $530.00. Self-pay is $349.00. Cost-prohibitve for many.

Huskerfanz · December 2015

Lilwatz said:

MsBeachNJ said:

@lilwatz - I'm under 35 with no known risks and my insurance is covering the test. When I spoke to the doctor she said that historically the test hasn't been covered without those factors but many insurance companies now cover it. Have you checked with your provider to be certain? Could be worth the call if you haven't already done so! Stinks how many variations there are in coverage for pregnant women... we should all be able to get the best coverage/care available.

Yes, I have. The test gives me an info screen for payment. They claim the test costs $750.00. With my insurance they say it is $530.00. Self-pay is $349.00. Cost-prohibitve for many.

So you think your OB should be doing an optional test for free? Have you talked to your insurance about it?

Lilwatz · December 2015

huskerfamily said:

Lilwatz said:

MsBeachNJ said:

@lilwatz - I'm under 35 with no known risks and my insurance is covering the test. When I spoke to the doctor she said that historically the test hasn't been covered without those factors but many insurance companies now cover it. Have you checked with your provider to be certain? Could be worth the call if you haven't already done so! Stinks how many variations there are in coverage for pregnant women... we should all be able to get the best coverage/care available.

Yes, I have. The test gives me an info screen for payment. They claim the test costs $750.00. With my insurance they say it is $530.00. Self-pay is $349.00. Cost-prohibitve for many.

So you think your OB should be doing an optional test for free? Have you talked to your insurance about it?

Nope. I never once said that. The NT scan is optional, yes. And widely covered by insurance. The genetic is also optional and widely not covered by insurance. What I want is for the OB to provide a lower cost option (i.e. covered by insurance typically) for testing. Nothing free. Just not a test that is $350 out of pocket as the only choice when a covered test exists and a year ago this OB office was ordering them standard.

Tawny87 · December 2015

What about the progenity verifi test? That's what my office uses. They say if insurance doesn't cover it the max out of pocket for everyone is 99$

Just wondering if this test was common in other offices, especially since it seems so much cheaper?

Huskerfanz · December 2015

Lilwatz said:

huskerfamily said:

Lilwatz said:

MsBeachNJ said:

@lilwatz - I'm under 35 with no known risks and my insurance is covering the test. When I spoke to the doctor she said that historically the test hasn't been covered without those factors but many insurance companies now cover it. Have you checked with your provider to be certain? Could be worth the call if you haven't already done so! Stinks how many variations there are in coverage for pregnant women... we should all be able to get the best coverage/care available.

Yes, I have. The test gives me an info screen for payment. They claim the test costs $750.00. With my insurance they say it is $530.00. Self-pay is $349.00. Cost-prohibitve for many.

So you think your OB should be doing an optional test for free? Have you talked to your insurance about it?

Nope. I never once said that. The NT scan is optional, yes. And widely covered by insurance. The genetic is also optional and widely not covered by insurance. What I want is for the OB to provide a lower cost option (i.e. covered by insurance typically) for testing. Nothing free. Just not a test that is $350 out of pocket as the only choice when a covered test exists and a year ago this OB office was ordering them standard.

But they are offering it at a lower cost. Your insurance decides what is covered so have you talked to them? Your OB doesn't dictate what insurance will pay for.

When I was pregnant two years ago, it wasn't standard at my OB.

Lilwatz · December 2015

huskerfamily said:

huskerfamily said:

Lilwatz said:

MsBeachNJ said:

@lilwatz - I'm under 35 with no known risks and my insurance is covering the test. When I spoke to the doctor she said that historically the test hasn't been covered without those factors but many insurance companies now cover it. Have you checked with your provider to be certain? Could be worth the call if you haven't already done so! Stinks how many variations there are in coverage for pregnant women... we should all be able to get the best coverage/care available.

Yes, I have. The test gives me an info screen for payment. They claim the test costs $750.00. With my insurance they say it is $530.00. Self-pay is $349.00. Cost-prohibitve for many.

So you think your OB should be doing an optional test for free? Have you talked to your insurance about it?

Nope. I never once said that. The NT scan is optional, yes. And widely covered by insurance. The genetic is also optional and widely not covered by insurance. What I want is for the OB to provide a lower cost option (i.e. covered by insurance typically) for testing. Nothing free. Just not a test that is $350 out of pocket as the only choice when a covered test exists and a year ago this OB office was ordering them standard.
But they are offering it at a lower cost. Your insurance decides what is covered so have you talked to them? Your OB doesn't dictate what insurance will pay for. When I was pregnant two years ago, it wasn't standard at my OB.

I think we disagree that $350 is affordable and not cost prohibitive for many people. We decided to get it and have the money. I know MANY moms who could not and could have afforded the much smaller copay for the NT scan. That's classist in my opinion and not ok. Have money or don't get testing. Not cool in my book.

