Health Choice insurance (state employees) pg Q?

llizzyb

This is probably mainly directed at the teachers who have been pregnant recently or just research better than me. I'll call tomorrow, but I'm sure I'll get fifty-five answering service recordings before I get a real person. If you have Health Choice, did it cover the first trimester screenings (NT scan, etc.)?

Steven&Jamie

I have GlobalHealth but I had Health Choice before switching last year and, in anticipation of being pregnant, I researched both providers. I'm pretty sure their coverage was basically the same, but HC has a deductible and copays are different. All that to say yes, I believe first tri screenings are included however, instead of an NT scan I just had bloodwork done and my insurance paid for 1 ultrasound prior to 20 weeks and 1 after 20 weeks (unless more were deemed medically necessary). I think HC's benefits are very similar.

llizzyb

Thanks for responding! I know my early ultrasound with my RE wasn't covered, because it was under infertility services, so I wasn't sure about the coverage of any other imaging other than the anatomy scan at 20 weeks.

However, I'm high risk, so I know I'll get ultrasounds at that doc, in addition to my normal OB. I've got a lot of questions for insurance call tomorrow!

Steven&Jamie

Your doctor/hospital should also have a financial counselor/advisor who knows the ins and outs of your insurance policy. I met with the one at our hospital during first tri and she went over how much we would pay for prenatal care, what all was covered (u/s, bloodwork, etc), how much we'd pay OOP for the hospital stay, etc. She knew her stuff! And so far everything has been exactly as we've expected--no $$ surprises thus far which is nice. You might check and see if your doctor/hospital has someone like this you can speak with as well.

jesseandbri

My DH is a state employee so I too looked at this plan when choosing coverage last year, on pregnancy most of the coverage is very similar.  

Make sure you write down the name and the id number as well as the time and date when you call to get answers from the insurance company.   

Something I will tell you is that everything that is "normal" (first tri screenings being one of those things) is covered in the lump sum bill that you will get after baby is born.  BUT, look closely at your bill and the EOBs they send you and make sure they all match.  If not, do not pay until you get clarification.

Dannyand Allison

llizzyb:

Thanks for responding! I know my early ultrasound with my RE wasn't covered, because it was under infertility services, so I wasn't sure about the coverage of any other imaging other than the anatomy scan at 20 weeks.

However, I'm high risk, so I know I'll get ultrasounds at that doc, in addition to my normal OB. I've got a lot of questions for insurance call tomorrow!

I have HealthChoice High and it covers fertility services. Might be worth asking why it wasn't covered for you. Congrats again!

+buttercup+

Steven&Jamie:

Your doctor/hospital should also have a financial counselor/advisor who knows the ins and outs of your insurance policy.

If you are still seeing Dr. K, don't count on their office to be able to tell you anything about your insurance.  I had to tell them what my portion of the co-pay/deductible was every time.  They would have no clue.  Last month I finally got a $350 refund check from a surgery I had in 2009.  I had to fight long and hard with the insurance about that one!

I would check with one of the counselors at the hospital where you are going to deliver. 

llizzyb

Dannyand Allison:

llizzyb:

Thanks for responding! I know my early ultrasound with my RE wasn't covered, because it was under infertility services, so I wasn't sure about the coverage of any other imaging other than the anatomy scan at 20 weeks.

However, I'm high risk, so I know I'll get ultrasounds at that doc, in addition to my normal OB. I've got a lot of questions for insurance call tomorrow!

I have HealthChoice High and it covers fertility services. Might be worth asking why it wasn't covered for you. Congrats again!

Hmm, you are right. I know it has some limitations when it comes to IF services, so I assumed an early ultrasound would be under "not covered". But you're right, I should call and ask! Thanks

llizzyb

+buttercup+:

Steven&Jamie:

Your doctor/hospital should also have a financial counselor/advisor who knows the ins and outs of your insurance policy.

If you are still seeing Dr. K, don't count on their office to be able to tell you anything about your insurance.  I had to tell them what my portion of the co-pay/deductible was every time.  They would have no clue.  Last month I finally got a $350 refund check from a surgery I had in 2009.  I had to fight long and hard with the insurance about that one!

I would check with one of the counselors at the hospital where you are going to deliver. 

Yes, I'm staying with Dr. K. Thanks so much for the heads up. I know he personally has no clue about how much any service costs patients (didn't even know about some drug coupons!) but I haven't really had to talk insurance stuff with his office much since I've met my OOP max and so far everything except the ultrasound has been covered.

+buttercup+

llizzyb:

+buttercup+:

Steven&Jamie:

Your doctor/hospital should also have a financial counselor/advisor who knows the ins and outs of your insurance policy.

If you are still seeing Dr. K, don't count on their office to be able to tell you anything about your insurance.  I had to tell them what my portion of the co-pay/deductible was every time.  They would have no clue.  Last month I finally got a $350 refund check from a surgery I had in 2009.  I had to fight long and hard with the insurance about that one!

I would check with one of the counselors at the hospital where you are going to deliver. 

Yes, I'm staying with Dr. K. Thanks so much for the heads up. I know he personally has no clue about how much any service costs patients (didn't even know about some drug coupons!) but I haven't really had to talk insurance stuff with his office much since I've met my OOP max and so far everything except the ultrasound has been covered.

Yeah I don't think he has a clue what goes on in the business office. But I think you will love having him for delivery!