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Dulcinea
Weekend Warrior
Member since 3/08 2530 total posts
Name:
Dulcinea
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United Healthcare and 20 Week Sono
I was just informed that United Healthcare is not covering the 20 week sono so I'll have to find another way of paying for it - w/o coverage it'll cost $350 for the sono.
It's apparently medically necessary to make sure the baby's anatomy is developing properly but UH refuses to pay!
Anyone has experience with this? Does it really cost $350 for the 20 week sono?
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Posted 7/9/08 8:26 PM  |
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Porrruss
Nya nya nya
Member since 5/05 11618 total posts
Name:
Amy
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Re: United Healthcare and 20 Week Sono
I have UH and all my sonos were covered. If the doctor deems it medically necessary- then it should be covered!
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| Posted 7/9/08 8:32 PM |
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KateDevine
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Member since 6/06 24950 total posts
Name:
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Re: United Healthcare and 20 Week Sono
Why are they not covering it? Did you already have your allotted amount of sonos?
I had oxford when I was pg and I was entitled to 3 (the one confirming, the ultrascreen and the anatomy scan) and since DS was small, my doctor wanted me to have a growth sono and they covered that as well.
What do your doctor say?
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| Posted 7/9/08 8:34 PM |
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FelAndJon
needs to update her avatar pic
Member since 6/05 10212 total posts
Name:
Felice (aka LuckyBride2004)
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Re: United Healthcare and 20 Week Sono
Really? I am shocked. I had United (until last week - long story...) and they covered all my sonograms. Call and fight it..
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| Posted 7/9/08 8:36 PM |
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DRMom
Two in Blue
Member since 5/05 20223 total posts
Name:
Melissa
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Re: United Healthcare and 20 Week Sono
definitely call or send them a letter and have you Dr call too. That is ridiculous
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| Posted 7/9/08 8:38 PM |
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Dulcinea
Weekend Warrior
Member since 3/08 2530 total posts
Name:
Dulcinea
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Re: United Healthcare and 20 Week Sono
Apparently UH is refusing to pay because they don't deem it medically necessary anymore! They will cover the 12 week and 32 week though. :P
It's not even a matter of any sort of limit on sonos per pregnancy. The doctor's office informed me of this and are trying to fight it since their other UH patients are facing the same dilemma. :P
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| Posted 7/9/08 8:49 PM |
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Kelly9904
Mommy to 2 amazing little boys
Member since 5/05 9306 total posts
Name:
Kelly
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Re: United Healthcare and 20 Week Sono
I had UHC and had no issues, I didnt have an ultra screen just a regular sono and they paid for it.
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| Posted 7/9/08 8:59 PM |
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headoverheels
s'il vous plaît
Member since 6/07 42079 total posts
Name:
LB
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Re: United Healthcare and 20 Week Sono
Posted by Porrruss
I have UH and all my sonos were covered. If the doctor deems it medically necessary- then it should be covered!
same here - why wouldn't it be covered? 
ETA: i am 31 weeks, i had a level II at 20 weeks and 22 weeks and a growth sono at 30 weeks and they were all covered by United Healthcare. i just had to pay my $18 copay.
maybe your dr's office entered in the wrong code?
Message edited 7/9/2008 9:36:03 PM.
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| Posted 7/9/08 9:34 PM |
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ThreeCats
Train Ride
Member since 5/05 3127 total posts
Name:
A
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Re: United Healthcare and 20 Week Sono
Oxford would not pay for my 20 week - my doctors office is fighting it for me -
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| Posted 7/9/08 9:49 PM |
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Dulcinea
Weekend Warrior
Member since 3/08 2530 total posts
Name:
Dulcinea
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Re: United Healthcare and 20 Week Sono
For those who don't have to pay, are you doing the regular sono?
Maybe UH is not paying because they don't feel you need to have a 3D sono to detect anatomical anamolies. That is the type of sono that my doctor recommended though. :P
Message edited 7/9/2008 10:40:43 PM.
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| Posted 7/9/08 9:59 PM |
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DeniseMarie
<3
Member since 8/07 10682 total posts
Name:
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Re: United Healthcare and 20 Week Sono
Posted by Porrruss
I have UH and all my sonos were covered. If the doctor deems it medically necessary- then it should be covered!
same here
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| Posted 7/9/08 10:04 PM |
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sometimesmommy
Always in my heart.....
Member since 11/06 6686 total posts
Name:
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Re: United Healthcare and 20 Week Sono
really..wow. I had UHC and got sonos like every 2-3 weeks in the hospital. I'd try to fight it.
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| Posted 7/9/08 11:08 PM |
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Laura1976
Member since 5/05 5754 total posts
Name:
Laura
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Re: United Healthcare and 20 Week Sono
thats very odd. For DD they covered all my sonos and this pregnancy i've had 7 or 8 so far and haven't had a problem.
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| Posted 7/9/08 11:12 PM |
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FelAndJon
needs to update her avatar pic
Member since 6/05 10212 total posts
Name:
Felice (aka LuckyBride2004)
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Re: United Healthcare and 20 Week Sono
Posted by Dulcinea
For those who don't have to pay, are you doing the regular sono?
Maybe UH is not paying because they don't feel you need to have a 3D sono to detect anatomical anamolies. That is the type of sono that my doctor recommended though. :P
Ahh, that could be it. Typically the Level II (AKA 20 week sono) is not a 3D, it is a regular black and white. That could be it?
