# Stupid Insurance....ultrasound problems



## AriannasMama

So my insurance is driving me crazy...they cover 1 routine ultrasound plus any others that are medically necessary, now I am not sure what that means in insurance terms, but now I am afraid my 20 week ultrasound will not be covered because I already had one to date the pregnancy....or would that be considered medically necessary? Ugh...they already screwed up the billing for the first ultrasound and submitted the claim twice, we got a bill for $940 but said we owed nothing? I dont get it


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## Croc-O-Dile

What kind of insurance do you have? I've had two different insurances during my pregnancy, my first was Amerihealth HMO & now I have Horizon BC&BS EPO. As long as your doctor orders the ultrasound it should be covered by your insurance. Basically what that means is that they won't cover and private scans or ultrasounds for entertainment purposes only. They should cover your 20 week ultrasound as long as your doctors bill it right. It's a "medically necessary" ultrasound because it's to check that the baby's growing properly and there are no complications that can't be detected early on. 

If you get billed for it call your office and ask them about it first before calling your insurance, because they'll give you the "It was how it was billed" excuse.


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## AriannasMama

I have Cigna.


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## amygwen

I have Cigna too, and I was able to get one ultrasound done at 14 weeks (to see how far along I was, I didn't know I was preggo til very late on) and I also had another one done at 20 weeks (to find out the sex & see if everything looked normal). The 20 week ultrasound is very medically necessary because this is when they usually can determine if everything looks normal or if there are abnormalities. Unfortunately in my case they found an abnormality (cleft lip) and now I get one done every 4 weeks (high-risk pregnancy). But in a normal pregnancy, you should get one done at 20 weeks, that's usually without question. You can double check with your doctor's office, because it's medically necessary to have it done at 20 weeks.


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## AriannasMama

Thanks ladies! After being on the phone with the insurance company for 30 minutes I finally got to talk to a real person and they said it will be covered as well. Again, I hate insurance companies!


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## nightkd

Glad you got it sorted. :)

Also, sorry to hijack a little...does anyone know of any insurance I can get this far into the pregnancy? We've been paying out of pocket so far, because we went to get insurance, but conceived before it was sorted and have basically been told that no-one will cover a woman who is already pregnant (DH can't even get insurance for HIMSELF because I'm pregnant... :wacko:)... We've also read that many places require you to have coverage for a year before you conceive, which isn't worth it! Any ideas? Would be great to have some help, even at this point, because we have so many expenses coming out over the next couple of months (and still have part of a $2500 bill to pay for our MW!)...

xx


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## Croc-O-Dile

nightkd said:


> Glad you got it sorted. :)
> 
> Also, sorry to hijack a little...does anyone know of any insurance I can get this far into the pregnancy? We've been paying out of pocket so far, because we went to get insurance, but conceived before it was sorted and have basically been told that no-one will cover a woman who is already pregnant (DH can't even get insurance for HIMSELF because I'm pregnant... :wacko:)... We've also read that many places require you to have coverage for a year before you conceive, which isn't worth it! Any ideas? Would be great to have some help, even at this point, because we have so many expenses coming out over the next couple of months (and still have part of a $2500 bill to pay for our MW!)...
> 
> xx

I have Horizon BC&BS and was switched to them at about 20 weeks. My previous insurance was dropped because my dad's boss couldn't pay them. They didn't give me any problems, so maybe check with them? If not, can you apply for state insurance? (I.E Medicare/caid I can't remember which one is for old people and which one isn't :haha:)


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## amygwen

nightkd said:


> Glad you got it sorted. :)
> 
> Also, sorry to hijack a little...does anyone know of any insurance I can get this far into the pregnancy? We've been paying out of pocket so far, because we went to get insurance, but conceived before it was sorted and have basically been told that no-one will cover a woman who is already pregnant (DH can't even get insurance for HIMSELF because I'm pregnant... :wacko:)... We've also read that many places require you to have coverage for a year before you conceive, which isn't worth it! Any ideas? Would be great to have some help, even at this point, because we have so many expenses coming out over the next couple of months (and still have part of a $2500 bill to pay for our MW!)...
> 
> xx

Hey there! I agree with Ally, have you tried applying for Medicaid? Even though I have insurance, I wanted to try and apply for Medicaid as a secondary insurance just in case my primary insurance didn't cover something! Which is great, because all my doctor's bills are paid for :thumbup: And, I applied around 32 weeks and got it accepted at 33.5 weeks! You can apply online and then it'll be expedited because you're pregnant and since you're so far along they will really rush it to make sure you have health insurance in time for your baby being born! And it will also last for 6 months so it will cover your baby when it's born as well :) So yeah, try and apply for that firstly.. that's all I can really say. I don't know any insurance companies that would cover you that isn't under your job. Sorry! :)


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## nightkd

Thanks girls, I don't qualify for Medicaid due to DH's income and I don't think I'm entitled because I'm an immigrant...

DH is going to try and talk to someone tomorrow about BC & BS again (even if we can't get something for the pregnancy, we need to figure out something for Bean)... We were actually told by an insurance guy that BC & BS wouldn't cover from mid-pregnancy..... :shrug:

We've done searches online to try and find something, but there are so many different options and some of the plans are really expensive, it's difficult to work out WTF is worth it and what we're actually covered for :wacko: Pain in the butt!

xx


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## baby.moo

Same with my insurance! .. SOOOO STUPID .. but I also think it depends on how your doctor is .. my doctor is strict on doing things right and not ordering unnecessary ultrasounds.. sometimes i wish the doctor would see how much i want another one and make up an excuse!


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## nicholatmn

I lost my insurance with my job two weeks after I found out I was pregnant. And no other insurance wanted to cover me because I was pregnant. It really sucked. I did find out that if you have a state-funded hospital, they more than likely have waivers so you don't have to pay them and they'll take it as charity and they'll get the money next year for taxes. :)
That's what I did. But now my DH is military, so now I am covered under military insurance.


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