stupid. stupid. stupid. Aetna

iVillage Member
Registered: 08-04-2003
stupid. stupid. stupid. Aetna
7
Wed, 06-30-2010 - 3:33pm

I am so mad right now I can't even see straight.

My Dr's office billing called me to have a chat about my insurance, Aetna. As they are telling me Aetna doesn't cover the routine US at 20 weeks... because it's routine. All other ultrasounds they will cover but not the 20 week one. But wait... they will cover it if there is a problem. How can they not cover the most important US of your pregnancy? You know the one that checks for defects and looks at the heart and spine and limbs. Seriously.

My cost... about $600... but they will give me a 20% discount since I have to pay out of pocket... unless there is a problem. Seriously??!!

My brother died of an undetected heart defect, and they want to pull this BS on an ultrasound that looks for these things. Seriously??!!

Oh, and they want a credit card on file to cover the cost of this US.

Photobucket

Photobucket
iVillage Member
Registered: 12-18-2007
Wed, 06-30-2010 - 3:47pm

That stinks for two reasons...one your insurance is being unreasonable and two your dr's office is charging an outrageous amount.

iVillage Member
Registered: 08-24-2005
Wed, 06-30-2010 - 4:08pm
WOW that's expensive!!!! I can't believe they won't cover such an important thing as a 20 week u/s!!!!
In your case, I would talk to your Dr. because if your brother passed because of a heart condition, I think it is absolutely necessary for you to get such an u/s, and the insurance b*stards won't be able to get out of it.
PhotobucketDaisypath Anniversary tickersLilypie First Birthday tickersLilypie Breastfeeding tickersPhotobucketPhotobucketPhotobucketPhotobucketPhotobucketPhotobucket

Photobucket

iVillage Member
Registered: 03-19-2007
Wed, 06-30-2010 - 4:51pm

Having paid for too many ultrasounds (I have a high-deductible plan), that sounds really high. And a huge boo on the not-covering the u/s. My sister was saying that tricare (i think - insurance for military dependents, someone correct me if I'm wrong) has stopped paying for the 20 week u/s as well. Some of her friends were repeatedly being asked by the doctor if they were having any problems; in other words, the doctors were trying to have a reason to have the insurance cover it.

I think it's pretty backward that medical insurance doesn't do a better job of covering preventative care. I'm so sorry that you have to deal with this but hopefully your doctor will work with you and your insurance so that you can get the u/s covered.

Photobucket

Lilypie Second Birthday tickers

PhotobucketPhotobucket

Photobucket
Photobucket

iVillage Member
Registered: 04-22-2006
Wed, 06-30-2010 - 6:01pm

Wow Kate - that's awful!! It does not make sense at all that they would pay for all other U/S's but not the mandatory (is it mandatory in the USA?) - or at least very important - 20 week one. I would see if your doctor could recommend it for you because of your family history.

Is it possible to get it done somewhere else where it won't cost so much? $600 sounds absolutely ridiculous.





Powered by CGISpy.com







I love the sig offers at SMFB








Powered by CGISpy.com

<
iVillage Member
Registered: 02-26-2008
Thu, 07-01-2010 - 7:06am

Kate - I would talk to your doctors office, maybe then can code it differently so it gets covered...I have aetna and have found some ways around it. My doctors office also charges a but load for the US when it's at the hospital, vs when it's at the clinic, so maybe you can do that as well?

Good luck!









Powered by CGISpy.com



Daisypath Anniversary tickers

iVillage Member
Registered: 11-27-2007
Thu, 07-01-2010 - 1:11pm
That is so dumb. Do you think you can schedule it and then the day before say you have some spotting? Maybe they could just use the "problem u/s" code then? You should call Aetna about it. They covered ALL my ultrasounds, even the routine ones.
iVillage Member
Registered: 06-25-2006
Fri, 07-02-2010 - 6:42pm
Call Aetna and work on getting it pre-approved due to family history. We have found that several things for G "aren't covered" yet have gotten pre-approval and ended up being covered 100%. I would not give them a credit card, that is ridiculous.
Photobucket


AlternaTickers - Cool, free Web tickers

Lilypie Breastfeeding tickers

Photobucket
Photobucket