Back from my 1st appt!

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Joined: 07/21/02
Posts: 1007
Back from my 1st appt!

And we have a bean measuring 10 w 0 days, 1 day ahead of their calculations (exact with mine) with a heartbeat--and s/he even gave a little wiggle while we were watching and kicked its legs. Smile Yay!! I'm so excited! She said the m/c rate goes way down now that the baby is measuring so on target.

We are deciding on the NT scan (maybe if insurance will cover it) and if so, I'll go in 2 weeks for that. If not, my next appt is not until Aug 2nd at 16 weeks--6 weeks away! I want to do the NT scan just to make sure things are still ok since I have to wait so long! We also scheduled my 20 week u/s and ob visit for Sep 1st!

Thanks for all your kind words--I was a nervous wreck!

Jenn0113's picture
Joined: 03/09/07
Posts: 5335

YAY! I'm so glad it went well and you got to be entertained by your LO.

I would say GO FOR IT on the NT Scan if its covered. I didn't do it with #1 but did with #2 and now wish I had done it both times.

Yay for already scheduling the gender scan!

turtnjay's picture
Joined: 02/24/09
Posts: 2095

Yay!!! Yay!!!! Super yay!!! I had a great feeling about this bean!

I hope the NT is covered. It is really nice to see baby again and they do such a detailed scan you just get stare at baby forever!

Mommyin0406080912's picture
Joined: 02/16/08
Posts: 1644

YAY!!! Glad everything went GREAT!!!!

kridda_88's picture
Joined: 01/28/08
Posts: 1798

Maybe you were just waiting to be on another BB with me. Wink j/k. I'm so glad that everything looked so good!!! I know what you mean about the long wait for the appointment, it still seems like mine is forever away! Awesome about scheduling the gender u/s already!!! Even my OB wouldn't let me do that until I was 18 weeks.

RoniBoo's picture
Joined: 06/07/11
Posts: 903

awsome !! Great news... So happy for you that all went well Smile

lesleynka's picture
Joined: 04/26/11
Posts: 1845

Wonderful Holly!!

I would imagine your scan would be covered. It's basically like preventative care, an insurance company would be stupid not to cover it.

Joined: 07/21/02
Posts: 1007

I called insurance, and they said it is covered "when deemed medically necessary" I asked her if she could tell me what "medically necessary" means? She has no idea! They are such a help :roll: Anyone have Cigna and know if it is covered for you?

I guess I have to call the dr to see if it is medically necessary. I have 2 weeks to figure it out.

turtnjay's picture
Joined: 02/24/09
Posts: 2095

Yeah, just call the doc and they can say it is.

It tests for downs and trisomy so I can't see why they would give the ok and deem it medically necessary. With my insurance it needs prior approval but they call and get that once I've made the appt.

lesleynka's picture
Joined: 04/26/11
Posts: 1845

You can't go to Cigna's site, log-in & look? That's what I did w/ blue shield. I just looked up genetic testing under maternity/pregnancy.

kridda_88's picture
Joined: 01/28/08
Posts: 1798

Ugh!!! Don't get me started on Cigna!!!! That's what we have and they are awesome when the cover stuff but man it can be a pain to get them to cover some things. If you go with an out-of-network provider with our plan they WILL NOT cover the expenses unless it was life or death and even then they will only cover what they decide to cover.

Sorry that probably wasn't much help to you. lol. I would imagine that if you could get your doctor to say it was medically necessary that they would cover it. Just make sure that your doctor, and the nurses, and the billing department all know this. I just fought a bill from my clinic and insurance on something that should have been covered but someone just didn't get the right information in the computer. :rolleyes: I have a love hate relationship with insurances, particularly cigna.

Joined: 07/21/02
Posts: 1007

She sent me to the website and neither of us could find where it said WHEN it would be deemed necessary. Nothing said "IF YOU ARE 35 OR OLDER" yadda yadda. Or anything of the like.

