Pregnant Mom of Four Faces High Medical Bills

A pregnant mother of four said she has been impacted by failed negotiations between CHI Health and Blue Cross Blue Shield Nebraska.

In her third trimester of pregnancy, Ann Bauer learned her CHI Health doctor is no longer covered through her Blue Cross Blue Shield Alabama insurance.

Bauer, who is expecting her fifth child in weeks, said she contacted her insurance company several times to see how her plan would be impacted by the failed deal.

"We were really led to believe that being my third trimester of the pregnancy, we shouldn't have any issues," said Bauer.

Bauer was told she met one of Blue Cross Blue Shield's conditions for continuing coverage, and that she needed to simply fill out a form.

"This is my fourth C-section so I''m really comfortable with my doctor, he delivered all my other kids. I had some complications in the past. And to have to leave him possibly is just heartbreaking," said Bauer.

Ultimately, Bauer said Blue Cross Blue Shield Alabama denied continuing coverage. Susan Beaton, Director of Care Management at Blue Cross Blue Shield Nebraska said different state plans require different conditions to continue care.

"Each plan determines what they feel for continuity of care and what conditions would be covered under that. So it may vary from plan to plan," said Beaton.

Now Bauer will have to find a new in-network doctor, or pay the out-of-network price for her delivery.

Blue Cross Blue Shield said for a $20,000 C-Section, in-network would cost about $2,800 but out-of-network would cost more than $15,000.

"It's the last thing you want to have to worry about," said Bauer.

Out of state plans are typical for employers in Nebraska. A company based in another state may branches in other, but the insurer remains the same. Blue Cross Blue Shield Nebraska estimates that 100,000 out-of-state members used CHI Health in the last two years.

They recommend that members check in with their specific state plans to find out what is covered.


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