Medicaid question

[Love034]

I went to my first obgyn and had a 14 week ultrasound ...and the day of my second apt I over heard the nurse speakn very unprofessional about me and my due dates .... I had got them confused and was thinkn it was jan 1 but she said she would check on it for me.... Well while in the room I over heard her laughing and carrying on n said something's that wasn't very nice ( I was raped did not tell dr or my husband and he was with me at the time until I had to tell him bc I left crying Hysterically) So the lady got fired and I just felt super weird so I decided to find another dr.
And i did... i didnt tell the second dr anything a out the first dr i just felt to funny to even go back there at all ... so i told the second dr office i just found out that i was Pregnant .Well the second doctors office the nurse practitioner and I'll really didn't see eye to eye... I told her I've been taking Xanax And I didn't want to take that anymore I'd like for her to prescribe me something that would be safe for the baby and something for my anxiety... I'm about 20 weeks now... She looked at me up and down and said I hope your babies organs are Developed in a VERY nasty way.... So anyway I get the 20 week ultrasound done everything looks so perfect.... On the way out leaven my husband and I over heard her speakn to The receptionist about how she thought I was on pills or something was her Exact words ...I didn't ever go back needless to say I was so embarrassed ... If she thought that I wonder why she didn't ask me about it instead of talkn to someone that works at the Front desk..anyway I Decided to find another doctor because she was just not very good at all not with just that but I get forgetful at times and she said that me forgetting things from time to time had nothing to do with my pregnancy that I need to see my primary care physician for that... So I'm like we're not gonna work either .... This leads me to my 3 rd dr he's out of a different county and omg I love him ... He's the best dr ever ... Explains things and is very Patient ../but I told him that I have only seen one doctor and that was the first doctors office because I didn't want to go get my medical records from my second I'd rather go in there and get them from the first because the second doctors office clearly had something against me... Now keep in mind only went to that second doctors office and get my 20 week Anatomy ultrasound... So my new doctors office what's to do another anatomy an ultrasound and I'm now 29 weeks and three days which when I got back I'll be about 30 weeks.... My question is if he does ordered the 20 week anatomy ultrasound will Medicaid pay for this again I've only had two ultrasounds throughout my whole Pregnancy... But I don't know if the anatomy ultrasound is any different from a regular ultrasound as far as Medicaid's concerned... And I don't won't my third doctors office knowing about the second one at all .... So my question is will the Medicaid office pay for this 20 week anatomy ultrasound again.. Any advice would be great please let me know

[MKristine]

I've had about 5 ultra sounds, maybe 6 because I was bleeding and every time I bleed m OB would send me for ultra sound to hopfully find the bleeding. (They finally found out my plcinta is bleeding.) My medical card has cover all of mine, but it might be fdifferent since mine was mediclly nessasary. I would just tell your doctor about your second doctor. If he's as nice an everything as you say, they he souldn't judge you or mind. Sometimes doctors can even fax over records so you won't have to go in.

[motogp93]

I'm hoping I don't get billed. They even paid for a hospital bill I had.  They ask when you apply if you have pending bills at a hospital while you were pregnant but not on Medicaid.

But why would they charge for ultrasounds? It's ink and time. The machine is there. My clinic is for low income. Called La Clinica Del Valle. So they do stuff for free either way. Or depending on income they charge 25 dollars for consultation. This was my clinic before I was pregnant and I didn't have Medicaid. So sometimes I'd get free flu shots or sometimes I'd only pay 40 dollars at most.

[msmitchell811]

Im with you on this one. As long as your doctor wants you to have an ultrasound you will, doesn't matter how many! If you are on medicaid they are free.

[heatherr322]

@ motogp
Yes I realize that u/s don't cost the dr any more money but they still bill for it. I just received a bill for one of mine. they wanted $331 for the ultrasound and with my regular insurance discount my insurance ended up pay $95 which was %100 covered. Not Medicaid though. So either the dr office is just nice and not billing Medicaid for it or they are scamming Medicaid into thinking it needs to be done. I don't care either way im just saying your situation is very unique. Most dr office don't do stuff for FREE, if yours does then great for you :)

[Love034]

Ok thank u for taken the time and responding:) very helpful

[lexi915]

No I get what u mean my ob is the same way any lil scare feeling bad dream anything n he'll do a sono but see we all have that understanding with our obs. She doesn't yet and if she isnt honest hes going to bill it thinking she hasnt had one and she'll get stuck paying

[motogp93]

What do you mean code it? /: my baby daddy went once only and they made him 3 pictures and they made me 3.

