BCBS coverage for testing following miscarriage/D&C?

[Anonymous]

Last summer I miscarried at 9 weeks after doing IVF. I had a D&C at Shady Grove Fertility and agreed to have the fetal matter tested for abnormalities. I asked about insurance coverage and got a wishy-washy response along the lines of "insurance usually covers this but you should check with your carrier to confirm." I was pretty distraught at the time and didn't follow up. My mistake. I asked a friend who had the same procedure and she said everything was covered by her insurance. Can you guess where this is headed?

Yesterday I received a check from my insurance company for over $1000. Cool. Except according to EOB, I owe the provider $1500 out of pocket (which I believe is in addition to the money they sent me).

I'm just kind of shocked. I had this procedure 9 months ago and am just now finding out that there will be charges for this? What the heck? Has anyone experienced this before? If you had testing done as part of a D&C after a miscarriage, did you insurance cover it?

[Anonymous]

This happened to me too - i got the same prep speech from shady grove before my d&c (9 weeks along) in June 2011, but I just got a bill for approx $600. I have blue cross carefirst (fed). I keep meaning to call and fight it, but haven't done so yet. As an aside, the test was completely useless as they were unable to distinguish fetal tissue from my tissue, so there were zero findings.

[Anonymous]

Oh no. I just had a d&c at 11 weeks and gor the tissue tested. I already know they couldn't distinguish tissue from cells so no real findings. I just assumed it was covered by bcbs.

[Anonymous]

Aaaand this is why I didn't even bother with the testing (I'm referring to the previous two posters, not the OP, but the cost sucks too). This was my first miscarriage though and I had no trouble conceiving, and my doctor recommended that I not even bother testing unless it happens again.

[Anonymous]

OP, the amount you owe is probable $1500, not $2500. If it was $2500, the $1000 would have been sent to your provider. Read the EOB carefully and if you have questions, call your insurer.

[Anonymous]

OP here. Thanks for the replies. I was reawlly hoping that someone would tell me that insurance DID cover this. Darn it!

FWIW, the testing did reveal that the fetus had genetic abnormalities. Not sure that it was truly helpful though. It certainly wasn't worth this kind of money. Ugh!

[Anonymous]

Someone else mentioned this thread today (but didn't post) here, for some reason.

This happened to me as well. In case this happens to anyone else - in my case, it was a billing error; the hospital coded the miscarriage (and subsequent tests, I had some minor complications) as an elective abortion, which is not covered under my plan. I called the insurance company, and within minutes they called my doctor and the hospital and confirmed it was an error. So, if this happens to you, check how the hospital coded the procedures.

[Anonymous]

Where was your testing done? If it was done through Natera, I sugget calling them directly. In the end, I did not have insurance issues getting coverage for testing post D&C, but originally I thought I would. Their finance department was pretty helpful. And if I recall, the oop rate was something like $900 (so your $1000) check should cover.