Insurance hassles

[littlemisssunshine]

Anyone having a nightmare time with insurance? I decided to do a birthing center, but my insurance doesn't offer coverage for any center that is within 100 miles of me. I can ask for an exception, but it has to be done by my primary dr. My primary is on maternity leave until July and there's no one else in the office who can do it. My options are to either pay out of pocket for the birthing center ($5500) or pay to go see a random primary dr for the sole reason of asking them to submit a letter on behalf. Realy?!?!?! 

I saw an OB several times before deciding to go with a birthing center, but right now I'm between care providers. I'm 24 weeks but suppose to have another appointment with in the next 10 days for a glucose test. Why is insurance so difficult?! The birthing center is significantly less expensive, why can't my insurance just say thank you and make the exception? 

[callmehales]

i currently want to punch our insurance because i can't call OR log on to the website to figure out how to order my breast pump. LISTEN ASSHOLES, I'M ALMOST 35 WEEKS. my boobs are gonna need that bad boy.

[elliemonster21]

Apr 27, 2016 13:38:11 GMT -5 callmehales said:

i currently want to punch our insurance because i can't call OR log on to the website to figure out how to order my breast pump. LISTEN ASSHOLES, I'M ALMOST 35 WEEKS. my boobs are gonna need that bad boy.

I did mine directly through areoflow! We have bcbs ppo and they look care of contacting the insurance for me!

[frozentoes]

littlemisssunshine, Would you just have to pay a co-pay to see a new primary or would it be more? I get that it's a total pain, but it sounds like it might be the easiest and least expensive way to get your exception and a closer birthing center covered.


callmehales, I called the number on the back of my insurance card and they gave me the name and number of the medical equipment company so I called them directly to find out what to do. Unfortunately, my doctor refused to write me a prescription until I am in the hospital after giving birth. They say it's because people get the pumps and sell them. The medical equipment company confirmed that I could not order the pump until after I've actually given birth. I'm so flabbergasted by this. Luckily the equipment company said that once it's ordered they ship it overnight so I should have it within 1-2 days. Hope nursing goes ok and I don't need it before then. Annoyance!

[ratherbepaddling]

callmehales I went to yummymummystore.com (I promise it's legit ha) under insurance orders you should be able to see if your insurance company is one of the available ones and the pumps they offer.

[mandapanda18]

Apr 27, 2016 14:38:54 GMT -5 frozentoes said:

littlemisssunshine, Would you just have to pay a co-pay to see a new primary or would it be more? I get that it's a total pain, but it sounds like it might be the easiest and least expensive way to get your exception and a closer birthing center covered.


callmehales, I called the number on the back of my insurance card and they gave me the name and number of the medical equipment company so I called them directly to find out what to do. Unfortunately, my doctor refused to write me a prescription until I am in the hospital after giving birth. They say it's because people get the pumps and sell them. The medical equipment company confirmed that I could not order the pump until after I've actually given birth. I'm so flabbergasted by this. Luckily the equipment company said that once it's ordered they ship it overnight so I should have it within 1-2 days. Hope nursing goes ok and I don't need it before then. Annoyance!

Not true, you have to have a medical need. My ob last time wrote my script at 34 weeks knowing that I was going back to work at 7 weeks. I got it before I delivered. Plan on doing the same this time!

[lolo]

Apr 27, 2016 20:50:45 GMT -5 mandapanda18 said:

Apr 27, 2016 14:38:54 GMT -5 frozentoes said:

littlemisssunshine, Would you just have to pay a co-pay to see a new primary or would it be more? I get that it's a total pain, but it sounds like it might be the easiest and least expensive way to get your exception and a closer birthing center covered.


callmehales, I called the number on the back of my insurance card and they gave me the name and number of the medical equipment company so I called them directly to find out what to do. Unfortunately, my doctor refused to write me a prescription until I am in the hospital after giving birth. They say it's because people get the pumps and sell them. The medical equipment company confirmed that I could not order the pump until after I've actually given birth. I'm so flabbergasted by this. Luckily the equipment company said that once it's ordered they ship it overnight so I should have it within 1-2 days. Hope nursing goes ok and I don't need it before then. Annoyance!

Not true, you have to have a medical need. My ob last time wrote my script at 34 weeks knowing that I was going back to work at 7 weeks. I got it before I delivered. Plan on doing the same this time!

I also got mine delivered before giving birth.

[smock]

callmehales, you can always go through a medical supplier; I used Edgepark.com. You enter your insurance provider and they tell you what pumps are available. Then you enter your OB info and they take care of everything. You can order when you're 30 days from your due date, and my pump arrived in less than a week. I used them both times and it was super easy!

[frozentoes]

Interesting. It must be something within my state or my specific carrier. I called the insurance again and they confirmed that I can't order it until I give birth. They only work with one medical equipment provider (I tried both of the ones listed in this thread and neither of them worked with my insurance) and that provider (MedCare) confirmed that they couldn't process the order until the insurance could confirm that I had delivered the baby. Oh well, hopefully it ships quick and I don't need it for the first week.

[JRo]

For my last pregnancy, I ended up using the medical supply store that was part of the hospital system where I delivered. I called them the day after I delivered and they brought the pump to my hospital room. So it was after I delivered but I didn't have to wait for a pump in the mail. Maybe that is an option for you?

I'm probably going to use an online supplier this time just because I want to try a different pump and the local supply store only carries one kind (PISA). And I still have my old one if I need it in the meantime.

[statlerwaldorf]

Apr 28, 2016 8:39:03 GMT -5 frozentoes said:

Interesting. It must be something within my state or my specific carrier. I called the insurance again and they confirmed that I can't order it until I give birth. They only work with one medical equipment provider (I tried both of the ones listed in this thread and neither of them worked with my insurance) and that provider (MedCare) confirmed that they couldn't process the order until the insurance could confirm that I had delivered the baby. Oh well, hopefully it ships quick and I don't need it for the first week.

This happened to me too. I ended up driving an hour with a newborn to the nearest medical supply store that accepted my insurance. I needed one for the twins as soon as I got home, so I was lucky I had the one from ds.

[frozentoes]

Apr 28, 2016 21:00:33 GMT -5 statlerwaldorf said:

Apr 28, 2016 8:39:03 GMT -5 frozentoes said:

Interesting. It must be something within my state or my specific carrier. I called the insurance again and they confirmed that I can't order it until I give birth. They only work with one medical equipment provider (I tried both of the ones listed in this thread and neither of them worked with my insurance) and that provider (MedCare) confirmed that they couldn't process the order until the insurance could confirm that I had delivered the baby. Oh well, hopefully it ships quick and I don't need it for the first week.

This happened to me too. I ended up driving an hour with a newborn to the nearest medical supply store that accepted my insurance. I needed one for the twins as soon as I got home, so I was lucky I had the one from ds.

I do have the one from DD that I could use in an emergency, I'd just need to wash the parts real quick. 

Oddly, the medical supplier called yesterday and said they received the prescription from my doctor and verified the coverage with my insurance and everything was all set.  So someone must have broken down and written the prescription despite technically not being allowed to.  Of course, they still can't ship the pump until I deliver, I still have to call them from the hospital to let them know I delivered and THEN they will mail it.  But at least they have everything else they need.