Insurance probs... Need to vent!

jthomas2270 · March 2016

So I just found out (after filling out the preregistration) that while my doctor is in network, the hospital she has privileges at no longer is. I switched insurance companies at the beginning of this pregnancy and specifically chose one that my OB accepted (she delivered my first baby and it was a complicated delivery so we have great relationship and a lot of trust). It's looking like my only option is to switch doctors at 31 weeks! This makes me so uncomfortable... And I'm seriously stressing. Anyone had this happen? Any advice?

doozer1345 · March 2016

I haven't had this happen. However, sometimes if you call your insurance and explain that that is the only hospital your doctor has privileges at they CAN (not WILL) pro rate your coverage there if given enough time in advance. I had surgery done at a hospital where my surgeon was covered, the hospital was covered, but the anesthesiologist wasn't covered in network. I called ahead to my insurance and they told me they could pro rate the hospital or anesthesiologist on any procedure as long as the doctor was covered. It's worth a shot at least.

jthomas2270 · March 2016

Thanks @doozer1345I'll give it a try

gamommyx3 · March 2016

I second this...if you give them a heads up they can probably tell you how to deal with it. Your doctor might have some suggestions too...if you have a popular insurance she may have other people in the same situation & know how they dealt with it.

Knottie64278661 · March 2016

Another possible option is to ask your insurance if they will do an "in-network referral." Means you make a request through them to approve an out of network facility as in-network for you. I am currently doing this because I've decided to deliver at a birth center instead of a hospital but it's not in my network. Since the closest birth center in my network is over an hr away, they consider it too far to travel for birth and will consider the birth center I want as in-network. If you go this route, make sure to have them expedite the request because it could normally take 30 days to process. I've waited a week and hopefully will have my answer by the end of today. Good luck!

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Insurance probs... Need to vent!

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