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beachalice

hospital not in network

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beachalice    23

We're through with contracts and I'm nearly 8 weeks along. 

I just got a letter that my local hospital will no longer be in network for my insurance beginning in January.  There's only one insurance company that's available in my county. 

:theeye:

So I'll be talking to my IPs.  I'm guessing we need to make a decision before the PBO is issued so the contract can be updated?  How does all this work legally?

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beachalice    23

(too late to edit my above post)

I'll check in with my agency and all.  I'd love a head's up of what might be needed before I talk to my agency rep.  All her other surros just lost insurance all together so she's in a bit of a tizzy.  :blink:

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beachalice    23

@traci72 - Do you have any experience with changing hospitals?

My hospital and OB are named in the contract.  I don't see any provisions for a reason we'd want to change. Does it sound like we'll have to amend the contract before we can get a PBO?

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traci72    202

Unfortunately there are going to be quite a few surrogates whose Dr's/clinics/hospitals will now be out of network, thanks to the changes taking place. There are fewer options overall, that are covering surrogate pg's. I don't know if you would need to have an addendum or not. I would start by talking to your Dr, explaining the situation w/insurance and ask for a referral. If he/she isn't able to give one, I'd call the L&D at that hospital and talk to the nurses, see if they have any they recommend you look into...or who to stay away from. Once you find one, you can have your records sent there.

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NJLyn    4

Same issue here. My due date is 12/27 and my carrier is canceling all policies in my state as of Dec 31st. IP has to carry my insurance 6 weeks postpartum though. I am waiting to hear what options we have. 

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beachalice    23

Hmmm.  Insurance is getting tricky.  Does your OB bill the postpartum checkup separately or is a part of global fee for prenatal and delivery care?

Hopefully you'll not have any complications so that a change in companies doesn't affect your care in any way. 

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