Humana SUCKS!!!!! ok sorry had to get that of my chest...... They have denied every single claim that I have sent to them regarding my treatment for my pcos, First they wouldn't cover my met,, then Back in Febuary I had dozens of Polyps removed from my uterus and my RE wanted to give me Progesterone shots to induce my menses and make my uterus shed it's lining,,, Well they didn't cover that either a month ago they said all I had to do was send in a letter from my RE stating that this wasn't an infertility treatment and that it was to prevent the polyps from comming back,, well I called them today a month later and now they are giving me the stick and saying that that should have never went down like that , they should have sent my RE an authorization form to state what it was for so now I have to wait another month to get reimbursed for the shot and to see if the will cover my next shots to come.. AHHHHHH!!! so not only do I have to deal with my health issues of not being normal no I have to fight my insurance company!!!!!!!!!!!
__________________ Met 2000mg a day
Yaz 1 a day
Spironolactone 1 a day
laparoscopic/hystereoscopic 2/16/07 Found dozens of polyps Horrible HSG test 3/28/07
Emergency Laparoscopic,06/05/2007
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I'm so sorry! I have Humana, although I don't know much about it because I'm still in college so I'm still under my parents' insurance. I do know that they covered the met for me and my mom, though. I haven't had any of the other things done you're talking about. It seems weird they won't cover these things, though! My mom works at a Catholic hospital (and we have our insurance through that), so when the dr prescribed BCPs for me we had to fight them to cover it, but it ended up okay and they agreed to cover it. So I'm surprised it's so hard for you. I'm sorry
__________________ Previously on Met, currently on Ortho Tri-Cyclen, Spiro, and cinnamon
Iam so sorry that you have to go through this. I hope it all works out for you in the end.
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-*-*-*-*-*-*Jessica-*-*-*-*-*-*
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I work in insurance. Insurance won't ususally cover anything that is for infertility. You'll have to talk to your doctors office and make sure they classify it as something other than infertility treatment. It really doesn't help that you are going to a Reproductive Endocrinologist either. Insurance sees that and automatically assumes whatever procedure you are having has to do with infertility treatment.......
__________________ Stacie To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Married
No children
Age 31
PCOS diagnosed 03/03
Hypertensive Heart disease - dx'd 03/07
Left Ventricular Hypertrophy - dx'd 03/07
Metformin 2000mg/day
Dermatographia (a type of hives, cause unknown)
Longest time gone without AF - 10 months
Fibromyalgia (dx'd 7/07)
Chronic Fatigue Syndrome (dx'd 7/07)
Glutathione/ATP injections :
Pulmonary Obstruction (dx'd 3/5/08)
Inhomogeneous Endometrium (2/08)
I work in insurance. Insurance won't ususally cover anything that is for infertility. You'll have to talk to your doctors office and make sure they classify it as something other than infertility treatment. It really doesn't help that you are going to a Reproductive Endocrinologist either. Insurance sees that and automatically assumes whatever procedure you are having has to do with infertility treatment.......
Actually through my journey I have always made sure that if it was a fertility issue even if it was for 5 minutes I always paid for it,,,, Me seeing the RE was because i was in and out of the ER and other things like that. But I have always made things clear with my insurance company The point I'm trying to get at with mine is the fact that they have been such a pain to deal with I have never had these many problems with any insurance company ever before
__________________ Met 2000mg a day
Yaz 1 a day
Spironolactone 1 a day
laparoscopic/hystereoscopic 2/16/07 Found dozens of polyps Horrible HSG test 3/28/07
Emergency Laparoscopic,06/05/2007
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Insurance companies stink. I have Blue Cross Blue Shield HMO and they said as long as the testing and treatment is not apart of infertility, they will cover it and all I have to pay is the co-pay. Each insurance company is different, but I would definitely call them before going back to the doc to see if you need an authorization number for whatever it is you're having done.
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Kristen (27) To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. Jim (31) together since...July 27, 2003
engaged...October 10, 2006
getting married...December 1, 2007
Symptoms Since: 1994
Dx: April 2, 2007 Rx: Meridia 10mg Diet: Weight Watchers Flex Plan
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Yeah , Because right now I can't even go on the fertility drugs at this point. My tubes are blocked granted that is one of the reasons that I have been in pain but the pain is no where near as bad as it was when I had the polyps in there it was terrible so I'm hoping to get the surgery for my tubes approved but as of right now the procedures that I have been having are to make me better physically ( not infertility wise). I called My insurance case manager for the company and she will be taking care of it aparently right after the company switched to humana in DEC 06 they were giving people a very hard time, as she said " I thought we were over this, but I guess they are just giving you a harder time, Don't worry I'll take care of this for you" Oh yeah the cool thing she to has PCOS : ) so at least she'll know what she's talking about when she talks to them....
__________________ Met 2000mg a day
Yaz 1 a day
Spironolactone 1 a day
laparoscopic/hystereoscopic 2/16/07 Found dozens of polyps Horrible HSG test 3/28/07
Emergency Laparoscopic,06/05/2007
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I will keep you in my prayers that this is all taken care of as the case manager told you. *crosses fingers* too for good luck!
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Kristen (27) To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. Jim (31) together since...July 27, 2003
engaged...October 10, 2006
getting married...December 1, 2007
Symptoms Since: 1994
Dx: April 2, 2007 Rx: Meridia 10mg Diet: Weight Watchers Flex Plan
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Is the insurance policy through your employer "self insured" or "fully insured"? If self insured, you can challenge claims that are denied. If fully insured, under the dept. of Labor Law in Michigan, you cannot challenge a denied claim.
I'll be praying for this matter to be resolved quickly for you.
__________________ Peace be with you all To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
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No more Pampered Chef To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
I'm helping a friend with her business:
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Just a gardening-chef-domestic engineer-SAHM who helps out in DS's school just about everyday (I'm there for the big bucks -LOL! )
Just wanted to add that you can get Met really cheap at Wal-Mart. For me I am taking 1500 mgs of ER Met daily and for a month's supply it was $6. So if your insurance doesn't want to cover it try there (if you haven't already). It may end up cheaper that way even if your insurance does cover it. It was for me.
I HATE my insurnace 
