Additional health insurance during pregnancy

[rl.user 5]

Hi all

 

We have some question regarding first tri-semester pregnancy test

 

We visited Gynac second time for Ultrasound test.

 

1) Dr. said that public insurance covers only 3 ultrasound test so for all of next ultra sound test we have to pay some 150 € at once.

 

2) Dr. recommend us to have a bacteria infection blood test (some toxo test) which will cost around 60 € and this is also note covered in insurance

 

3) Dr. also recommend us to have a test for chromosomal abnormalities(trisomy) and again we have to pay around 150 € for this

 

So all together we have to pay 360 € in our next visit.

 

Me and my spouse are insured by TK.

 

We need suggestion/information for some other addition insurance which will cover some of the above tests. Can we start some insurance now ( after 2 month of pregnancy)

 

Please also provide some other related information of tests and insurances .

 

Thanks in advance

Rl

[Owain Glyndwr 889]

what chance do you really think there is of finding an insurance that will cover something with a 100% probability of paying out?

[Kommentarlos 983]

Presumably the one where you can stop contributing after the pregnacy is over? :rolleyes:

[westvan 9,706]

 

We need suggestion/information for some other addition insurance which will cover some of the above tests. Can we start some insurance now ( after 2 month of pregnancy)

I highly doubt it, since all those things are optional (even if your doc recommends them and you also feel they're necessary) and belong to the IGEL (Individuelle Gesundheitsleistungen) catalogue of gynecological/obstetrical tests and exams that aren't covered by regular insurance. I pay big bucks to my ob/gyn every time I go if I want extra stuff done. That's just the way it is.

[Für Elise 3,847]

My insurance (also TK) has covered all the ultrasound scanning, which included the early scans, the emergency scans and the routine ones at every visit. We've seen the foetal development all the way through.

 

It didn't cover the toxoplasmosis test - but that's not necessary for all patients, Google it and see if you fit the risk factors.

 

If you're 11-13 weeks pregnant, you can have the NT test, which is a test for certain abnormalities based on ultrasound, and if the risk is high you can decide whether or not to pay for the trisomy testing.

 

It sounds to me like you may need a different OB-GYN. All our first trimester screening, including all the blood tests and toxo test (because we have a cat) cost €210 or so, and apart from the €10 quarterly payment that's been it.

[Geldar 1]

TK = Techniker Krankenkasse? If so, that's what I have, and I only paid for the toxoplasmosis tests since we have a cat, and I decided that I would have felt really stupid not paying the 50 Euros or so and then ending up with problems with the baby. I didn't have any other tests, and it seemed like I had an ultrasound at almost every visit, but I didn't have to pay for those, so it sounds like something is off with your Frauenarztin.

[Für Elise 3,847]

I'm replying here since I don't respond to unsolicited PMs and it seems that this information would be useful to others so is better in the public domain.

 

Anyway:

 

TK pay for three ultrasounds, unless further scanning is medically indicated. The person who decides whether the scanning is medically indicated is the Frauenarzt/in, and most think it is and will tell TK so accordingly.

 

This sounds like a problem with your specific Frauenarztin, not the insurer.

[cinzia 2,643]

I'm with llees and Geldar here. My daughter is now almost 4, but we had public insurance through BKK when I was pregnant in Munich. I had ultrasound screenings every visit (3D and even 4D on occasion), amniocentesis, treatment for gestational diabetes, even acupuncture in the last 4 weeks of pregnancy, and never paid for anything besides the 10 euro quarterly charge.

 

Get a second opinion at a different Frauenarzt!

[Krieg 15,074]

4D?

[Für Elise 3,847]

Includes video rather than just still images.

[Elfenstar 1,676]

i'm not pregnant, but i have had very different experiences when it comes to ultrasounds. i am also BKK insured, my gyno in Esslingen did one as part of my yearly exam. The one I had in Munich charged me for it (€75), which i did pay for. why, i do not know. she (the doc in munich) said it was not a necessary exam and the insurance would only pay for it if I had issues (to which I replied, ugh, it can be used as preventative medicine... but I digress), my doc in Esslingen (I called her and asked her opinion) said she felt it was.

 

but if you're pregnant, i would assume it is necessary.

 

it is sad that there is no standard.

