Pregnancy Question: About ultrasounds

[diznee25]

My husband and I are wanting to start a family soon, and I have a question regarding the ultrasound that determines gender of baby. Is this ultrasound covered under insurance in general? (Or does it vary depending on insurance company?) Because I've been watching a lot of Baby Stories on TLC where the couple didn't know the gender because the baby was moving around too much.
Why not go back for a second ultrasound at a later date?

If someone could clarify this for me, I'd appreciate it!

Thanks,
Michelle

 

[jennyl772003]

I think insurance generally does not cover finding out the sex of the baby, since it is not really necessary. I do think that some Dr's will fib a little about the purpose of a repeat ultrasound so that insurance will cover it though.

 

[va32h]

I have had ultrasounds with all three of my kids - with the first two our insurance did pay for it; with the third, they did not. Same insurance company, I have no idea why the claim was denied, even after writing back and forth, all they would tell me was that it was "not necessary".

Certainly having an ultrasound just to find out the sex is not a necessary procedure; perhaps it depends on how your doctor codes it.

There are also some schools of thought that an ultrasound could be dangerous to the baby; I do not know the exact arguments though.

 

[diznygirl]

It depends on your insurance. Usually one is covered, and any others have to be paid for. Unless there is a medical necessity, and finding out the gender is not.

 

[dcgrumpy]

The sex of the baby is usually found out during the 20 week ultrasound. That's when they check how the baby is developing and check all of the organs....If everything is fine most women don't have another sonogram and insurance won't cover it just to find out the sex. I had to have about 8 with each pregnancy and they were covered, but that's because they were considered medically necessary

 

[Twinprincesses]

I had twins so I had alot of ultrasounds. I believe that every pregnancy gets 1 ultrasound around 20-24 weeks to just check and make sure all lis well with thte babies health. However all insurance companies are different.

You cannot definatly tell the babies sex till around 16 weeks and further but to find out for sure I would wait till about 20 weeks.

We found out with my girls but have decided any further children we want it to be a surprise!!

 

[Jenn]

I think it also depends on your doctor. My OB did not have an ultrasound machine in his office, so I had to go to a lab (in the same building) to have mine done, and I was given one. Assuming all was fine, which it was, I didn't have another ultrasound.

My sister had a totally different experience with another doctor. She had an ultrasound machine right in her exam room and my sister had an ultrasound at each visit, so she was able to confirm the baby's sex easily!

 

[Lisa loves Pooh]

My insurance covers 1 ultrasound and that is it unless out of medical necessity I have to do another one. DD5 I had 2 b/c they found a CPC and needed a more detailed U/S. With DD2, I only got one ultrasound.

U/S are usually scheduled in the 18-20 week range so that in case you did want to know the sex, you could as long as baby cooperates.

My SIL is due in November, she has had 2 or 3 ultrasounds. They have given up trying to find out. Not sure if it is insurance related as to not getting more, but baby isn't cooperating, so they opted to not get anymore just to find out.

 

[crz4mm2]

Most insurance companies will cover the 'screening' ultrasound (the one that we do at about 22 weeks to check for the fetal 'parts' - heart, kidneys etc) this one can usually determine sex if the baby is cooperative and the tech can see the gender.
I have not had an insurance company yet pay for an ultrasound for 'sex determination'. or one just for the 'fun' of it.....
Some people just don't understand this at all

 

[goofy4tink]

However...ultasounds are not perfect when it comes to gender spotting. I have one friend who had 3 ultasounds and after each one she was told.."Yep, it's a girl." So, when her baby shower came around, I was the only one who bought something 'genderless'...everything else was pink and girly....well, baby is born and guess what..another boy. She was devastated. She so wanted that girl. Two other friends have had doctors tell them the sex of their babys only to be proven wrong. Amnio is the only 100% test. Most times ultrasounds are correct but there is room for error.

 

[WAHMto5]

I think it does depend on insurence companies and your Doctor. Most Doctors will do 1 during the pregnancy for medical reasons to make sure everything is going fine, ect.. I had them with all of mine, my last 2 I was high risk and needed them every month and then every other week near the end. I was lucky to get the 3D ones and they were incrediable!! We never wanted to find out the gender of the baby but you are correct that sometimes if the baby isn't turned the right way or has his/her legs crossed, they will not be able to tell.
Best of luck!

