Miscarriage, D&C and..... a $500 co-pay?! - Mothering Forums

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#1 of 10 Old 06-26-2009, 09:47 PM - Thread Starter
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With all due respect to the posters here, this was one forum I hoped to never have to start a thread in.

My pregnancy ended in 7 weeks. First ultrasound was a little small; second ultrasound, a heartbeat that looked too weak; third ultrasound, no heartbeat. I wasn't having any miscarriage symptoms, yet, but there was no hope.

My doctor presented my options: wait for my body to realize that I'd had a miscarriage, or make one happen with a suppository (apparently it's unpleasant), or get a D&C.

I really wanted closure. So I got a D&C today. I am sad about it, very sad. But I am OK. I am very lucky to have a happy, healthy 15 month old who I spend today snuggling with.

My question is - at the hospital I learned my copay was $500. Is that NORMAL? If it had been a healthy pregnancy, or even a high-risk pregnancy, there would have been no cost with my HMO (Tufts). But a loss is only covered after a $500 copayment??

I suppose the D&C was 'optional' - but my other option was to spend days or weeks waiting for blood to appear - the idea of knowing that it's coming is just wrenching. As was the idea (to me) of having the remains of the baby end up .... well, I just was more comfortable having it medically taken care of, personally. I know others feel differently, of course, that's fine but for me a D&C was the best option. If I'd know about the co-pay before I think I still would have opted for the D&C. But it's a whole lot of money I don't have to spare. Does ANYONE really have $500 to spare?

Anyway, just wondering if my experience was similar to anyone else's.
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#2 of 10 Old 06-26-2009, 10:10 PM
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I'm sorry for your loss.

I have not had a similar experience. However, my health plan has a pretty hefty co-pay on hospitalizations for everything BUT OB care. From what you've written, it looks like your insurance co. has a similar policy, but did not consider your D&C for your loss to be "OB care." I don't know if that's common, but it certainly is callous. Are you feeling up to filing an appeal with the HMO?
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#3 of 10 Old 06-27-2009, 12:48 AM
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I just posted about the extremely high cost of my ER visit and D&C. We're going to have to pay about $8000 out of pocket. sucks. It wasn't a copayment, it's just all of the stuff my insurance decided not to pay and my high deductible.
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#4 of 10 Old 06-27-2009, 11:36 PM
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I am so sorry for your loss.

I had a miscarriage and was treated with Cytotec this past winter. The insurance company (Cigna in my case) treated it as OB care - no co-pay. If and when you feel up to it, there are a couple of things I would check out:

1. Was the person you got this information from entirely correct? Sometimes people get confused, or are mistaken. It's worth a call to your insurance company to check.
2. Is it possible that the procedure was mis-coded in some way? It's not unheard of for incorrect info to be given to patients and incorrect billings to be issued because someone used the wrong billing code. What does insurance think they were billed for? Not all D&Cs are related to miscarriage - what sort of D&C does the HMO think you had?
3. IF you were given correct information, and the HMO correctly understands the nature of the service provided, then can you appeal?

I would certainly try to appeal this charge - it is just cruel that an HMO that would completely cover a normal pregnancy would charge you a co-pay to miscarry.
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#5 of 10 Old 06-29-2009, 01:52 AM - Thread Starter
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Thanks guys. I will wait to see what the actual bill is and at least try to appeal if it's that much. It was just the shock of hearing the lady at registration say "You know there is a $500 copay, right?" -- I don't blame her for giving the info, it was just one more piece of bad news on a terrible, terrible day.
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#6 of 10 Old 06-29-2009, 02:17 AM
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Is it possible that she said copay and meant deductible? I would understand a $500 so maybe she just worded it wrong.
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#7 of 10 Old 06-29-2009, 10:11 AM
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A $500 Co-Pay?

That sounds really ridiculous. I am sorry you were treated in such a manner.

I would be discussing that with my insurance company.

Not all those who wander are lost 
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#8 of 10 Old 06-29-2009, 04:12 PM
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Sorry for your loss. I have miscarried and had d&c's 2x now. I just got the bill for this recent d&c and we owe $500 deductable, plus $230 for the additional amount insurance didn't cover, plus $100 for the anethesia, plus whatever bill my OB sends me for her services. So basically close to $1000 for the whole thing. And last yr. my services were a little less, around $700, not sure why? Plus, both times I have had to go back to the office 2-3x to get my hcg levels checked. So that's another $5 for parking and $40 co-pay each time. It has been rough to go through such a horrible loss mentally, phyically and emotionally, and THEN get hit financially.
I'm also wanting to get a recurrent miscarriage pannel done and my OB said, "get ready, it's expensive." So, I'm not encouraged by that.
As for the Cytotec option, I asked my OB about that and her reply was, "we don't do that here in this office." And she strongly encouraged the d&c's.
While it has been rough, I have to remember there are women out there who don't even have the coverage that I have and they may be even worse off. So I hate to complain.

(due Mar. '10), wife to DH , mother to Dino : (born 2/17/07), (9/08), (5/09)
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#9 of 10 Old 06-30-2009, 11:15 PM
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First, I want to tell you that I'm sorry for your loss I have pretty good insurance (dh is a firefighter), and my d & c cost close to $900 when all of the bills came in. I had it at the hospital, with a general anethesia. It was not considered part of my ob care, but a surgical procedure. I tried to complete my miscarriage at home with cytotec, but had a piece of retained placenta and had to have the d & c 7 weeks later. Sorry

~Manessa mama to one teenageer, one tweenager, and a toddler
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#10 of 10 Old 07-11-2009, 08:45 PM
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