(Closed) NT Scan Not Covered?

posted 6 years ago in Pregnancy
Post # 3
Member
403 posts
Helper bee
  • Wedding: September 2010

My doctor didn’t order one, and it’s not standard at the practice I go to if you’re under 35 and don’t have other risk factors.  My insurance wouldn’t have covered it either for the same reasons.  If you would consider terminating a pregnancy because of a genetic abnormality, then I would suggest you get this earlier test.  But if you just want to know to be prepared for a possibly disabled child, then you are ok with doing the quantitative screening blood test and the anatomy scan which happen a bit later. 

Post # 5
Member
6009 posts
Bee Keeper
  • Wedding: May 2009

It seems like the real issue here is that your doctor didn’t discuss the scan with you.  Maybe just communicate to your doctor that you’d like to be informed of all procedures, voluntary procedures included, in the future.  To be honest, I’m in the process of changing doctors right now, and it’s such a hassle.  I’m not sure I’d switch doctors over this, since it seems more like a miscommunication than a deliberate omission.

Post # 6
Member
554 posts
Busy bee
  • Wedding: August 2011

@PandasWifey:  My first doctor said the same thing even though my insurance covered the screening.  She said it would be insurance fraud to have the test if there were no risk factors in our families. I switched because of this and had my NT Scan today. I can tell you for me at least, it was incredibly reassuring and I’m very happy I decided to change providers. 

Post # 7
Member
1144 posts
Bumble bee
  • Wedding: November 2011

@PandasWifey:  With my now 3 year old son my doctor didn’t even offer the test and IRL I have never heard of anyone having a NT scan.

Post # 8
Member
1110 posts
Bumble bee
  • Wedding: September 2011

Many doctors don’t offer NT scans for women who have no risk factors, I was never offered one and was never told what it was. You can’t always opt to have medical procedures, there needs to be justification or insurance won’t cover it. For example, you can’t go to your doctor and say you want an xray if there’s no medical need for it. I don’t think wanting the scan because you would consider terminating if the test showed a high risk of DS is a valid enough reason for the insurance companies, but I’m not entirely sure? But that is something your doctor probably should have gone over with you.

I wouldn’t change doctors because he doesn’t see a medical need for an NT scan, because whatever doctor you switch to will probably agree, unless you believe you have some risk factor for some reason? Did they offer you the blood test? The results from that test should be factored into whether or not you need the scan.

I agree it’s a good idea to let someone at the office know you’re interested in maybe sitting down and going over the common pregnancy tests and understanding why they are or aren’t recommended for you. If they won’t go over this information with you then maybe switching is a good idea.

Post # 9
Member
494 posts
Helper bee
  • Wedding: November 2011

When we had our 8 week appointment, we were told that the nt scan isn’t covered by insurance but the later ones are. We were made well aware of this when we went in.

Post # 10
Member
2410 posts
Buzzing bee
  • Wedding: July 2011

maybe schedule a talk with them to go over everything as other posters have suggested? I have never heard of anyone not having an NT Scan, I thought it was standard procedure. Maybe it differs regionally.

Post # 11
Member
2142 posts
Buzzing bee
  • Wedding: August 2010

I have to double check but if I remember correctly it was covered like all my other u/s. Which my insurance only covers a portion because I have coinsurance on mine.

Post # 13
Member
679 posts
Busy bee
  • Wedding: November 2010

My doctor told me that she was federally mandated to discuss the test(s) with me, but that it was my decision to proceed if I chose to do so.  Since she was required to provide me with the option, the insurance company does not have the choice to not approve it.  BUT, they did require me to go to a specific place for the test.

Post # 15
Member
368 posts
Helper bee
  • Wedding: July 2011

Actually having a downs baby is not based on family history, there is a small likelihood of downs being related to family history, but the majority of babies born with downs, there is no family history of Downs Syndrome.  Also, your risk of having downs is lower if you are under 35, but that does not mean that because you are under 35 you have no risk of having a downs baby.  The NT scan should be discussed by all doctors, but it is your election to have the scan or not. 

Post # 16
Member
988 posts
Busy bee

@PandasWifey:  Props to you for choosing to change to a practice whose procedures you are more comfortable with!  Is an NT scan always medically necessary? No.  It is a useful test to do anyway to make sure the baby is developing properly?  Yes.  Should your other doctor have clearly laid out your options and explained things to you?  Most definitely!  Also, I would like to point out, that I have a friend whose mother was told she already 3 healthy children and was under 35 so there was no risk and no need for the test.  Her 4th child was born with Down’s syndrome.  She sued since she was advised not to have a test that could have diagnosed her daughter’s condition in utero.  I think it’s better to have as much information as possible.  Also, to the PP whose doctor said it was “insurance fraud” if you didn’t have any risk factors, I find that laughable!

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