Huskerfanz · December 2015

Lilwatz said:

huskerfamily said:

But they are offering it at a lower cost. Your insurance decides what is covered so have you talked to them? Your OB doesn't dictate what insurance will pay for. When I was pregnant two years ago, it wasn't standard at my OB.

I think we disagree that $350 is affordable and not cost prohibitive for many people. We decided to get it and have the money. I know MANY moms who could not and could have afforded the much smaller copay for the NT scan. That's classist in my opinion and not ok. Have money or don't get testing. Not cool in my book.

I didn't say it was affordable. I just think it's a weird reason for multiple calls to your OB and wanting to switch practice when an OPTIONAL test isn't offered at the price point that you want. Not sure why you are ignoring my questions about your insurance as I think that is who your ire should be directed.

I'm not going to get all the testing done for this pregnancy for a different reason (multiples means no blood tests, not insurance coverage issues necessarily) and I'm just going with it as that's all I can do in my case. I'm glad you are getting all the testing you want and have the money to pay for it. Hope it goes well.

Lilwatz · December 2015

huskerfamily said:

Lilwatz said:

huskerfamily said:

But they are offering it at a lower cost. Your insurance decides what is covered so have you talked to them? Your OB doesn't dictate what insurance will pay for. When I was pregnant two years ago, it wasn't standard at my OB.

I think we disagree that $350 is affordable and not cost prohibitive for many people. We decided to get it and have the money. I know MANY moms who could not and could have afforded the much smaller copay for the NT scan. That's classist in my opinion and not ok. Have money or don't get testing. Not cool in my book.

I didn't say it was affordable. I just think it's a weird reason for multiple calls to your OB and wanting to switch practice when an OPTIONAL test isn't offered at the price point that you want. Not sure why you are ignoring my questions about your insurance as I think that is who your ire should be directed.

I'm not going to get all the testing done for this pregnancy for a different reason (multiples means no blood tests, not insurance coverage issues necessarily) and I'm just going with it as that's all I can do in my case. I'm glad you are getting all the testing you want and have the money to pay for it. Hope it goes well.

I missed your question about insurance, not ignoring it. And yes, it's optional, but testing *IS* important to me. I am someone who likes as much time as possible to prepare for things. If my child has a genetic abnormality, I would like time to process and plan. The fact I am angry and made multiple calls is that the office DOES see value in this optional testing. They put everyone in for the genetic testing. But they refuse to put people in for the version of the testing that is affordable. I find that to be wrong.

Was your question if I checked with my provider? Yes. Of course I did. Someone who is a planner and calls the OB multiple time to get a test also calls insurance.

Lilwatz · December 2015

Also, if it's optional. Why will my OB not support my option to do it? If they don't OF COURSE I should find an OB in line with my values. I'm not sure why you are so shocked I would leave an OB over this. (And there are other reasons/concerns too).

Atlast111 · December 2015

@Lilwatz. The NT test can not be done past 14 weeks so if you decide to switch OB you might miss the window.

Lilwatz · December 2015

Atlast111 said:

@Lilwatz. The NT test can not be done past 14 weeks so if you decide to switch OB you might miss the window.

Oh I am well aware! Hence the many phone calls. We decided to pay the money and do the genetic test so we are covered, but thanks!

Huskerfanz · December 2015

Lilwatz said:
Also, if it's optional. Why will my OB not support my option to do it? If they don't OF COURSE I should find an OB in line with my values. I'm not sure why you are so shocked I would leave an OB over this. (And there are other reasons/concerns too).

Sorry, I didn't know your OB refused to do the test. I thought the issue was with their cash cost. If you would feel more comfortable with a different office, then switch. I misunderstood and thought it was more of an issue with insurance paying for the test.

Huskerfanz · December 2015

Also I completely understand planning, I'm also type A.

Lilwatz · December 2015

@huskerfamily Ah! Yeah, without that I wouldn't care.

HBamama2B · December 2015

@happygal5 hi! I'm 34, will be 35 at birth. I had the MT21 two wks ago and the NT today. I asked the same question, why have both? I have a very advanced Obgyn office, so no 'habit' issues, just good medicine.

The DR explained that the two tests both test for the same three key trisomy concerns, but each covers different other issue areas and have different sensitivities (for instance MT21 is 91% sensitive for downs). In my drs case, he orders both and reviews them together. If one is positive for any parameter, he can quickly check it against the other rather than risk missing the NT window. So there are definitely things one test will tell you that the other will not. If you have the option and it's covered, I say the more information the better.

happygal5 · December 2015

Thanks I might see if they will also honor a request for a NT scan...I heard it can catch some anatomical abnormalities early on which NIPT can't

Trinirican3ondway · December 2015

My Dr explained to me that the Harmony doesn't test for spina bifida but the NT scan does. As I understood, you have to have 2 scans about 4 weeks apart as well as blood work and they combine all of that together to determine the risk.

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Doctor only ordered NIPT.....what about NT scan?

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