9 answers

Question About Medicaid & Ultrasound

I was wondering if anyone else has/had medicaid for their pregnancy that knows something about getting an ultrasound done. I was all excited to go to my next appt. until I was told that medicaid will not cover my ultrasound because it is not a medical emergency. (I have had no complications)We can't afford to pay for it out of pocket. Does anyone know any way around this or any suggestions? My doctor won't lie and say the ultrasound is needed if its not. Really want to see my baby and maybe find out the sex. Thanks!

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Hi Sarah, I remember how much fun it was to be expecting. I had my son in 2004 and my first ultrasound at 5 months. I also had one in my 10th month because my baby was over due. I remember that they did alot of clicking they were looking at the inside health like the heart and lungs to make sure they were growing right. Now at the time I lived in Carbondale so I don't know if it was just different there. But if I was you I would talk to another doctor. When you call don't tell them what your doctor said because they don't like to question another doctor if you know what I'm saying. Good luck. S.

I have never had a problem with getting an ultra sound even on medicaid. The problem could be with the hospital or doctor accepting the card. Call your caseworker and question why the ultra sound is not covered because it is a part of the pregenancy process.

I was on medicaid for my pregnancy and had two ultrasounds done (one at about 4 1/2 or 5 months and another at about 6 months). Medicaid covered both. Every pregnant women gets at least one ultrasound, most of the times they get more - even if everything is fine. You should be due for an ultrasound soon. And when you do get an ultrasound, medicaid will definitely cover it. And if your doctor tells you that you don't need one, CHANGE DOCTORS! It is with an ultrasound that they determine the weight, head circumference, and general development of the baby. It is not harmful to the baby (despite what some may think). You should be due for an ultrasound soon. Hope this helps.

I think it's customary to have II level ultrasound around week 20. The dr. should check baby's organs (heart, stomach, brain, legs/arms/spine etc) know what to expect.
I'm sure this test is performed where you are going and this should be categorized as medical necessity even if it's not emergency.
Maybe you could ask your insurance if they're covering level II ultrasound?

J.

That is the most ridiculous thing I have ever heard. I was on medicaid at the time of my pregnancy and I was given one ultrasound and told I would not have another unless the doctor's thought something might be wrong with my baby. I had my ultrasound around four months I believe. You should have at the VERY least one ultrasound to make sure that the baby is healthy ( ie. has two arms, two legs, two hands, and the organs are in the correct spots.) I would definately call up your local public aid office or the caseworker that you were asigned to and file a complaint or start by telling them of your situation. You can warn you doctor that you are doing this as well. If you still don't get any result I know of a clinic that will give you an ultrasound for free based in schaumburg, IL.

N.

Hi Sarah,

I was on medicaid for my pregnancy, and did have the routine ultrasound during the 5th month, that was covered by medicaid, as it is compulsary to have at least one ultrasound during the pregnancy, so I didn't have to pay out of pocket. You'll only know the baby's sex after the 4th month anyway. If you want to have higher tech ultrasounds-like the 3D type,etc, then you may have to pay out of pocket. If your doctor is not doing any ultrasound, I think that's crazy, and you may want to find a new doctor!I had my baby in the Elmhurst Memorial Hospital.

Good luck.
Susan

Sarah,
I am currently 20 weeks pregnant and on Medicaid also. I just had a routine ultrasound yesterday, and paid a $2 co-pay. I am not high-risk. Ultrasounds are a routine part of pre-natal care, just like the lab-work I'm sure you had done at the beginning of the pregnancy. To my understanding, Medicaid covers routine prenatal procedures; they even cover dental and vision services! Remember, the state's goal is a healthy baby, because that will cost them less money in the long run. I think whoever told you ultrasounds are only covered for high-risk pregnancies was either misinformed or choosing to lie to you. Please dig deeper on this issue. You may either need to confront your doctor about this (tell him/her you've spoken to people who have had routine ultrasounds covered by Medicaid) or maybe look for a new doctor.

Good luck to you!!!
L.

The only way you can get an ultrasound is if you are high risk. I know it seems really important, but you will have a lifetime of being able to see the baby. It is really so much cooler to be surprised about the sex, labor seems less painful and more like your working for a goal.

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