Insurance/Rhogam Shot

Ladies, I am RH Negative and must have my first Rhogam shot next week.  I'll have to have another if the baby is born RH Positive.  I have insurance thru Blue Cross/Blue Shield of North Carolina.  I'm a state employee, a teacher.   My insurance is saying that they will not cover the cost of the shot, which can be up to as much as $140 per shot.  How can this be if I MUST have it? Have any of you came across this same problem?  I'm just curious if other insurance companies cover the cost. Thanks so much! ~Monet

I have Blue Cross/Blue Shield of Florida, but mine is a Federal Employee program, my insurance cover all that is pregnancy related, from pregnancy test to 6 wk post partum chek up, I pay nothing for the hospital or anything, even if you ended up in m/c they will cover evrything. Call your insurance and double check your policy becuase I had some problems at the beginning specially if your dr office just go thru the internet to get coverage because in my case the fed employee coverage won't show on the regular bcbs of fl page you will need to a different web page to find the coverage. call directly to your insurance and double check.

Good luck,

YES I did go through this with my most recent child. When I had my Rhogam with my others, my doctor had it right there in his office and gave it to me at 28 weeks and at the hospital I was givin it right after birth. Well 3 years ago my OB hands me a script and I had it filled. They charged me $128 and I was LIVID. I fought this all the way to the insurance commision of Michigan and eventually discovered that it was because I filled it myself. WHATEVER. My insurance paid for the one I had in the hospital but most likely it was because I was stuck paying 40% out of pocket anyway because I was taken by ambulance to an out of network but let's not go there LOL. Anyway, they just called in my script for Rhogam to my pharmacy and I currently have different insurance, BCBS Michigan State Employee PPO and it is the higher copay of $30 vs $7 for generic. I will happily pay it this time. My only advice is to call your OB and tell him that your insurance won't cover it. See if he has some for that situation. I think it really sucks that some companies refuse to pay for Rhogam but VIAGRA is covered. MEN SUCK!!!! LOL

I also had to have the shot and my insurance did NOT pay for it. I think there was an issue with having the drug pre-authorized. The issue was that I had spotting so it was an emergency not something my doctor's office had time to get authorized. I tried to get reimbursed, but had no luck.

Hey

I have BCBS of NC for BB&T.  They cover *anything* related to pregnancy, with one copay at the beginning and the rest is charged to my deductible.  Is your plan like this too?  If so, you might call and ask to be sure it isn't covered as long as it is billed with the rest of your pregnancy visits, U/S's, etc.  Even my lab work is covered, as long as lab corp bills it as pregnancy-related (but if I get lab work and it's listed as preventative maintenance, it's not covered.. wha?).

I wouldn't take a no from just one representative.  I would ask specifically why its not covered if everything else is.

Good luck!

Andrea

Huh, I didn't know there might be an issue with paying for the shot. I got mine last week at my doctors office. I am assuming my insurance will be paying for it, or at least 80% of it. We'll see if I get a bill, i guess!! Warning-- they give you the shot in the butt... lol :) Michelle

I have a different health insurance, it is covered 100%.  It is very stupid for an insurance company not to cover it considering the devastating affects it could have on the child and mother.

Monet, I should be covered.  You might want to call and make sure you are getting the correct information.  I had the shot with both my kids and they covered them all. Good luck!