(Closed) Health Insurance and babies

posted 7 years ago in Babies
Post # 3
Member
6572 posts
Bee Keeper
  • Wedding: February 2010

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
Member
6824 posts
Busy Beekeeper
  • Wedding: June 2011

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
Member
1032 posts
Bumble bee
  • Wedding: August 2009

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
Member
1220 posts
Bumble bee
  • Wedding: November 2009

Also, be prepared for the bill that will come when you deliver.  Things like epidurals are routinely not covered.

Post # 8
Member
681 posts
Busy bee
  • Wedding: May 2009

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.

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