And yes, I'm kinda new to the whole insurance hassle thing. My dh had a different job from the time we graduated college together, until last december--one that had "magic insurance" I never paid a copayment, never had a deductible. Anything and EVERYTHING was covered 100% (thanks Mr. Gates Wink ) BUT he since left his previous job and took a good growth opportunity job elsewhere, now we have to deal with insurance. So this is my first pg with this insurance. Last 3 times I was like "sure, whatever you need to do!" Luckily too, because with my first baby, I had in depth genetic testing, since I have/had 2 siblings with very major heart defects/developmental delay (mental retardation), and other health issues. My sister (born before me) died at 4 days old from her heart defect, my brother is in constant trouble with his heart--surgeries, pacemaker etc. So I'm glad all that was done previously, as I had nothing they found genetically to make us suspect I could carry something on. And I had like 5 u/s with ds1--including a detailed fetal-echo.

kridda_88's picture
Joined: 01/28/08
Posts: 1798

Wow! You were lucky! With William we only paid $15 to have him and that was with cigna. I would imagine where it doesn't have "limitations" on it anywhere in their records that as long as your doctor will say it was needed they will probably cover it then. If they don't I would bring it up with them if you get charged and fight them about it. I had to start taking down names, dates, and time that I called and right down all the information they gave me because of something that happened before we had William that I fought but couldn't remember all the details I had been given and they basically laughed at me. Now if I ever have to fight them on something I have all the information I was given including the representatives name and paper work if it was involved. Smile Like I said Cigna can be great with somethings but other things you have to fight.

turtnjay's picture
Joined: 02/24/09
Posts: 2095

Holly, I would say with your history it will not be a problem to get doctor to advise for NT scan/first trimester screening and notify the insurance.

Renee595's picture
Joined: 12/09/05
Posts: 307

I work in the healthcare field in the business end of a large speciality practice. Medically necessary is such a common excuse to avoid having a policy to pay for certain things, mostly testing. Your MD can write a medical necesseity letter if needed and Cigna should allow the test. Health insurance in the US is failing by leaps and bounds, it will get worse before it gets better.

Joined: 06/04/11
Posts: 573

Congrats on a good appointment!

can't say much about the insurance thing- where I am health care is covered, only thing you have to pay for is private or semi-private rooms, phone line if you want it oh and tv . My work benefits plan will cover the room- so should be set.

Sounds confusing when I read about the insurance and what is covered. I have read a bit on here- interesting how it works in the US

Joined: 12/01/10
Posts: 997

I don't have any extra insight on the insurance coverage part but I hope everything works out and you can have the scan covered. Maybe check with the clinic where you may do the scan because they might have someone in their billing dept who is familiar with which insurances cover their services...or they might tell you to call your insurance company which doesn't sound like it has helped :confused:

JuneorJulyBaby?'s picture
Joined: 10/20/08
Posts: 2479

Yay for a great appointment! Sounds like you have a great looking baby in there Smile

As for insurance issues, I called my insurance (no help at all) and then looked online and FINALLY I found that blue cross covered the NT as long as I had the bloodwork to go along with it. I had to do a LOT of digging though as it said "genetic testing" wasn't covered in our employee manual but then once you log on to the website and sign up they had better details. My biggest help was just asking others that had the same insurance if their scan was covered (my co-workers). So maybe DH can ask some of his co-workers if they or their wives had the NT scan done.

Joined: 12/01/10
Posts: 997

"JuneorJulyBaby?" wrote:

As for insurance issues, I called my insurance (no help at all) and then looked online and FINALLY I found that blue cross covered the NT as long as I had the bloodwork to go along with it. I had to do a LOT of digging though as it said "genetic testing" wasn't covered in our employee manual but then once you log on to the website and sign up they had better details. My biggest help was just asking others that had the same insurance if their scan was covered (my co-workers). So maybe DH can ask some of his co-workers if they or their wives had the NT scan done.

That makes sense that they might say only covered if blood test is done along with u/s because they probably want to weed out people who are only doing the NT u/s to get an extra peek at the baby...though can they blame us? That's a good idea to ask other co-workers with same insurance if DH is comfortable with that.