Are OBGYN exams covered on regular HMO?

Question

Are OBGYN exams other than the annual papsmear covered on regular HMO policies? For example, exams in the first trimester when I would be pregnant: would they be covered under my copay or would I have to get maternity ins?

Answer 1

Call the toll free number on your card to make sure, but usually prenatal care, labor & delivery, and postnatal care (for a certain # of days) are covered. You would just be responsible for your copays. Please check with your insurance on tests, though. Some insurances don't cover certain blood tests or lab tests unless there is an absolute need. Congrats!!

Answer 2

I'm not going to insult you for having asked this question because some women are not familiar with the prostate gland. Why that is remains a mystery. In answer to your question, women do not have prostates; so logically, your HMO will not cover prostate exams if you're a female because you don't -- or shouldn't if you are a normal female -- have one. That would be like the HMO providing men with coverage for cervical or ovarian exams when males have neither a cervix or ovaries. If you are a transgendered female, that may be another thing. You may have to inform your health care provider that you are a male biologically who had a sex change to become a female and may, therefore, need to have your prostate examined. It seems your outrage is based on ignorance and nitpicking. In nitpicking, I mean trying to make a sex discrimination issue out of everything. Men and women ARE biologically different, so there will be some differences in health coverage. I don't mean to offend you; but lighten up. This issue is not that serious.

Answer 3

When I had an HMO, I had to pay a $10 copay for my first office visit to the OBGYN. Everything after that was covered except for $100/day for staying in the hospital. Your HR manager should be able to explain the benefits specific to your HMO policy.

Answer 4

You need to look at your policy. My policy covers maternity just like anything else. Some policies don't cover maternity, but they will state that maternity is not covered. Look at your policy or talk to your HR person at work. If you don't want to talk to them yet, there should be a number to call on the policy to ask questions about your coverage.

Answer 5

My insurance did not have maternity coverage. At all. We asked for a maternity rider and thought we were paying for one, but we were not.

If the insurance is through a group (like an employer), you most likely have coverage. If it is individual insurance, you may not have coverage. If you were pregnant before you started the policy, unless it is a group policy, it is HIGHLY unlikely you have coverage. In addition, many individual plans have a one-year waiting period before they cover pregnancy.

All of this information is spelled out very clearly in your policy. Take a look at the documents to find out. If you can't find them, call your insurance agent and ask.

Answer 6

Usually, but every policy is different. You need to call your HMO.

Most of the time, everything for pregnancy is covered, including a big chunk (if not all) of the hospital delivery.

Answer 7

I am pretty sure that would be included. Most insurance covers maternity costs.

Sorry I couldn't give you a more definite answer. I have tricare.

Answer 8

Almost always. I would call the # on the back of your card or look it up via the internet.

Answer 9

yep usually