 

[diznee25]

Thanks for all the replies!

Yep, that's what I thought, insurance won't cover an "elective" ultrasound to check for gender. Oh, well. My husband and I feel differently about this anyway. He wants to know the gender early on (if possible), I'd rather wait until the birth to find out. Especially when I hear about women who were told the wrong gender!

Diznee26

 

[ceiligh1]

In my experience the insurance covered one ultrasound only per pregnancy. If you needed more it was denied, so when my doctor did a quick one min. ultrasound to determine that I was pregnant they covered it (a whole $100 charge.) It wasn’t until the real ultrasound that determined the health and gender of the baby that I found out they would not pay for it (almost $600). I would check with your insurance as it can be confusing. I had to pay for the second ultrasound and a third that we did later. Also, I have had friends here who had insurance cover the hospital and the OB but not the epidural, so its best to know before you go so to speak. Best wishes

 

[mtemm]

usually one u/s is covered unless medically called for that will be the only one, which is normally done at around 18 weeks. This is also a good time to find out the sex, so while the u/s is not about finding out the sex, it can usually be done.

 

[leighe]

Most insurance companies will cover the 'screening' ultrasound (the one that we do at about 22 weeks to check for the fetal 'parts' - heart, kidneys etc) this one can usually determine sex if the baby is cooperative and the tech can see the gender.

This is what my insurance covered. We were able to find out the sex but the ultrasound was really to measure the baby's size, check the growth and development of organs, stuff like that. I have actually had several ultrasounds that were deemed medically necessary because at first the dr thought I was expecting twins because there were two sacs of fluid. It turns out one had a baby in it and one didn't but I got to have an ultrasound at every doctor's visit after for a while so they could make sure the sac without the baby was getting smaller and the sac with the baby was getting enough nourishment and was growing.

 

[Beth76]

Ultrasounds are not used solely for finding out the gender. They use it to take all sorts of measurements. I had two with my first and one with my second--all covered. With my first, I had one at 10 weeks because my doctor couldn't find the heartbeat with the normal thing they use, so she had to use the ultrasound. Then with both I had one at 20 weeks for them to take the measurements and we also were able to determine the gender.

 

[crz4mm2]

Ultrasounds are not used solely for finding out the gender. They use it to take all sorts of measurements. I had two with my first and one with my second--all covered. With my first, I had one at 10 weeks because my doctor couldn't find the heartbeat with the normal thing they use, so she had to use the ultrasound. Then with both I had one at 20 weeks for them to take the measurements and we also were able to determine the gender.

You are absolutely correct! US is not done solely for sex determination (if we are talking about MEDICALLY necessary US). BUT, some patients THINK they can just request an US be done for sex determination just because they want to know the sex before delivery. Many patients then become upset when they are told that insurance will not cover an us done that is NOT medically necessary.... Although, there are now places that will do an US for entertainment (not physician's offices but freestanding places) and charge for pictures, portraits, videos etc. I just had a patient travel 3 hours for a 4-D US which she paid for (300 bucks) to get several 'portraits, video, and DVD'...

 

[mickeyboat]

I agree with the majority, that insurance will usually pay for one u/s at around 18-20 weeks, and then deny coverage for the rest unless they are medically necessary.

I had several u/s's at the beginning of each PG because I was high risk for ectopic pregnancy. Then I had the standard u/s at 18 weeks. With Hannah they repeated the u/s 2 weeks later because there was a question about her kidney development. It was fine and insurance covered it. I also had several towards the end because I was hospitalized at 31 weeks with premature rupture of membrane.

With Emily I had the several initial ones, the 18 week one, and one around 36 weeks. I was measuring larger than expected and the midwife wanted to take a look. The insurance company denied coverage at first, then after I called to complain, the hospital re-coded it so it was covered. It's all about medical necessity.

Here's an interesting story about coverage. I was brought into the hospital at 31 weeks with Hannah and monitored for the day. I was told I was on complete bed rest. Since I got there at 6AM and hadn't had time to eat, I asked for breakfast and they sent some up. I was billed $7 for this because I had not yet been officially admitted (I was later that evening). I fought with the hospital and insurance company for a long time about this one. What was the alternative? Let a pregnant lady starve, or have me run to Dunkin Donuts for a snack? I can't remember if the hospital wrote it off or the insurance company paid, but I didn't.

Good luck to the OP when you are ready!

Denae