Federal Employees Health Insurance - which has the best maternity coverage?

[Anonymous]

I have BCBS Standard. So far it has been good. I've only paid the copay for the first OB visit and a portion for the genetic testing. MaterniT21 was covered (though I don't know if it's because I am AMA). They have covered all the extra sonograms and a couple of non-pregnancy related ER visits. I have been billed about 1K out of 5K for a fetal MRI.

[Anonymous]

PP - that is a high copay for an MRI and what I'm worried about with the Standard plan.

Comparing the two BCBS programs it does look like the basic may be a better option as long as you are OK using the in network drs. My reading of it is that with Standard you can be charged a % for certain procedures like PP. However, basic has a set copay. I also read a recent review that stated paying more doesn't always get you more and they compared the two BCBS programs stating the basic was the cheaper but better program IF you are ok with the in network drs.

[Anonymous]

Are there no co-pays with BCBS basic also?

[Anonymous]

Anonymous wrote:Are there no co-pays with BCBS basic also?

There are NO copays for prenatal care or pediatrician care until age 22 with the Basic. You will pay a $150 one-time flat fee for delivery, regardless of what type of delivery you have.

There is a really good tool for comparing the Basic and Standard plans on the Federal BCBS website. I used to have Standard. I now pay MUCH less for the Basic for the same doctors.

[Anonymous]

What about for NON prenatal care, like well visits. What is the copay for BCBS basic?

[Anonymous]

Anonymous wrote:What about for NON prenatal care, like well visits. What is the copay for BCBS basic?

$25 for primary care provider and $35 for specialists. http://www.fepblue.org/benefitplans/compare/index.jsp

You can also search their provider directory to make sure the doctors you want are covered. I've never found a provider that doesn't take BCBS (unless they don't take insurance at all), but my experience is mostly with larger offices.

[Anonymous]

I have BCBS standard federal. For all of my pregnancies all has been covered EXCEPT the initial pregnancy test and initial blood tests in office to confirm pregnancy and full work up(~100) Also I pay a $20 co-pay every time I see the doctor.
What is this about BCBS fed covering the cost of a breast pump in 2013? Can't seem to find this info can anyone forward it to me.

[Anonymous]

Anonymous wrote:I have BCBS standard federal. For all of my pregnancies all has been covered EXCEPT the initial pregnancy test and initial blood tests in office to confirm pregnancy and full work up(~100) Also I pay a $20 co-pay every time I see the doctor.
What is this about BCBS fed covering the cost of a breast pump in 2013? Can't seem to find this info can anyone forward it to me.

I actually got a letter from them in the mail summarizing the changes that would start in Jan 2013, and the breast pump thing was noted in there.

I just searched their website and found it listed on pg. 43 of their 2013 brochure - it's covered for both standard and basic but only two types of pump and you have to order them through CVS. If you have your own pump it sounds like they'll pay for a certain number of storage bags.

http://www.fepblue.org/downloads/2013-service-benefit-plan-brochure_100512.pdf

[Anonymous]

The link posted states that it is the Ameda Double electric brest pump KIT. Has anyone called to see if it is actually the pump or just the getting started kit. BIG difference!!! I guess a call is in order as it also mentions nothing about having to have a prescription. Just doesn't seem to be real but if it is this is huge!!! Calling!!

[Anonymous]

I don't think it includes actual brest pumps since if you go to the next page it states Not included: Breast pumps

[Anonymous]

Anonymous wrote:

Anonymous wrote:What about for NON prenatal care, like well visits. What is the copay for BCBS basic?

$25 for primary care provider and $35 for specialists. http://www.fepblue.org/benefitplans/compare/index.jsp

You can also search their provider directory to make sure the doctors you want are covered. I've never found a provider that doesn't take BCBS (unless they don't take insurance at all), but my experience is mostly with larger offices.

Those co-pays are only accurate for sick visits. Well-baby visits are free under BCBS basic.

[Anonymous]

Anonymous wrote:I don't think it includes actual brest pumps since if you go to the next page it states Not included: Breast pumps

It says "Not covered: Breast pumps and milk storage bags except as stated on pg. 43" (emphasis mine) Based on the online brochure and the pamphlet I got in the mail - plus what I've read about Obamacare - I'm pretty sure BCBS is going to cover the pump itself. But yeah, I guess always best to check with your individual insurance provider to confirm.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Are there no co-pays with BCBS basic also?

There are NO copays for prenatal care or pediatrician care until age 22 with the Basic. You will pay a $150 one-time flat fee for delivery, regardless of what type of delivery you have.

There is a really good tool for comparing the Basic and Standard plans on the Federal BCBS website. I used to have Standard. I now pay MUCH less for the Basic for the same doctors.

Ditto! I switched to the Basic and found that I'm saving money. Standard did come in handy, however, during my 3rd trimester with my daughter. I used an out-of-network chiropractor to turn DD head down. I haven't needed any out-of-network care since then and that was 3 years ago.

[Anonymous]

BC/BS Basic also. Been very happy with prenatal & pediatrician coverage and regular coverage for us. Dental is really basic, but maybe that is the case for all the plans.

Baby was in the NICU for almost 2 weeks and we ended up paying I think $500 of the 30k that the hospital billed for her care.

[Anonymous]

NP here and I really appreciate all the insight into BCBS standard vs. basic. We currently have standard, but I am seriously thinking we should switch to basic. DC1 was born under standard and, if I recall correctly, the only out of pocket expense was a payment towards our deductible when DC needed to be aspirated right after birth. (Baby considered own patient at that point, not part of maternity/delivery.)

It's my understanding that with Basic, you MUST use an in-network provider to be covered. I don't see that as a problem day to day, but how does that work with delivery. If I deliver at Fair Oaks Hospital, which is in-network/preferred, can I assume all the doctors practicing at the hospital (anesthesiologist, neonatal team, etc) are all in-network as well? I couldn't be surprised by a bill for a delivery/post-delivery check up because the on-call doctor isn't preferred, right??