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07-24-2006, 03:19 AM
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#1 (permalink)
| | Fingers Crossed
Join Date: Apr 2005 Location: Borger, TX
Posts: 5,233
Points: 52,049.76 Bank: 0.00 Total Points: 52,049.76 |  Insurance
I had made an RE appt but they called back and said that infertility wasn't cover on the insurance. My Dad's girlfriend told me that I need to call the insurance and tell them that I am going in for the PCOS and my cycle being so long. My ? is, isn't that still considered infertitlty?
Jessica
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07-24-2006, 03:39 AM
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#2 (permalink)
| | Caden's Mommy!
Join Date: Jun 2006 Location: New Jersey
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No b/c you don't have to tell your insurance that you are TTC. The dr can classify it as amenorrhea, and then your insurance will have the justification that it isn't infertility. I think it has to do with the fact that they know that not getting AF could possibly lead to cancer, so they would rather cover helping you get AF rather then possibly covering treatment for something worse.
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Nicole (31) & Marc (28)
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TTC #2 February 2008 - currently taking 1500mg Metformin, 50mg soy cd 2-6, Vitex, and prenatals
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07-24-2006, 03:49 AM
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#3 (permalink)
| | Fingers Crossed
Join Date: Apr 2005 Location: Borger, TX
Posts: 5,233
Points: 52,049.76 Bank: 0.00 Total Points: 52,049.76 |
Thanks Nicole
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07-24-2006, 03:52 AM
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#4 (permalink)
| | Caden's Mommy!
Join Date: Jun 2006 Location: New Jersey
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No problem. I'm glad that you made another appt w/ the RE!
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Nicole (31) & Marc (28)
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TTC #2 February 2008 - currently taking 1500mg Metformin, 50mg soy cd 2-6, Vitex, and prenatals
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07-24-2006, 03:54 AM
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#5 (permalink)
| | Fingers Crossed
Join Date: Apr 2005 Location: Borger, TX
Posts: 5,233
Points: 52,049.76 Bank: 0.00 Total Points: 52,049.76 |
I didn't get to go because of insurance but I will be calling them back to see about calling it amenorrhea.
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07-24-2006, 04:00 AM
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#6 (permalink)
| | Caden's Mommy!
Join Date: Jun 2006 Location: New Jersey
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Oh i see. I hope everything works out!
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Nicole (31) & Marc (28)
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TTC #2 February 2008 - currently taking 1500mg Metformin, 50mg soy cd 2-6, Vitex, and prenatals
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07-24-2006, 06:34 PM
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#7 (permalink)
| | OMGosh! #3
Join Date: Oct 2005 Location: Michigan
Posts: 1,907
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I talked to my dr office about what codes they would be billing it as...then called my insurance co & said this is the code of what I have to have done-is it covered? I acted like I was unsure of exactly what was being done..LOL But at least I knew ahead of time what my coverage was.
As Nicole said-they don't have to know you are TTC...as long as the code is covered.
Good luck to you!!!
__________________ June 1 BFP Miscarriage June 21, 2006 (7wks 6days)
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07-24-2006, 06:47 PM
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#8 (permalink)
| | Registered User
Join Date: Jun 2001 Location: Reno Nevada
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I agree with Nicole. I had to do the same thing to get my treatment covered, and it worked all the way through that magical BFP! It's none of their business if you're TTC, only that you have medical problems that require attention and treatment. As far as they are concerned you and the doc are investigating your symptoms and trying to find the reason. My insurance would cover up until a firm "infertility" diagnosis was made - so the doc never did officially diagnose me. He understood what needed to happen to get the coverage and did it with all patients in the name of helping us achieve this monumental goal of having a child. Good luck to you. You may have to fight some more - be prepared that somewhere along the line someone will code a procedure wrong, but you can always argue and appeal a claim and usually they will give-in and change it. - Julie
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07-24-2006, 08:58 PM
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#9 (permalink)
| | Fingers Crossed
Join Date: Apr 2005 Location: Borger, TX
Posts: 5,233
Points: 52,049.76 Bank: 0.00 Total Points: 52,049.76 |
Thank you ladies so much. This is great insight for me.
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07-24-2006, 09:24 PM
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#10 (permalink)
| | Caden's Mommy!
Join Date: Jun 2006 Location: New Jersey
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Your Welcome Jessica....oh and congrats on the new job!!
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Nicole (31) & Marc (28)
3 angels in heaven
TTC #2 February 2008 - currently taking 1500mg Metformin, 50mg soy cd 2-6, Vitex, and prenatals
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IVF#1 - BFP 4/24 - Caden Joseph born 12/27/07
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07-25-2006, 04:23 AM
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#11 (permalink)
| | expecting FUR baby meow!
Join Date: May 2002 Location: ATL
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GA is an unmandated state and they still paid all my "work up" bloodwork, a few ultrasounds, etc. Depends on what it is coded as. PCOS is a medical condition and they do have to treat that. My insurance stopped at doing injectibles, IVF, pills, etc. Although they will do ovarian drilling if coded as a medical condition.
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Nuvaring--stopped due to mood swings & some TMI issues. waiting to try cerazette!
allergy shots 2 yr
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08-01-2006, 05:48 PM
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#12 (permalink)
| | Registered User
Join Date: Jun 2006 Location: Dallas, TX
Posts: 576
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Hi everyone,
USA Residents!!!! Resolve has a link (incase you are not aware of it) where you can fill out your name & address & it will automatically send a letter to your states HOUSE OF REP. asking them to please co-sponsor a bill (HR 735 The Family Building Act - Rep. Anthony Weiner) that would require all insurance companies to cover infertility treatments if they also cover obstetrical benifits. It only takes a minute to do & the letter is sent from resolve in your name, directly to the rep/s that you specify... No going to the post office or fax machine - no looking up the reps info - it's simple!!! PLEASE EVERYONE WHO LIVES IN THE USA - DO THIS NOW!!!!! WE AS THE INFERTILE PEOLE OF THIS COUNTRY NEED THIS DESPERATELY!!! I ALSO ENCOURAGE YOU TO PASS THIS LINK TO YOUR FRIENDS & FAMILY & ENCOURAGE THEM TO DO THIS AS WELL... TOGETHER WE CAN CREATE CHANGE!!!!
FOR THOSE OF YOU WHO DO NOT LIVE IN THE USA, PLEASE - IF YOU HAVE ANY FRIENDS OR RELATIVES HERE - PLEASE PASS THIS LINK ON & ENCOURAGE THEM TO SUPPORT THIS AS WELL...
Thanks so much.
Here is the link...
https://secure2.convio.net/res/site...erAction&id=112
__________________ Tyra - 28 DH 29 EDD - 05/03/07 Magic combo - 1st round of 7.5mg Femara, 1500mg metformin, preseed and hcg shot. It's a BOY ! 04/25/07 To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts. To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Last edited by Bundle of joy; 08-01-2006 at 10:23 PM.
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