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Old 11-05-2009, 02:36 PM   #1 (permalink)
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Are your insurances paying for your Gyn visits? I know it wont pay for Clomid but now it is not going to pay for my follow up visits either or progesterone levels? What can I do?
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Old 11-05-2009, 02:46 PM   #2 (permalink)
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My insurance pays for it all but I live in Maryland where fertility coverage is mandated by the state. Did you call your insurance company to see what they cover?
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Old 11-05-2009, 03:23 PM   #3 (permalink)
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So far my insurance has covered everything. I have had at least 7 blood panels done since June including 4 progesterone checks. I am seeing a regular obgyn and she is writing it up as ovarian disfunction not infertility. I expect the insurance will eventually catch on especially since I just had an HSG. I pay for clomid and met out of pocket because they are not covered but they are inexpensive at Target. My clomid is about $18 a month (10 50mg pills) and my met is I think less than $15 (90 500mg pills) I do know my insurance will cover a percentage once they figure out I am being treated for infertility but I have not looked into how much yet. I am on pacificare (united health care) through my job. My DH has kaiser and they would not even pay for his SA. They don't cover anything.
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Old 11-05-2009, 03:35 PM   #4 (permalink)
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I just called my insurance on this too, basically just checking to see what my infertility benifits are. As long as my U/s and office visits are sent as PCOS 256.4. They are covered cause its considered medical treatment. If they ever send my claim in just once as infertility 628.0 they will deny all other u/s and office visits that have either diagnosis.
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Old 11-05-2009, 04:50 PM   #5 (permalink)
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I wish I had a doctor that would work with me and try to code so insurance would pay. If you know any in DFW please let me know. Unfortunately my insurance does not cover Infertility treatment only diagnostics/testing. And my RE not only won't try to bill things so that insurance will pay, they made me pay out of pocket and refused to bill insurance for a semen analysis, which to me clearly qualifies as diagnostics not treatment. I am very frustrated.
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Old 11-05-2009, 04:59 PM   #6 (permalink)
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It really depends on what your insurance covers (which depends on the state & what your employer signs up for). I would ask for a benefits book to see what's covered/not covered b/c every persons insurance is different.
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Old 11-05-2009, 05:00 PM   #7 (permalink)
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Happywife... I am also in California and having a VERY hard time finding insurance for me here on the central coast. How did you go about talking to your Dr. About the billing? Did they just suggest it?
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Could it be true? Did I ovulate? Am I really not TOTALLY broken?


It is SO time to have a romantic dinner with the DH!


Score so far:

PCOS - 1,345

Me - 2

I'm closing the gap yo!

Love Hugs and baskets full-o-baby dust to all my cysters!



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Old 11-05-2009, 05:01 PM   #8 (permalink)
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My insurance will pay for anything that is coded for PCOS. So with the way my RE's office does things, that means my office visits, ultrasounds and bloodwork are all covered. But anything above and beyond that? I'm on my own. I usually spend about $1,000 a cycle out of pocket.
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My Vital Information:
Cycle 2 2009 - 7.5 mg Femara CD 3-10 w/ HCG Trigger - BFN
Cycle 3 2009 - 7.5 mg Femara CD 3-7, Repronex injections CD 8-13, HCG Trigger CD 14, IUI CD 16, BFN
Cycle 4 2009 -
7.5 mg Femara CD 3-7, Repronex injections CD 8-19, HCG Trigger CD 20, IUI CD 22, BFN
Cycle 5 2009 - Repronex injections CD 3-7, HCG Trigger, IUI, Progesterone injections
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Old 11-05-2009, 05:12 PM   #9 (permalink)
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I asked them about billing under PCOs and my doctors said that they will ask to see your chart so what can I do. Each visit is $150 once a month and my Clomid is 19 so not to bad
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Darn insurance lame! I'm trying to think positive cause I dont want to be stressed out this cycle praying round 2 works!
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Old 11-05-2009, 05:21 PM   #10 (permalink)
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Yah I feel yah Nicole. I'v been trying to get into the Dr.'s office and between finding a new Dr, being told that because I was treated for infertility I was "un-insurable" and taking too much soy isoflavone I am a bit ... flusterd as of late. Wish i could just catch a friggin breake... And all I want is to get a script for a pill so I can start a new cycle... -sigh-...
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Could it be true? Did I ovulate? Am I really not TOTALLY broken?


It is SO time to have a romantic dinner with the DH!


Score so far:

PCOS - 1,345

Me - 2

I'm closing the gap yo!

Love Hugs and baskets full-o-baby dust to all my cysters!



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Old 11-05-2009, 05:58 PM   #11 (permalink)
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Quote:
Yah I feel yah Nicole. I'v been trying to get into the Dr.'s office and between finding a new Dr, being told that because I was treated for infertility I was "un-insurable" and taking too much soy isoflavone I am a bit ... flusterd as of late. Wish i could just catch a friggin breake... And all I want is to get a script for a pill so I can start a new cycle... -sigh-...

I know well I got my RX and billing thought that they might pay for this visit but for following cycles Im on my own hoping that this will be my BFP month. I posted a thread about the Fertility massage and seems like no one has tried or had any luck with it but I am going to look into because it says that it can remove blockages and increase blood flow and egg quality plus you are relaxed so couldnt hurt. 2 years ago I lost 15 pounds and ran a marathon and was able to keep my PCOS SX down to a minimum with diet excersise but after got married me and DH began eating unhealthy again so I have packed on the pounds lol it is hard to pass up all the good stuff. In order for me to lose I have to live on Chicken Brown rice and veggies Good luck hope you get your RX.
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Old 11-05-2009, 07:10 PM   #12 (permalink)
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Quote:
Happywife... I am also in California and having a VERY hard time finding insurance for me here on the central coast. How did you go about talking to your Dr. About the billing? Did they just suggest it?
My doctor does it on her own and told me that's what she will do as long as she can but she said eventually the insurance will catch on
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Ray 39
TTC #1 25mo
Met 1500mg
Clomid 9/4/09 50mg 1st
Clomid 10/2/09 100mg 2nd
Clomid 10/29/09 100mg 3rd
HSG 11/2/09 not completed
Dialation & HSG 11/3/09 clear


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