 

any case, it's too late for the OP to get this insurance to cover her current pregnancy.

[batchfile 690]

 

Get a second opinion at a different Frauenarzt!

My understanding, from a doctor friend here, is that when they carry out the extra scans that are not covered by the patient's health insurance they describe them as something else when billing the insurer. Obviously if you get a doctor who won't do this then they'll charge you for the extra scans.

[sluzup 268]

She doesn't need any additional insurance, just a different doctor. I am insured with TKK and had so many ultrasounds that I lost count, also at least 2 or 3 in 3D. If the doctor thinks the test is really necessary then he will say that to the health insurance company and it will, in most cases, be paid by them.

 

(TKK have only once ever refused to pay for something for me and that was my Ante-natal class and because it was not carried out by a qualified midwife.)

[Showem 868]

The number of scans and tests you get paid for might be related to your age. If you are over 35 at the time of birth, I would think most things would be automatically covered. As you don't say, it's hard to judge.

[Für Elise 3,847]

 

The number of scans and tests you get paid for might be related to your age. If you are over 35 at the time of birth, I would think most things would be automatically covered.

Oi!!

[cinzia 2,643]

 

The number of scans and tests you get paid for might be related to your age. If you are over 35 at the time of birth, I would think most things would be automatically covered.

Guilty as charged. My doctor also offered me a scheduled c-section and said he could explain that away to the insurance, too, if I wanted. A lot depends on your doctor.

 

Trisomy is normally only recommended for older mothers (over 35), due to the risks and higher chances of genetic abnormalities for the fetus of an older mother. So if you're not older, you might want to question why the doctor thinks it's necessary for you.

 

You know, the German way is to at least ask questions about why a procedure is necessary if the insurance doesn't pay for it, if not outright refuse it. Witness teeth cleanings. :blink:

[westvan 9,706]

Yep, any mother-to-be 35 or over in Germany is automatically considered a Risikoschwangerschaft whether there are problems or not. That could indeed have a lot to do with what is covered.

[cinzia 2,643]

That's pretty much standard in the Western world, westvan. The official medical term for a woman over 35 in her first pregnancy is "elderly primigravita."

<_<

[Vikstar 2]

I'm 14 weeks right now and my doc also said that my health insurance (DAK) will pay for 3 scans. One at 8-12 weeks, one at 20 weeks, and one right at the end. He then gave us a price list for all the other procedures he can do.

 

We opted for the trisomy test (tesing for Down's and also for trisomies 18 and 13) and paid around 125 euros for it. The test came back with a (very) slightly elevated chance for trisomy 18 and he gave us the option of having more screenings and potentially tests if the screening shows anything. This will all be paid by our insurance as it's now considered 'necessary'. Whether or not you want to have the test at all is up to you. The risk goes up with age, so you might consider that as a factor in whether or not you get it. But there's also the issue of what you would do about it if you got a positive test - or if you would just like to be prepared for having a disabled child long ahead of when he/she is born etc. Have a talk about it with your partner, but don't feel pressured by the doctor.

 

The toxo screening - do you have a cat which goes outside? Do you garden a lot? Do you eat undercooked meat? These are the main reasons for having a toxoplasmosis test as a cat can carry lots of nasty things in it's excrement (in it's litter box or on your plants in your garden) and it's also found in undercooked pork, lamb and venison along with other meats. If you don't have a cat, it's probably not necessary. The disease is only dangerous to the fetus if you are exposed to it for the first time in your life during pregnancy.

 

Good luck with your pregnancy - make sure to inform yourself of all your options and try to acquaint yourself with some of the major tests and problems which could occur during pregnancy so as not to get side-tracked by a doctor wanting to bombard you with tests.

[shabi 0]

Tk pay only for 3 Ultrasounds. The rest are totally depend on your Op/gyn. For me she always charged me for the additional ultrasound if I ask for. So basically if I don't pay I won't be aware of the baby's health and growth. In addition while I do not have cat and I only one time visit a family who had a cat and I even did not touch it she asks for toxoplasmosis test every 8 weeks and I have to pay out of pocket. Unfortunately changing doctor in the middle of pregnancy is another catastrophe in Germany because basically all doctors refuse to accept you with the excuse that their patient list are full. At least it was what I have experienced.