$1000 for an ultrasound?? Is this normal?

[Anonymous]

Speaking from experience, fight everything. Call the insurance company, document each conversation including date, time, who you spoke to, length of call, what was said. You have to be aggressive - ask for the person’s name because they often won’t give it. Ask for a supervisor if necessary and document their name, etc. Keep these records impeccable. Get an explanation for why they aren’t covering it. Then call the hospital billing and tell them you’re disputing it and ask them to put the bill on hold and not send to collections and document that conversation including date, time, name of staff person. Ask for documentation of that conversation and note any dates they give you, Eg if they put the bill on hold for 60 days, 30 days, etc. Be in regular conversation with them and don’t just ignore any deadlines - if you’re approaching any deadlines call them and tell them the status of the negotiations.

If you can’t get insurance to cover the charges (which is surprising since I thought prenatal care is covered under Obamacare and I’d tell this to the insurance company), you can negotiate with the hospital to not pay full sticker price as other previous posters have said.

I have gotten thousands of dollars of bills I received erroneously corrected or dismissed simply because I am the rare person who refuses to just pay for a medical bill that is wrong or that insurance should be covering and I am ruthless in my follow through on both sides. Most insurance companies and hospitals eventually get sick of patients fighting them (since so often people just pay for bills and don’t even bother to consider if they are actually responsible, and far fewer are willing to make multiple phone calls and continue to follow through) and you’d be surprised how often a bill can simply disappear or an account be zeroed out. I’ve successfully gotten rid of erroneous bills from Sibley, GW, an outpatient surgery center, and many more places because I refuse to just pay when I get a bill that’s wrong.

That said, a high deductible plan is never a good option, and you need better coverage ASAP.

[Anonymous]

Anonymous wrote:My neighbor on Medicaid told me she calls the ambulance any time she has to go to the doctor because it’s free and she doesn’t have to sit in a waiting room. Your routine prenatal care pays for that.

Thanks for furthering stereotypes about who gets Medicaid. Hint: most recipients are not who you think they are, and many are disabled, white, rural poor, and the elderly.

[Anonymous]

Anonymous wrote:Definitely call your insurance company and maybe call your OB as well. Routine prenatal care is supposed to be 100% covered.

This happened to me in 2014 and 2016 - unless medically necessary, the 20 weeks scan is not considered part of routine prenatal care. I almost lost my mind!

[Anonymous]

Anonymous wrote:Definitely call your insurance company and maybe call your OB as well. Routine prenatal care is supposed to be 100% covered.

The prenatal visits are covered, but not necessarily tests like ultrasounds (which is crazy because those are pretty standard).

[Anonymous]

I have a HDHP too with United. My ultrasounds were about $600 each. I may have satisfied the $3K deductible before the 20 week scan (I’m older, so I did one every month).

[Anonymous]

I can believe it. A family member ended up in the ER recently for several hours (could have been faster if they were motivated to work) for something that turned out to be mostly unexplained and requiring no either treatment, and the bill was $8k with very good insurance. That’s the part we had to pay. I wish I was kidding. They offer discounts but only to poor people, so if you’re a donut family who can’t afford it comfortably but can technically afford it then you’re SOL.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Definitely call your insurance company and maybe call your OB as well. Routine prenatal care is supposed to be 100% covered.

The prenatal visits are covered, but not necessarily tests like ultrasounds (which is crazy because those are pretty standard).

Same thing here. I see other posters commenting on calling your insurance company and citing Obamacare. I did try that but didn’t get anywhere; they said I had to fulfill my high deductible first which I will once I deliver. I am curious if others with high deductible plans have other experiences than this - not those with PPOs. And for those saying to find another plan, I wish. That’s all my work offers.

[Anonymous]

You always have to fulfill the deductible. Ultrasounds aren’t covered. A lot of people have government insurance and it’s really good so they are out of touch. A friend only paid $100 for prenatal care. We paid 15k but that’s including the monthly premiums and dh works for a big pharmaceutical company.

[Anonymous]

Anonymous wrote:You always have to fulfill the deductible. Ultrasounds aren’t covered. A lot of people have government insurance and it’s really good so they are out of touch. A friend only paid $100 for prenatal care. We paid 15k but that’s including the monthly premiums and dh works for a big pharmaceutical company.

Honestly, it depends on the plan what is covered.

Paying 15K seems really unusual for someone with good private insurance. What’s your deductible and OOP max? What kind of plan was this with what coverage level? What do you pay per month?

We had an 80/20 PPO plan with my first and I think we paid less than 5K total for that pregnancy, then we switched to my husband’s amazing PPO with BCBS (not government) and I don’t think we paid anything for that pregnancy and birth after we hit our family deductible which was very low, like a few hundred dollars. Our coverage is extremely, extremely good, but we also pay a lot per month for it we intentionally chose the best plan even though it was the most expensive option by far.

Obviously YMMV but in our experience it’s been well worth the extra money per month in premiums for a better health insurance plan. When we have gone with cheaper plans when we were younger (HMOs, higher deductible plans, or less coverage eg 70/30) we always ended up paying a lot more out of pocket and we eventually figured out that the cheaper plans actually cost us way more in OOP spending over the course of a year.

Obviously everyone’s budget and options limit your choices but I do think sometimes people don’t realize that choosing a cheaper plan with less coverage only saves you money if you never go to the doctor, and that you’re taking a gamble with it. I have a good friend who makes 3x my salary alone but always chooses the cheap health care plan for her family and then complains how much stuff costs, and I don’t think she ever realized that paying more in premiums with a better plan can actually save you hundreds or thousands every year, especially if you have to go to the ER, have a family member who sees specialists or has a chronic condition, etc.

Which insurer you go with can also make a huge difference. I will always choose a BCBS over UHC, Aetna, etc. for the better customer service and billing alone.

[Anonymous]

When we pay exorbitant medical bills it furthers the idea that healthcare is only for the rich, when it should be a human right. Paying these bills also emboldens greed. It’s a sad situation.