Health Insurance for Maternity Services

posted 3 years ago in Pregnancy
Post # 2
Member
1206 posts
Bumble bee
  • Wedding: September 2015

I’d recommend calling your insurance company to get an explanation of that and to clarify exactly what’s included. 

Post # 3
Member
47190 posts
Honey Beekeeper
  • Wedding: November 1999

liade :  Give them  call to clarify but my understanding is that ultrasounds done only for gender determination would not be covered but ultrasounds done for pregnancy care would be.

ultrasounds… performed exclusively for gender determination or selection are not covered.

Post # 4
Member
2680 posts
Sugar bee
  • Wedding: September 2014

liade :  I’d suggest calling the member services number for your plan for clarification. There are so many variations in the way plans are structured, there’s a high likeliehood other people’s experiences may not apply to your situation. 

Post # 6
Member
1179 posts
Bumble bee
  • Wedding: July 2015

liade :  I’ll be 11 wks tomorrow and my coverage says something quite simial to yours. At my first appointment, we were given an insurance breakdown stating that as long as we don’t have any complications, we will pay $0 out of pocket except maybe some hospital fees-YAY! If we do have complications, there’s an 80/20 rule or something like that.

The limitations section… read the WHOLE statement for #1… tests (ultrasound CVS etc) done EXCLUSIVELY for determining gender are not covered.

Ultrasounds are not as common as you might think or hope. I had 1 at my confirmation appointment that is used to make sure the baby is in there and for dating purposes. I will have another Friday at my 2nd appointment as part of the NT scan (checks for downs, etc), and then I’ll have one around 18-20 weeks for the anatomy scan (gender usually determined here, but not the sole purpose of the scan). Most people who get more have gone through fertility treatments to get pregnant or they are considered high risk.

Other prenatal tests include urine tests and blood work, glucose testing, pap smear, and probably a few others. As far as I can tell most tests use blood and urine samples. Group B Strep is tested with a swap late in the pregnancy.

As for the cost of tests outside of insurance… Probably not worth asking here. I’d imagine answers will vary. Talk to your doctor about optional testing, then see what insurance will cover as well as any costs you would be responsible for. I’m having the NT scan which includes an ultrasound but I could have opted for other testing at this stage that would have given us the gender also but it’s just done via bloodwork and since I’m not over 35 or high risk, I was told by my dr it was unlikely my insurance would cover it and could be anywhere from $300-500 depending on a few things.

 

Post # 7
Member
2021 posts
Buzzing bee
  • Wedding: September 2013

labs and ultrasounds weren’t covered for my pregnancy. i think the ultrasound was a few hundred bucks. cant really remember. 

Post # 10
Member
652 posts
Busy bee

Ultrasound coverage varies greatly and I know mine are covered 100% under prenatal care because I’m designated as high risk (so it’s medically necessary testing), but other friends had to pay if they needed more than 2 sonograms without having any additional risk factors. If you look under the imaging/radiology portion of your policy it might further indicate if there is an additional copay for ultrasounds.

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