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BCBS State insurance - Medi-Call - "Coming Attractions"


Forum: June 2013 Playroom

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  • 2 Post By MrsLat
  • 1 Post By 8miraclez

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  #1  
October 20th, 2012, 06:24 AM
zombiemommy's Avatar Veteran
Join Date: Oct 2012
Location: Charleston SC
Posts: 218
So, our health insurance is through the misters work. I was going through the little booklet to determine how much my first appointment copay is going to be and I ran across this:

"If you are a mother-to-be enrolled in the State Health Plan (SHP), there is an important call you should make as you start planning for your baby.

That call is to Medi-Call. When you do so, you will enroll in the Employee Insurance Program’s comprehensive maternity management program, “Coming Attractions.” The program monitors expectant mothers throughout pregnancy and manages Neonatal Intensive Care Unit infants or other babies with special needs until they are a year old.

“Coming Attractions” is designed to ensure regular prenatal care and can help protect the health of you and your baby.

During the first trimester of your pregnancy, you must call Medi-Call at:

800-925-9724 (South Carolina, nationwide, Canada)
803-699-3337 (Greater Columbia area)

Note: Participating in “Coming Attractions” or contacting Medi-Call about the birth of your baby does not add your baby to your health insurance. You must contact your benefits administrator to add your baby to your policy within 31 days of his birth.
As part of “Coming Attractions,” a maternity nurse will follow you through your pregnancy. You will receive a pregnancy and newborn care book, Caring for Tomorrow’s Children — Having a Healthy Baby. If complications develop, a maternity nurse will help coordinate your care in a cost-effective way. After your baby is born, you will receive a diaper bag filled with samples and an insulated soft cooler to help keep formula or breast milk cool while you are traveling. You will also get a Dynaband and an exercise sheet to help you get back in shape. If your baby needs special care, a maternity nurse will help coordinate the equipment and services.

You must call Medi-Call during the first trimester of your pregnancy. It isn’t necessary to wait until you have seen your physician. If you do not call Medi-Call, or if you refuse to participate in “Coming Attractions,” you will pay a $200 penalty for each maternity-related hospital or skilled nursing home admission. This penalty will be in addition to the Medi-Call preauthorization penalty, and the coinsurance maximum will not apply."

That makes me feel like I'm forced to do something I may not want to do. I don't want yet another nurse or doctor insisting I do this, or do that or do this. Anyone else have to do something like this or have you done it before? The whole having to pay penalties thing kind of ticks me off and makes it feel more like a forced action to be under control... or maybe I just have problems with authority...
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  #2  
October 20th, 2012, 06:39 AM
Farmers-wife's Avatar Platinum Supermommy
Join Date: Mar 2008
Posts: 6,066
As I was reading I thought that seems nice, but then I got to the penalty for not participating and wanted to tell them to piss off for you. I think you need to clarify what the penalty would be for. Like if you aren't in the program and you go into preterm labor and have to be hospitalized? Or if everything is fine and then at the end something comes up? It doesn't seem to tell you.

But I have been accused of problems with authority too. But I don't see any authority here. You are a customer, not a ward.
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  #3  
October 20th, 2012, 06:41 AM
QueenCrafty's Avatar Courtney
Join Date: May 2007
Location: North Carolina
Posts: 25,860
Oh that's weird. DH has BCBS so I wonder if there is something similar for us. That doesn't seem fair that there is a penalty for not using this service. If anything I would think it would cost more. Insurance is already paying for your pre-natal care, so wouldn't having a nurse call you throughout the pregnancy cost them more?
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  #4  
October 20th, 2012, 10:35 AM
zkat's Avatar Mega Super Mommy
Join Date: Aug 2009
Posts: 3,743
I had a similiar service with my last pregnancy on Cigna, except there wasn't a penalty for not participating. It was basically a phone call from a nurse ever couple of months and a post birth follow up call. It wasn't a big deal.
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  #5  
October 20th, 2012, 11:03 AM
MrsLat's Avatar Mega Super Mommy
Join Date: Oct 2012
Posts: 3,772
That makes me kind of angry. You are going to be penalized for not wanting to be bothered by useless, pointless phone calls? Grr.. I did this last pregnancy and every time I asked the nurse a question she would just tell me to follow up with the doctor. I started ignoring all the calls and emails because they did me absolutely no good whatsoever.
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  #6  
October 20th, 2012, 11:55 AM
zombiemommy's Avatar Veteran
Join Date: Oct 2012
Location: Charleston SC
Posts: 218
Thanks for the input ladies!
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  #7  
October 20th, 2012, 12:00 PM
phantomsgrl11's Avatar Mega Super Mommy
Join Date: Jun 2009
Location: Ardmore, PA
Posts: 1,192
My insurance does something a little bit similiar it's called Baby Blue Prints or something along those lines and we were required to sign up in order for the maternity care and hospitalization to be approved. I would check into it to make sure it's not more than just the 200 dollars because if my OB didn't notify my insurance by 20 weeks that I was pregnant they would not cover any of the costs of the pregnancy.

I have a PPO too not an HMO so every plan is a little different but especially because it is a state plan it might have different regulations. Never hurts to get more information about it before you make a decision.
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  #8  
October 20th, 2012, 12:00 PM
navywifey2003's Avatar Home Birth Mama
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I would be so annoyed that seems pointless.
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  #9  
October 20th, 2012, 04:20 PM
8miraclez's Avatar Formerly Halfbaked
Join Date: Jul 2007
Posts: 7,472
It's the insurances way of making sure you go to all your appointments and get what they consider "proper care" so they don't have to pay for problems later.
We have BCBS too and it's not a big deal. They just make sure you are being seen, etc.
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  #10  
October 20th, 2012, 04:28 PM
~*Nicole*~'s Avatar Nicole
Join Date: Oct 2010
Location: Idaho
Posts: 2,903
Our insurance has a similar program although it's optional. They bribe you with $150 in gift cards too. I would be annoyed if I HAD to do it or be penalized. But, that's kind of where healthcare is heading, so I'm not surprised.
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