[Parentsgroup-list] No well-baby visits with BCBS??

Justine Firnhaber-Baker firnhab at fas.harvard.edu
Mon Dec 4 10:37:40 EST 2006


Thanks for the tip about the patient advocate.  I hope she can help  
fix this.  I'm really irate about paying $7500 for health insurance  
(for the 3 of us) and not getting to even chose my own pediatrician.

You can do OB with an in-network non-UHS provider for a $100 co-pay.   
I did the Cambridge Birth Center for my delivery, and that was my  
only copay.  This was with last year's policies, but this year's  
pamphlet makes it look like the same policy is in place for pre/post  
natal care.

best,
Justine


On Dec 4, 2006, at 10:28 AM, Anna Shusterman wrote:

> I left the UHS pediatrics system on my husband's health insurance,  
> but I think that I called BCBS to find out why they would only  
> cover 3 visits a year and I was told that they would cover all  
> routinely scheduled pediatric visits, including the extra ones the  
> first year. I also had a friend who did all of her OB stuff at  
> Mount Auburn, and it was entirely covered by the student version of  
> BCBS. (This is all 2-3 years ago.)
>
> I have found the patient advocate at UHS member services to be very  
> clear on the various policies and helpful as well (to the extent  
> that she has any power to do anything about existing policies). She  
> is reachable by email, phone, or web comments, all at http:// 
> huhs.harvard.edu/AboutUs/QuestionsConcernsPatientAdvocate.htm
>
> I would definitely give her a call if I were having questions about  
> these issues.
>
> Anna
>
> On 12/4/06, Amanda Alvine <amueller at math.harvard.edu> wrote:
> My daughter *is* 4, and they laid out *in the BCBS list of covered  
> care*
> that you had x # of well-baby visits for this age child, with any  
> doctor
> who took BCBS, *certainly* 4 years ago, and almost certainly this last
> year when I had my second baby and checked back into it.  I have  
> used the
> out-of-house pediatrics.  I have been with UHS for going on 8 years  
> now
> (blush!).  This is new--at least relatively new.
>
> UHS is absolutely primary care for adults.  No argument.  But they  
> used to
> let you choose your pediatrician elsewhere, perhaps because they don't
> have as full a range of drs to choose from on the 4th floor.
>
> Do they still let you go out-of-house for OB?  They also have in- 
> house OB
> staff....
>
> --Amanda
>
> On Mon, 4 Dec 2006, wenc at fas.harvard.edu wrote:
>
> > Hmm--as far as I know this is not a new policy--my son is almost  
> 4 and I have
> > always been under the impression that UHS was our primary care  
> source--and
> > anything else was for special care.
> >
> > They do have some kind of pamphlet or something that I saw last  
> year and the
> > year before that makes this clear.  I think it's a common  
> misconception that
> > UHS is 'just' student health services, when it's actually  
> designed to be a full
> > clinical service not just for students but for employees and  
> their families as
> > well.  (I know it took me about 2 years to figure this out.)
> >
> > Christine
> >
> >
> >
> >
> > Quoting Amanda Alvine <amueller at math.harvard.edu >:
> >
> >> But this policy has changed recently (like just *this school  
> year*)--as
> >> Justine pointed out, they used to cover all well-baby visits  
> (they even
> >> laid out how many--6 for the first year, 3(?) for the second,  
> etc in their
> >> literature) but appparrently they have stopped.  Thank you  
> Justine for the
> >> warning, Perhaps we could ask HUHS to make that a bit clearer-- 
> back when I
> >> started using HUHS for more than just me, they pretty much told  
> me *I*
> >> had to get primary care there, and that the only two things I  
> could go
> >> out-of-house for were pediatrics (the whole thing) and OB care.
> >> Apparently this has changed, and they should make this more  
> clear to the
> >> continuing subscribers.
> >>
> >> Good luck with your appeal, Justine!
> >>
> >> --Amanda
> >>
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> >>
> >
> >
> >
> >
> >
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>
> -- 
> ********************************************
> Anna Shusterman
> Post-Doctoral Fellow
> Harvard University
> Department of Psychology
> 33 Kirkland St.
> Cambridge, MA 02138
>
> Phone: (617) 224-6900
> Email: anna.shusterman at gmail.com
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