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Is Pregnancy a pre-existence condition?

A week after my son was born my OB sent me a bill for $900.00 on basis of pre-existence conditions not covered.

Here is the story:

Due to reasons out of control we had to switch OB's around the 2nd trimester. The new doctor was part of our HMO network plan.

The insurance pay for all charges. But know the receptionist is sending me letters and calling me and ask "are you thinking on paying".

Please help me to understand this nonsense.
s

 
Anonymous

Asked by Anonymous at 9:27 AM on Feb. 26, 2010 in Pregnancy

This question is closed.
Answers (27)
  • I was supposed to pay a $250 deductible when our first child was born, which I did. Several weeks later we received another bill in the mail for another $250 deductible...in our newborn daughter's name! I called the hospital to find out why I was responsible for another $250 deductible when I had already paid that $250 (in my name). I was informed that it is procedure to admit newborn babies after birth and that was why I received another bill in her name. I then explained that a $250 deductible means $250. Not $500, not $250 twice in two different names. They did not resolve the issue or remove the bill and I will not pay it because my insurance said that I was to pay $250, which was done. I resent the way insurance companies and the medical field manipulate people! That was their way of trying to rack in more money.
    NikkiMomof2grls

    Answer by NikkiMomof2grls at 1:00 PM on Feb. 26, 2010

  • sadly,it is....
    TMJ121099

    Answer by TMJ121099 at 9:31 AM on Feb. 26, 2010

  • have you tried calling your insurance? it might take forever to get someone but they can tell you if they billed for that or it could be an office policy that they failed to tell you about.
    aheuszel

    Answer by aheuszel at 9:31 AM on Feb. 26, 2010

  • have you tried calling your insurance? it might take forever to get someone but they can tell you if they billed for that or it could be an office policy that they failed to tell you about.

    The insurance says that the pay the standard and customary fee to the Doctor. The doctor is part of the network meaning they are willing to work with what insurance pays them. Then the insurance said that they can't not intervene with the Doctors practice policy. ???? op
    Anonymous

    Answer by Anonymous at 9:34 AM on Feb. 26, 2010

  • If you had insurance before you got pregnant then it could not be considered a pre-existing condition. Simply switching doctors within your plan should not be a problem, though your insurance might not cover things that are duplicated at two different OB offices. I would call the insurance company and also the OB's office to try to get this corrected. It sounds like your OB's billing department is giving you an invalid reason, so I would definitely ask them to explain to you what the real problem is - be sure they understand you were covered by your insurance even before you became pregnant, so the pregnancy cannot be a pre-existing condition.
    Anonymous

    Answer by Anonymous at 9:36 AM on Feb. 26, 2010

  • it sucks but yes it is, if you had already been to a doctor for the pregnancy, and then try to get future visits covered, it's pre-existing. I really don't think they should be allowed to count it as such and not cover a pregnant woman. I understand like not wanting to cover other illnesses, but it's crazy to not cover a pregnant woman.
    Anonymous

    Answer by Anonymous at 9:42 AM on Feb. 26, 2010

  • op here, thank you for the advise.'

    To stop the doctor's office from calling us we've sent a check for $300.00. With what the anon had said I'll be calling the office to dispute the fee. thanks again.
    Anonymous

    Answer by Anonymous at 9:45 AM on Feb. 26, 2010

  • Any condition, including pregnancy, that you have before you have isnurance is pre-existing when you apply for insurance. However, your insurance would still pay for that same pregnancy even though you changed OB's in the second trimester. The OB isn't the one who considers it a pre-existing condition, it's the insurance that determins that. You need to talk to your insurance as well as your OB. Don't pay anything until you know exactly what you're paying for and why you're paying. From my standpoint they cannot charge you for that, since you were covered by insurance through your whole pregnancy.
    JazzlikeMraz

    Answer by JazzlikeMraz at 9:53 AM on Feb. 26, 2010

  • I can not understand how if you changed doctors, but did not change insurance why it is pre-existing. My son has allergies and we have been to several doctors- all under the same health plan and have never had a problem. You main issue is with the insurance company-not the doctor. I would file an appeal with your insurance company, let your doctor know you have and see if the $300 is enough to hold them off until you can get this straight with your insurer./|
    soyousay

    Answer by soyousay at 9:57 AM on Feb. 26, 2010

  • Yes it can be considered that, you will need to go to your insurer and find out what the heck is going on. Best of luck
    Zakysmommy

    Answer by Zakysmommy at 10:21 AM on Feb. 26, 2010

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