High Risk, Medicaid...

MunecaLinda

My doctor sent me to a fetal medicine doctor due to my hyperthyroidism. I heard that this qualifies me for high risk. Ive had 2 ultrasounds and was told that after 3 I would have to pay for the additional u/s. I was speaking with my mom yesterday and she says that medicaid has to cover for all of the ultrasounds even if its more than 3 because Im high risk...

Does anyone know for sure, or anyone high risk that has medicaid also?
Does hyperthyroid and seeing fetal med doc. put me in high risk?

bwhite55019

As long as there is medical reasons they have to pay

hurstk28

If your doctor says they are medically necesary Medicaid has to pay for them. I have had 4 done already and have one scheduled for my next doctors appointment.

preggointx

we have been talking aout this all day I'm high risk because of my bp but have never had high bp during a visit it's crazy of and because I'm over weight but I guess it depends on the doctor because I have had way more than 3

MunecaLinda

So they cant bill you for the additional ones? Do they know Im high risk by seeing a fetal medicine doctor also?

hurstk28

As long as the doctor says you need them they can't bill you for them.

MunecaLinda

@preggointx Yea I was reading your thread but I didnt want to ask there because no one really answers when i do on the threads. So they havent asked you for anything because youve had more.. due to high risk?

MunecaLinda

@hurstk28 ohh ok thats great because Im sure theyll be doing a few more and Id hate to pay $200 for extras. ;-)

kdaniels

I agree with hurstk28 I have Medicaid and I'm high risk bc of past history of epilepsy and my five wants me to have an u/s every other month if not every month. I've had one I'm scheduled for my second next week. I'm 12 weeks and 5 days. If Medicaid knows you're pregnant they have to cover what ur doc says u need. Don't let them screw u over.

kdaniels

My *doc wants me to have

angieface

I am high-risk I get monthly ultrasound s also twice a week fetal monitoring,childbirth classes and even taxi rides back and forth to and Medicaid covers all

MunecaLinda

@kdaniels yea Ill probably speak to my doctor about it just to make sure theyre not going to bill me for u/s that I need because I need them and theyre not for my pleasure. (even though it is a plus to see that baby ) Good Luck with your pregnancy mama.

MunecaLinda

@angieface oh wow, Ive never heard of that thats wonderful. Im going to call and see what the medicaid will cover for me. I didnt know they would also cover the childbirth classes. Its my first!

junebug86

I'm very high risk I go to the hospital every 2 weeks to get ultrasounds and I've never had any issues with medicaid covering it as long as it medically needed they have to cover it the only thing I have problem with medicaid covering is some of my medications like progestone they wanted to put me on but after months my docs found a way for medicaid to cover it goodluck with ur pregnancy

MunecaLinda

You too! Thanks guys.

kdaniels

Thank u sweetie. And you too. Remember that your body that babys in don't let anyone tell u ur not entitled to make sure he/she is okay! Mothers instinct trumps everything else everytime

ckazfirst

Best thing to do is make sure your ob is a high risk qualified doctor, not just normal. They will work with Medicaid and you may not have to do anything. I am on Medicaid and also high risk for past seizures just like @kdaniels. But I was referee to a high risk doctor who is covered by Medicaid thank his. But he will call them if need be. Good luck hun. Just be patient and work it out.

hurstk28

After 5 prescriptions a month in Tn you have to pay for them.

MunecaLinda

@ckazfirst Im not sure if shes a high risk doctor because she sent me to a fetal medicine doctor. So shes my primary OB and I follow up with her but I see the fetal med doc once every few weeks or every other month. And shes a great OB, id hate to change. Sounds like Were in the same kind of situation but diff high risks. lol Thanks mama.

preggointx

My new doctor won't label me high risk because my pressure is only high when I'm not at the doctor...lol but I do think they can notate ur account for high risk and if it is due to medical reasons u tell them they can screw u giving them any extra money because it is in the guidelines and I agree u might need to make that doctor ur new primary ob for billing purposes

ckazfirst

@MunecaLinda no problem hun. It's hard I switched my doctors cause the other one didn't get it. I'm so happy now though. I hope all works out for you.

salsabia

I sure hope so cause I've had 10 already and another one on Monday. Im high risk in the hospital.