Post # 1
Help! Is this normal! I feel like every week I am getting 3-4 bills! I am so annoyed! I have good insurance and pay good money for it, prior to expecting I know what my insurance covered. I spoke with CS at the Insurance company and they told me I was 100% covered. Great!
After we found out we were expecting, we also found out that I had a condition that requires me to see a High Risk dr. I see the HR dr every 2 weeks and my normal OB every 2-4 weeks. My normal OB doesn’t charge me a copay after the first visit of being pregnant, however, the HR dr charges me a specialist copay of $40 every visit. This didn’t seem right to me, so I called my insurance company, who agreed, that is not right and that I should not be being them a copay, regardless if they are a specialist because. I fought with the HR dr office for over a month as well as called my insurance company serveral more times explaining to them and even having them call to tell them I was no longer to pay a copay, however, they refused and kept charging me. I just got the mail and in it was 8 different bills from the High RisK dr, varying in cost for all different things. I call up my insurance company, and the women I speak to NOW tells me that yes regardless of not paying a copay for my OB I am required to pay it every visit for the High Risk even though it’s considered maternity. She then goes on to explain what the bills are for that for every ultrasound, I have to pay 10%, WHAT! I get an ultrasound every 2 weeks by HR. I am furious, and then on top of all those bills I am getting tons of bills for all the blood work!
Does anyone else feel like they are paying a lot of baby related bills? Does my situation seem right? I mean I said to the lady on the phone that I am being sent there by my OB, it’s not like I have a choice and it’s the well being of my child, how can I be paying so much out of pocket when I am 100% maternity. I’ve never ever had to pay any insurance bills, I see 2 specialist for other reasons and again never paid anything but my copays.
Post # 3
I think every insurance and OB is different. For mine, we had to pay the deductible (which is $2,000) by 26 weeks. After that everything is paid for 100%.
Post # 4
Every insurance is different, I would talk to your insurance company again to find out item by item what is covered and what is not. I work in the health insurance industry. It all depends on what you are on for plan.
Post # 6
I’m dealing with a lot of insurance crap also. Told that maternity coverage is 100% but then I find out there are ALL these little loopholes. High risk isn’t covered, genetic testing isn’t covered and what they put into that category are some of the most BASIC tests that we all get.I have even gotten a bill for my rhogam shot which ALL pregnant women get if they are RH-. It’s not like it was an optional injection.
So yes, as sucky as it is…you may be stuck paying these bills.
Just because you have “100% maternity coverage” doesn’t mean that they don’t also have a long list off all these little loopholes where they don’t cover “x,y,and z” Or maybe you insurance will pay a percentage of the high risk fees for that dr. will still come to you to pay the remainder.
I feel for you. I know how frustrating this all is. I checked and doubled checked to make sure I knew what I was covered for, but there are STILL things that I didn’t even think about. Then I get a bill and come to find out that it’s one of the many little things that they don’t cover
As others suggested, you will need to get a very detailed list of everything they do not cover. Possibly you can speak to the dr. before you have upcoming appointments to find out what they are planning to do the next time, then call the insurance and ask them. I have found that often you only get the right info when you are asking a very specific question. You may get a canned “yes, everything is covered” answer when asking about your maternity coverage in general…but if you ask if “wyz is covered” then you may actually hear “oh, well we say maternity is covered but this thing is not”.
Post # 7
Also, be prepared for the bill that will come when you deliver. Things like epidurals are routinely not covered.
Post # 8
ditto what @spraguebride said – they will tell you that maternity care is covered across the board but there are millions of loopholes. it all depends on how the dr bills each service. like, for my son’s birth, the actual labor was billed as “surgery” and all tests and labs in the hospital were “inpatient care” – same as if i was in a car accident or something. so i ended up having to pay a portion even though they made it sound like it would be covered the same as all my prenatal stuff.
question – are you sure you have to continue seeing your normal ob now that you’re seeing a specialist? maybe you can start getting all your care in one place. or maybe the HR doc visits are temporary so you wont have to see him/her through the end of your pregnancy? i would try to work with the docs to minimize your visits, identify tests/screenings that may not be essential, etc.