I'm not on aca but the hospital called to inform me that my NT scan would be charged differently than most of my prenatal care since it is at the hospital. I tried to argue that it is still prenatal testing, and that if it weren't for covid my mfm office would do it at their office. (They say that due to covid they are not doing the NT scans.)

They said they will submit it to my insurance but wanted me to know how much it will probably cost.

It could be an actual mistake. I had to pay a copay for my first prenatal appointment and i was reimbursed.

It could also be that someone in the office put in the wrong code. They billed you for a urine culture not a urine check or some equally non sensical thing so it was billed not as part of pre natal. Look at your EOB and see if you can see what the uncovered charges are. Then argue with the office to get them to see if they misfiled.

My genetic screen was billed under the lab name not the lane corporation name so I got a 2,000 bill for standard NIPT testing because insurance said it was out of network and will not cover. I am in day 54 of fighting that. I am 38 and this is routine AND I have insurance! They need to resolve the coding error but that is pulling teeth.

Anyway good luck!

Could it be a hospital charge? Not for prenatal care but once I went to JHU and insurance paid the doctor bill but I had to pay the hospital bill. I guess it’s like a facility fee.

Anonymous wrote:ACA covers the prenatal doc visits - checking heartbeat, blood pressure, and talking to you. All the testing (blood work, ultrasounds, etc.) gets billed separately.... it sucks.

That's what they're billing for though. I've paid for all extras separately. These are literally just visits.

ACA covers the prenatal doc visits - checking heartbeat, blood pressure, and talking to you. All the testing (blood work, ultrasounds, etc.) gets billed separately.... it sucks.

OP- it was definitely routine prenatal appointments, the dates I had them with the provider I saw. I've already paid for ultrasounds and bloodwork through tongued parties so I know it's not that. My insurance company basically kept repeating my plan info when I spoke to them and there's nothing listed in my plan booklet about routine care. I need to speak to the provider on Monday and then calm insurance again. But I'm not crazy that routine should be covered right??

Ugh this has been the annoyance of my pregnancy. I also have an ACA plan (Blue Cross Gold PPO) and it says in big print that pre-natal care is covered after a $65 initial co-pay. Turns our the fine print in the coverage documents says I am responsible for other co-pays as allowed.

It turns out all MFM appts. are inside the hospital so even though they are just office appts I have to pay a $90 co-pay for any MFM appt. So far its been 3; standard anatomy scan, follow-up scan bc they didnt get all the angles/pictures they wanted the first time, and a growth scan.

MFM has recommended weekly pre-natal monitoring bc of risk factors at week 36 and each one will also be $90. BAH. Im looking at over $700 of co-pays before I even get to the delivery.

Yeah deductible doesn't apply to prenatal. Are you sure it wasn't for other stuff done during prenatal appointments that you are responsible for like bloodwork etc...? I ask because my prenatal appointments are covered but I have gotten a couple bills for some bloodwork/testing that wasn't covered 100%.

Deductible shouldn't apply to prenatal visits.

What is your insurance?

Definitely contact insurance on Monday.

What was the bill?

Most insurance plans still have a deductible, is it possible you haven’t met it yet?

I just got a large bill from my OB's office for my portion of a bunch of routine prenatal appointments. Of course my insurance company was no help and the billing department is now closed for the weekend. I thought that under ACA all routine prenatal visits were covered? Or at least a copay? Has anyone been billed like this?