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

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

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[quote=Anonymous][quote=Anonymous][quote=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.  [b]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?[/b]  I couldn't be surprised by a bill for a delivery/post-delivery check up because the on-call doctor isn't preferred, right??[/quote]
[b]
I have BCBS basic and wondered the same thing but everything for my delivery (and epidural) at Inova Fairfax was covered except the co-pay[/b].  Not sure if I just got lucky or if the hospital somehow monitors this and only assigns doctors to your case who are providers?  The BCBS basic network is huge, so my guess is that most doctors do work with them.[/quote]

My understanding is that BCBS covers hospitals as one provider.  For example, I am seeing Wisdom for my prenatal care and delivery.  None of the midwives are listed on the BCBS website as providers.  When I called BCBS to ask if the midwives were considered "in network," I was told that all providers operating out of a covered hospital (i.e., GW) were covered.  I am 31 weeks and have paid $0 so far for my prenatal care.

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As for the PP asking about dental coverage... it is actually more annoying than anything that BCBS now covers minimal dental.  With the Basic, you pay a $25 copay for a semiannual cleaning, exam, and x-rays.  With the Standard, you pay a percentage (I think it's 15%) of the total cost of the appointment, which ends up being substantially more than $25.  Other basic services (fillings, etc.) are covered at the same rate... but nothing extra is covered.  If you know/think you might need extra dental work (root canal, crown, orthodontia, etc.) you need to buy separate dental insurance.  Getting the secondary (dental) insurance to pay is a huge pain because they want to first see that BCBS rejected the claim.[/quote]

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