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Old 02-12-2009, 05:52 PM   #1 (permalink)
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Default What does insurance cover?

I am looking for new Health Insurance. While I am doing that, I am curious to know what insurance covers in case I had a hard time getting pregnant down the road and needed to see a Endo, etc.

So my question is what does insurance normally cover, and if it depends on what kind of insurance you have.. then what do I need to look for as I'm looking for new insurance, to make sure I get the maximum cover in this particular area?

I know I have heard met is pretty inexpensive, I have also seen it on at Sams club on a discount program. Which I don't think I'll ever have to be on, I've pretty much controlled everything met can do with a low-gi diet, as far as I know. How much is Clomid per month... just some examples?

What are some other costs you incured while trying to get pregnant that weren't covered by insurance? I am trying to be as prepared as possible for down the road.
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Doing Low GI diet as of Sept. 07. DX with PCOS in Sept 07' as well.

Started at a size 24, now a size 14. My waist was 44", now it's 32".

I am on no medication, just diet and exercise.

Thank you all for your support and information! I encourage all of you to do a Low Glycemic diet!
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Old 02-15-2009, 10:13 PM   #2 (permalink)
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This is a broad question but I'll try to help. So met and Clomid are both on the generic lists at most pharmacies (like Wal-Mart or Target.) You'll just have to check before you have your scrip filled.

You'll need to check each plan's infertility, prescription, and pregnancy coverage. Every plan is different. You'll want to compare deductibles, coverage percentages, covered procedures, etc. It's going to be time-consuming, I'm sure.

Our plan through Human doesn't cover any infertility treatments or testing. We were lucky and didn't need them but if we had, we'd have been sh*t outta luck. Our pregnancy coverage is 90% after we hit our $1500 deductible for me. We'll likely do a midwife homebirth so we'll pay out of pocket unless we can find a Certified Nurse Midwife since Humana only covers CNMs.

Hope this helps a bit.
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Old 02-23-2009, 01:58 AM   #3 (permalink)
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I was wondering this same question. I have been really concerned about this the past couple of months as my husband and I have began trying to get pregnant. My OB/GYN will be sending me to an endo soon and I wasn't sure what would be covered.
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Old 03-04-2009, 09:08 PM   #4 (permalink)
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I was quite surprised when my insurance covered my progesterone test.
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Meds: 1000 mg Meformin; 2.5 Femara; HCG Trigger shot
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01/09: femara and hcg trigger shot; BPN
02/09: 2nd round femara 2.5 and hcg shot.BFN
03/09 3rd round femara 2.5 BFN prog level 10
04/09 4th round femara 2.5 and hcg shot BFN prog level 16
05/09 BREAK
06/09 BREAK
07/09 Femara 5 mg and trigger shot.... progesterone levels 33
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