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| Posted 7/9/08 11:44 PM |
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IrishMom77
Brothers!!
Member since 8/05 3498 total posts
Name:
Roseann
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Re: United Healthcare and 20 Week Sono
I have UHC and they paid for 2 sonos at 20 weeks
Seamus Finnw ouldnt cooperate the first time, so I had to go back to get better pictures of his heart. I was warned they probably wouldnt pay for the 2nd one, but they did. I ended up owing Madonna about 17 bucks
There are many different levels of insurance within UHC. My Dh has a very high level through Chase
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| Posted 7/10/08 7:35 AM |
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headoverheels
s'il vous plaît
Member since 6/07 42079 total posts
Name:
LB
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Re: United Healthcare and 20 Week Sono
Posted by FelAndJon
Posted by Dulcinea
For those who don't have to pay, are you doing the regular sono?
Maybe UH is not paying because they don't feel you need to have a 3D sono to detect anatomical anamolies. That is the type of sono that my doctor recommended though. :P
Ahh, that could be it. Typically the Level II (AKA 20 week sono) is not a 3D, it is a regular black and white. That could be it?
that sounds more like the case... you really shouldn't need a 3D sono for your level II. it costs more, i'm willing to bet that's why your insurance is denying it.
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| Posted 7/10/08 8:41 AM |
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SweetTooth
I'm a tired mommy!
Member since 12/05 20105 total posts
Name:
Lauren
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Re: United Healthcare and 20 Week Sono
Posted by headoverheels
Posted by FelAndJon
Posted by Dulcinea
For those who don't have to pay, are you doing the regular sono?
Maybe UH is not paying because they don't feel you need to have a 3D sono to detect anatomical anamolies. That is the type of sono that my doctor recommended though. :P
Ahh, that could be it. Typically the Level II (AKA 20 week sono) is not a 3D, it is a regular black and white. That could be it?
that sounds more like the case... you really shouldn't need a 3D sono for your level II. it costs more, i'm willing to bet that's why your insurance is denying it.
I would be willing to bet this is the reason as well. I have UHC and they have never denied, anything, even when I had two sonos on the same day! I am having the level 2 at 19 weeks and I have never even questioned whether or not they will cover it.
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| Posted 7/10/08 9:03 AM |
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Lillykat
going along for the ride...
Member since 5/05 16253 total posts
Name:
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Re: United Healthcare and 20 Week Sono
I would fight them on it - although I think the above posters were right that it might be the 3D part - I believe a 20 week sono is considered standard practice for a regular pregnancy without complications. Could you see if they will do one without the 3D or go to another location that can do a regular sono where it would be covered?
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| Posted 7/10/08 10:11 AM |
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mommy-of-2-angels
It's all about Sophia
Member since 9/07 1731 total posts
Name:
Laurie
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Re: United Healthcare and 20 Week Sono
mine was covered I also have united healthcare...
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| Posted 7/10/08 10:15 AM |
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sometimesmommy
Always in my heart.....
Member since 11/06 6686 total posts
Name:
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Re: United Healthcare and 20 Week Sono
Posted by Tigger77
I have UHC and they paid for 2 sonos at 20 weeks
Seamus Finnw ouldnt cooperate the first time, so I had to go back to get better pictures of his heart. I was warned they probably wouldnt pay for the 2nd one, but they did. I ended up owing Madonna about 17 bucks
There are many different levels of insurance within UHC. My Dh has a very high level through Chase
What do your mean level if I may ask?
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| Posted 7/10/08 10:43 AM |
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IrishMom77
Brothers!!
Member since 8/05 3498 total posts
Name:
Roseann
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Re: United Healthcare and 20 Week Sono
Posted by sometimesmommy
Posted by Tigger77
I have UHC and they paid for 2 sonos at 20 weeks
Seamus Finnw ouldnt cooperate the first time, so I had to go back to get better pictures of his heart. I was warned they probably wouldnt pay for the 2nd one, but they did. I ended up owing Madonna about 17 bucks
There are many different levels of insurance within UHC. My Dh has a very high level through Chase
What do your mean level if I may ask?
I mean there are different tiers of the insurance
I had UHC at my job and the coverage sucked. DH's is about 3 times better. It depends how your company signs up, etc...
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| Posted 7/10/08 10:53 AM |
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sometimesmommy
Always in my heart.....
Member since 11/06 6686 total posts
Name:
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Re: United Healthcare and 20 Week Sono
Oh I wasnt sure what you meant. I am in awe of how healthcare varies from person to person.
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| Posted 7/10/08 11:06 AM |
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hunnybunnyxoxo
this is what it's all about
Member since 11/07 3321 total posts
Name:
Lisa
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Re: United Healthcare and 20 Week Sono
That is very odd!!!!
you can def. fight this!
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| Posted 7/10/08 2:12 PM |
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KateDevine
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Member since 6/06 24950 total posts
Name:
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Re: United Healthcare and 20 Week Sono
Posted by Dulcinea
For those who don't have to pay, are you doing the regular sono?
Maybe UH is not paying because they don't feel you need to have a 3D sono to detect anatomical anamolies. That is the type of sono that my doctor recommended though. :P
Oh. It isn't being covered b/c it is 3D!!
Just tell the dr your insurance is only covering the regular one.
That actually makes sense.
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| Posted 7/10/08 7:00 PM |
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