[sbindert]

If I am correct (I have medicaid and my doctor explained this to me) all ultra sounds are covered but the anatomy scan is a one time thing because they use a more expensive machine. And heather322, it isn't extra because they already own the machine (its not like they have to get a new machine every time lol) so the ultrasounds are unlimited for me aswell, I've had one at every visit. It doesn't cost them anything (besides maybe the electricity and a bit of ink) to do as many as they can, and I wish that all pregnant ladies were able to have as many as they wanted! :)

[newmama21]

So they probably code it a certain way or use a modifier That's very nice of your dr I wish mine would do that lol I would be getting one every time then too!!

[motogp93]

Oh no. I'm definitely not high risk. I'm basing it on my sister's experience. We had the same obgyn and she had her twice. She created an album of her sonograms for her two little girls and I got the idea from her. Which I've began mine. I had one at 7 weeks when I found out I was pregnant. They usually say no recording in there but my first visit they let me record. Then I had another sonogram at 9 weeks. I had one at 12 & 13. Then one at 16, I'm now 18 and I'm getting another in 2 days. Now I'm wondering about back pay. I'll ask my doctor today. Either way I have an appointment with Medicaid to report a change in my income. I'll ask. I'm almost sure it won't happen but I can only ask.

[lexi915]

My sister works for medicaid and they only allow 2 or 3 3 if u needed one in the beginning to verify dates. Then the anatomy and the final to verify growth position etc. Unless u r high risk or your dr has a specific reason like something they r concerned about

[motogp93]

Let's wait to see how much the bill is then. I'm looking forward to it. My sister worked at this clinic. & they initially do have some type of policy of "only if the doctor medically requests it" however MY doctor said, "it's okay, just ask me and I'll give you one whenever, there's no issue and Medicaid will cover it" because a lady in the office told me she had only had 2. I'm confident there won't be any back pay as my sister had the same experience with 2 little girls.

[newmama21]

^^I agree your most likely going to get billed in the end. I am a medical coder and have never heard of medicaid allowing so many u/s without charging in the end.
But to love034 I think you should be honest with your doctor because he is going to be delivering your child there needs to be some kind of trust between you two and you need to tell him everything like what kind of meds you are on ect. Its all for the benefit of your child.

[motogp93]

I should upload a picture of the album I have so far of all the sonograms since then to give you the benefit of the doubt.
Medicaid pays for it. I find it weird to those who have an actual limit to how many they can have. Medicaid also pays for parenting classes at my clinic.
Otherwise I wouldn't be seeing an OBGYN.  
I know quite a few people on this forum including my sister who have had the same experience. & There's no back pay for "unnecessary sonograms" that absurd. I'm 5 months pregnant and never have I had  an issue.

[heatherr322]

that's weird that you get one every visit. I don't see why Medicaid should pay for that. It is expensive and unessesary and the gov doesn't pay for things that are unessesary. Why should tax money pay for you to get an ultrasound pic every visit for no reason? I have a hunch your guna get billed for that

[Alaysha91]

The government has changed a lot

[motogp93]

I could be wrong but I've never been turned down and have been told to get as many as I'd like and my cousin said Medicaid covers it.

[motogp93]

Lexi wait where's you get that from? My doctor said Medicaid pays for every single thing done to me while pregnant. I've had an ultrasound/sonogram every visit after 7 weeks. Because I'm not paying and my dr said just to ask. It'll take her 5 minutes to snap a quick shot and that she didn't mind. Medicaid also paid my 13 week gender reveal and Down syndrome test. My cousin works for Medicaid and she told me I didn't have a limit.

[heatherr322]

the doctor isn't going to judge you for not liking the other dr's you should just be  upfront with him. I think they will pay for it if it is medically nessesary but if he is just doing it because he thinks you have only had one then they wont pay for it. So ask him what the reason for the us is?

[lexi915]

No you have to let the him know becuz medicaid only covers so many