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February 2017 Moms
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NT scan not covered?

SweetTSweetT member
in February 2017 Moms
Has anyone had an issue finding out if their insurance covers the NT testing? 
My insurance can't really give me a straight answer and I'm trying not to get stuck with a $1200 bill. 
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Re: NT scan not covered?

  • fourPsinapodfourPsinapod member
    My insurance covers no genetic testing because they deem it "not medically necessary" but I don't know if that's true for every insurance. 
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  • SweetTSweetT member
    They say it depends on the diagnostic code. So I got that from my doctor and they said it may or may not be covered but they can't tell me for sure until the claim is processed. So I guess I will just cancel it just in case. 
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  • cinderincinderin member
    can your doctors office run it to get an estimate and see what it comes back with? 

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  • SweetTSweetT member
    cinderin said:
    can your doctors office run it to get an estimate and see what it comes back with? 
    I plan on calling tomorrow, originally to cancel but I'll ask this first. Thanks for the idea. 
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  • PerraSuciaPerraSucia member
    That's total bullshit I'm sorry. 
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  • hispenguinhispenguin member
    PerraSucia said:
    That's total bullshit I'm sorry. 
    Ditto. That is crap.
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  • momousekeemomousekee member
    Ask your insurance company if they have a written policy that covers non-invasive down syndrome screening? You should be able to get a copy of it. You might even be able to find it on the internet. 

    For example, Aetna's is here - https://www.aetna.com/cpb/medical/data/200_299/0282.html and for Aetna, in single pregnancies you can't do the NT ultrasound alone, you have to do it in combination with at least a blood test.  
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  • yogadevilyogadevil member
    Mine doesn't cover it, because it's deemed investigative and not medically necessary. If I was 3 months older they'd cover it since I'd give birth at 35. Theres other conditions too, like if any of the chromosomal disorders run in either of our families, or if my Dr somehow wants to code it as 'necessary'.

    We have awesome insurance, and prenatal care is 100% covered...however the loophole is that they get to define prenatal care as whatever they want it seems, and things aren't always coded as prenatal care to begin with. My weekly progesterone tests, for instance, aren't covered which sucks.
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  • SweetTSweetT member
    My sister has chromosomal abnormalities which is why my doctor encouraged it. 
    However, my sister is one of like 3 people in the world with this combo and it was completely spontaneous according to my mom's genetic counselor. So she won't change the diagnostic code because technically I'm not high risk.
    I know it's silly to worry especially since the NT scan or any of the blood tests don't look at the chromosomes she's affected by, plus the spontaneous part, it's just always a worry in the back of my mind. 
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  • cinderincinderin member
    how much is it if you paid for it? 

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  • SweetTSweetT member
    $1200 if I attempt to let it go through insurance. $500 if I just pay cash day of the appointment. 
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  • cinderincinderin member
    geeze. 

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    Expecting Baby Bean February 2017
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  • SweetTSweetT member
    Yeah a bit too much, H and I decided against it unless something changes with our insurance. Kind of bummed I won't have another ultrasound until late September too. But it is what it is. 

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