Ultrasounds and Insurance

iVillage Member
Registered: 06-03-2011
Ultrasounds and Insurance
Mon, 03-12-2012 - 10:52am

I really wish our insurance hadn't changed since I had Gabby. When I was pregnant with Gabby we had all the ultrasounds that I needed and it was never a problem with payment.

So here is the situation. I am about 4 weeks along and I called my MW today and made an appointment for a month from now, I will be about 8 1/2 weeks pregnant. She said that she wants to do an ULtrasound at that appointment but to check with my insurance company.

The idea of seeing my little one sooner than 20 weeks is so exciting to me. However I called my insurance company and they only cover 1 US unless it's medically neccessary. We have a $3000 dollar deductible that I highly doubt we will reach for awhile, so we will have to pay for this 1st ultrasound anyway. but if we for some reason were to meet it by then we wouldn't have this covered.

I am thinking of calling my MW's office and seeing if they can code this as medical neccessary so then my 20 week US can be the "one".... Just wanted people's opinions on this. I know I am being selfish.

iVillage Member
Registered: 08-04-2003
Mon, 03-12-2012 - 12:38pm
The insurance I had with Teddy covered "medically necessary" ultrasounds. They considered a dating ultrasound, due to irregular periods medically necessary. They considered the US that is part of the triple screen medically necessary. BUT they didn't consider the 20 week anatomy scan medically necessary IF you were having a regular pregnancy and we not high risk; which I was having and not high risk.

Your MW might be able to code this first US as medically necessary for a number of reasons, you would need to talk to them.
iVillage Member
Registered: 06-03-2011
Mon, 03-12-2012 - 4:41pm

Well I called my MW's office and unless when I have the appointment she deams it neccessary for me to have one I won't be having one until 20 weeks.

The desk person said it was unethical to code it that way when the dating one isn't "neccessary" so I am without an US for 1/2 the pregnancy....uggg!! Oh well.

Avatar for sandyc299
iVillage Member
Registered: 01-08-2008
Tue, 03-13-2012 - 10:02pm
I am lucky as all my u/s are necessary due to high blood pressure and this time will be to being over 35.

David Nicholas 12/5/09
Expecting a GIRL 3/23/13

iVillage Member
Registered: 07-15-2004
Tue, 03-13-2012 - 10:22pm
Jessica, My OB with Simon did an ultrasound at the first one and a few other times. They were covered in her price. The only US that I actually paid for was when the US tech came in and did it. Which was at 20 weeks and another one at 33 weeks. She used to give us peaks all the time cause she had the US in the room with us.



iVillage Member
Registered: 02-16-2008
Wed, 03-14-2012 - 9:04am
I'm the same way, Jess. For me, though, it's just because the midwives don't do any more than necessary, so I get to choose the 20 week one. When I had Peter, the OB did the dating u/s in office, so it wasn't considered one for insurance purposes.
by sara photo sigbysara.jpg
Community Leader
Registered: 02-06-2006
Wed, 03-14-2012 - 9:12am
Just be sure to monitor how you're feeling over the next couple weeks. If you have any kind of cramping at all, I wouldn't be shy about telling them & having them check on the pregnancy to see if things are going well. That should be considered medically necessary.

I wouldn't be comfortable lying about it, but I'd be pretty comfortable keeping an eye out for any twinge!


iVillage Member
Registered: 06-03-2011
Wed, 03-14-2012 - 9:25am

Unfortuntely if I have one that is "medically neccessary" I have to get it pre-confirmed or whatever that's called. So it's not like I can get it the day of. I plan on talking to my MW and see....if I have to wait I have to wait, but having to wait 20 weeks is going to kill me!! Oh well.

Thanks ladies!