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Old 09-15-2008, 08:16 PM   #1 (permalink)
Bella Moochie
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Default To avoid health insurance denials????

Hi!

My husband (41) and I (36) have been trying to conceive for a few years and had to take a break due to the constant disappointment. Emotionally drained! We have decided to get 100% back in the game because we are both older and our chances of success are dwindling. My husband's SA came back and the results were much better than average. I have not been diagnosed as of yet.

I go to a new gyn this Friday to have my yearly exam. At that time, I plan to discuss my suspicions of possibly having PCOS. After reading all of the problems so many of you have had with insurance companies, I was wondering if I should go about a PCOS diagnosis a different way??? Meaning, instead of walking in spouting off the possibility of PCOS, just tell the doctor my symptoms and see what she says???? Any suggestions? Anything you wish you may have said or not said to your doctor that would have made a difference insurance wise?

I have Blue Cross (California Care) which is now Anthem (Blue Cross) through my husband's employer. He works for the county in which we live, so there are thousands of employees on this insurance. I see that they cover 50% of infertility treatment; however, on the prescription information, it looks as if they do not cover fertility meds. Is that odd that they would cover 50% of the treatment but not the meds?

To be clear, I am not trying to rip the insurance company off! If anything, they rip me off....most of us!!! My husband was injured at work and the county does not pay any part of your health insurance if they dispute your claim....so, I pay over $900.00 per month for the three of us for health insurance ALONE! That does not include the dental insurance we are obligated to maintain!

I would appreciate any suggestions/comments! It really stinks to look back and think...shoulda coulda, woulda and then have to write an additional large check to the insurance company because I used the wrong word which in turn makes the doctor use the costly insurance codes!

Thank you very much!
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