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Old 05-15-2006, 04:09 PM   #1
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Does anyone else's insurance not want to pay for Rhogam?

We have pretty good insurance (Blue Cross Blue Sheild) and for whatever nefarious reason, they refuse to pay for Rhogam prescriptions. (My OB gave me a prescription for a shot of Rhogam to pick up from the pharmacy and take back to her office to have it administered.) Since our insurance refused to cover the prescription, she's going to send me to the maternity ward to get one, because she knows the insurance company will have to cover it there.

Any idea why they won't cover something as rudimentary as this? Seems lame to me!

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Old 05-15-2006, 04:36 PM   #2
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Re: Does anyone else's insurance not want to pay for Rhogam?

That's crazy...I'm A- and DH is something positive, so I always have to get the Rhogam shot...but I just go to the maternity ward for it. Our healthcare system is different here, though, too...

I can't believe an insurance company wouldn't pay for that! It's not like it's some "extra" or something, it can be a matter of life-and-death...wow...
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Old 05-15-2006, 08:19 PM   #3
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Re: Does anyone else's insurance not want to pay for Rhogam?

I'm O+ so I don't have to deal with it, but I have BCBS and I'm sure they would cover it! Under my plan at least - mine's pretty good. Maybe you got a crappy plan for maternity-type care, KWIM? I guess it all depends on the plan and where you are. I imagine that would be something that they'd have to cover... but if not there's probably a significant reason why they're not.
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Old 05-16-2006, 04:39 AM   #4
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Re: Does anyone else's insurance not want to pay for Rhogam?

I have BCBS and they pay for it. They made me answer all these dumb questions 1st though. I only needed to get them to pay for it for the 28 week shot bc the hospital supplies it at delivery if I need another. Good Luck!
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Old 05-16-2006, 08:00 AM   #5
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Re: Does anyone else's insurance not want to pay for Rhogam?

Ours did not pay. $175ish later, we still did not get reimbursment. We had to suck up the cost as well. Both of my girls are + and I'm negative. I'm glad I didn't chance it.
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Old 05-16-2006, 08:04 AM   #6
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Re: Does anyone else's insurance not want to pay for Rhogam?

My insurance doesn't cover it....I had to pay out of pocket for it with both of my previous pregnancies. And it's over $100 too...so dumb!
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Old 05-16-2006, 08:35 AM   #7
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Re: Does anyone else's insurance not want to pay for Rhogam?

My last two pregnancies our insurnace has paid for it because it was given either in the ER or at the OBGYN office. However, I'm using a different OB this time and her office has you go to the pharamacy and pick up a prescription and then bring it back to the office to have the shot admininstered. I just talked to my OB's nurse on the phone and they are sending me to the maternity ward today to have the shot, because insurance will have to pay for it there. Seems really lame...I mean, this is a routine life or death matter -- of course insurance should have to cover it!
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Old 05-16-2006, 09:27 AM   #8
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Re: Does anyone else's insurance not want to pay for Rhogam?

it sounds like it probably has to do with the prescription part of your policy (like you haven't met your deductible yet, etc.) it is lame, but then again so is a lot of stuff with health insurance. glad they figured out a work around for you though!
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Old 05-16-2006, 12:08 PM   #9
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Re: Does anyone else's insurance not want to pay for Rhogam?

Yeah, I agree with Katie.

But, that seems ridiculous they wouldnt cover it - it's not a luxury item or something!
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Old 05-16-2006, 12:13 PM   #10
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Re: Does anyone else's insurance not want to pay for Rhogam?

Quote:
Originally Posted by bethanyjoy
I can't believe an insurance company wouldn't pay for that! It's not like it's some "extra" or something, it can be a matter of life-and-death...wow...
My thoughts exactly. Im rh negative too & thats just BIZARRE. I mean like the pp said- this can mean life or death! I guess they just want you to conform to their ridiculous rules & get it where they want you to. UGH makes me sick!
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