Question by Love My 3 Babies: Will Aetna cover my 18-20 week ultrasound?
I am under my husband’s insurance policy through Costco. We have Aetna PPO Freedom of Choice (we chose to have the best one because we have three little ones). Well we had the same plan with my last pregnancy (this would have been about 2 years ago) and I remember the ultrasound place telling me to check my coverage to make sure they will cover it because Aetna is “iffy” with sonograms and usually only cover one per pregnancy (I was thinking that the 8 week was considered an ultrasound but I never knew otherwise). Well, I remember calling them and they referred me to the website with the coding and as long as the right one was used regarding abnormal pregnancy I would be fine. So I went in and had the screening done and they found a hole in one of the four chambers of my son’s heart and coded based on their evaluation. Aetna covered it.
Now, I got the same response from the same ultrasound place today when I called up to make my appt for the end of this month and if Aetna wasn’t going to cover it then I would have to pay $ 995.00, however I wouldn’t know until it’s already done. I called Aetna once more and they referred me to the website to type in “ultrasound for pregnancy” in the search area. I did and this whole policy crap came up which I don’t understand what the heck it’s talking about other than pretty much summing it up that it won’t cover an ultrasound for any reason other than mulitples, or if there is a problem with the baby, or a medical problem within mom to make sure the baby is ok. I just don’t understand how you can know if anything is wrong unless you have at least one ultrasound to determine if the baby is complete? I don’t even want to find out the sex I just want to make sure baby has all of it’s anatomy.
I’ve been reading so many horror stories that Aetna won’t cover it unless they find something wrong with baby which is a horrible reason…but you still get to find out the sex. I’m beginning to wonder if the ultrasound technician just made up the hole in the heart to send to the insurance so they’d cover it, she wasn’t a bit worried and told me everything was just fine and it would clear up. When I went back to my doctor that following week they didn’t even mention a thing about the hole until I brought it up and she brushed it off as there was nothing to worry. My son is going to be 2 in Jan and hasn’t had any heart related problems whatsoever.
So I told my husband that if they won’t cover it then we are just going to use this coupon for a $ 100 3d/4d ultrasound and at least we can see what the baby looks like and I’m sure they can do a full body scan for a little more…much less than a grand.
Best answer:
Answer by Kelli – Pregnant with #1
Honestly, I’d call Aetna again, and ask for a supervisor. Tell them you don’t want a website, you want to know what is included in your plan! Don’t let them get off the phone with you. The websites haven’t done you any good so far.
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