Anticipating Parenthood? Ask Your Insurer These Questions in Advance

A child costs more than $20,000. This is about the cost of a year’s tuition at a public university.

Despite the fact that medical insurance and health care are expensive, not having coverage can be disastrous. The insurer can negotiate with suppliers to reduce the cost of medical insurance. After a member has paid their deductibles and copays, the insurer will cover many of the remaining costs. Here’s a detailed example.

Your routine medical care during pregnancy
You will have to pay co-pays, deductibles and out-of pocket costs for doctor’s visits during your pregnancy. This can be a little overwhelming. Kelly Hill, MD is one of our Medical Administrators who was asked to provide her opinion.

First Trimester: MONTHS 1 – 3
In the first trimester of pregnancy, you may have monthly prenatal visits, laboratory work, ultrasounds and additional testing (genetic tests, invasive testing in high-risk situations).

Second trimester – Months 4-6
You will continue to have monthly prenatal appointments and you will also undergo additional lab tests, including glucose testing (to check for gestational diabetics) and blood screenings (to check for genetic defects). Additional testing or consultations may be scheduled. You may also need to undergo additional ultrasounds to ensure that your child has grown normally throughout the pregnancy.

Third Trimester: MONTHS 7 – 9
By the third trimester you can expect to have a regular OB visit every two weeks. Then, weekly visits will be made in the final stages of pregnancy. The costs and labor requirements vary based upon the type of delivery or whether any special care is needed.

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After I have explained what to expect throughout each trimester, you may still have questions about what your insurance covers and how to make the most of it.

I talked to our Buyer Support Staff to find out the most important questions that members should ask themselves after studying their pregnancy. A PDF is available for pregnant moms to download. The PDF also contains space to write additional questions for your doctor and an infographic about what you can expect during your pregnancy.

Questions to ask your insurance company
How and when do I notify my insurer that I am pregnant?
How can I find out what the price will be?
To download the guideline, click here
How can I make sure my doctor, hospital and other providers are part of the network?
Do I have to pay a deductible for every doctor that visits me and the hospital itself?
Will my doctor’s tests be covered? What should I do?
Does my protection have a limit?
What procedures require pre-approval before they can be used?
What if I have issues?
Does an in-home midwife or nurse have the necessary training to perform a home start?
How many ultrasounds have been coated? What about 3D ultrasounds?
Does a cesarean delivery come coated? Would I like to have prior approval?
Does tubal ligation come coated?
Does my insurance cover me if I need to take an ambulance because I am in labor?
Are breast pumps, supplies, and other components coated? How can I order one of these? Is there a specific form that it needs to take?
Who can I contact if I have questions about being pregnant protection?
We are always there for you
Our Customer Service Representatives are trained to assist you through this exciting time in your life. They will make sure that you understand your benefits, know how to utilize them and help guide you. Call the number on the back of your insurance card for assistance.

Information, ideas and a FAQ on being pregnant are available, along with a survey about pregnancy.

It identifies potential dangers of being pregnant and connects the client to 24/7 nurse assistance.

This site provides reliable information and useful Blue Cross NC resources on pregnancy milestones, health and safety.

Additional links to breast pump resources, insurance coverage suggestions, and lactation counselling providers.

Preparing for a baby is one of the best experiences that a mother, her partner and their siblings can have. You can take it from me that all the books in the world can’t prepare you for parenthood. However, Blue Cross NC will be with you and your baby every step of the way.


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