Log In Sign Up

Insurance Verdict: "Eh"


Forum: Trying to Conceive Your First Child

Notices

Welcome to the JustMommies Message Boards.

We pride ourselves on having the friendliest and most welcoming forums for moms and moms to be! Please take a moment and register for free so you can be a part of our growing community of mothers. If you have any problems registering please drop an email to boards@justmommies.com.

Our community is moderated by our moderation team so you won't see spam or offensive messages posted on our forums. Each of our message boards is hosted by JustMommies hosts, whose names are listed at the top each board. We hope you find our message boards friendly, helpful, and fun to be on!

Like Tree1Likes
  • 1 Post By AshleyO

Reply Post New Topic
  Subscribe To Trying to Conceive Your First Child LinkBack Topic Tools Search this Topic Display Modes
  #1  
July 9th, 2013, 02:51 PM
BabyBirdies's Avatar over the rainbow?
Join Date: Apr 2010
Location: Manhattan :)
Posts: 1,851
So, we finally got a straight answer about what's going on with my insurance. Not exactly the why, but at least the what, etc.

1. Because it's a specialist, I needed a referral from the Student Health Center. I went down there this afternoon and got it. Very clear that the primary care guy doesn't do a lot of referrals for an RE, but he was really nice about it. Even sympathized that he had to use the term "infertility" to describe it. I told him I was okay with it, and he said, "What the paper said doesn't define you." A+ mister random doctor from the Health Center.

2. One I have the referral, the appointment is a $30 copay. They cover testing at 80%.

3. They don't cover any treatment, not even fertility drugs. No idea why not, but they don't.

Basically, that means I can get any testing I need done, but after that it gets more complicated because of the money issue. The nice/hard thing is that my insurance is excellent once I am pregnant - 100% coverage of everything through delivery and hospital stay. And I can be on this insurance for another 18 months, even if I have a job. So...yeah.

My appointment is this Thursday, July 11 at 2:30pm EST.
__________________

Thanks Jaidynsmum for the siggy!
My fertility blog: Only Infertile



NTNP since March 2012, TTC since August 2012, HSG = one blocked tube, SA = normal, 1st RE 7/11 - took a zillion tests, 2nd RE appt = Tubal issue with PCOS tendencies, possible polyp, August 2013 - possible polyp, September 2013 - new job, insurance change! January 2014 - new insurance, March 2014 - new RE appointment, then surprise BFP!

Reply With Quote
  #2  
July 9th, 2013, 02:57 PM
momology's Avatar Platinum Supermommy
Join Date: Oct 2012
Location: Houston, Texas
Posts: 6,296
Insurance is so complicated and confusing! It is great that the testing is all covered but so weird they would cover that and not the treatment part. . . better than nothing I guess?

I cant wait to hear how the appointment goes on Thursday!! KUP!
__________________

Thank you *Kiliki* for the amazing siggy!!

Expecting our first baby August 25th, 2014!!!


Reply With Quote
  #3  
July 9th, 2013, 03:45 PM
girlsofsummer's Avatar Us two became we three <3
Join Date: Jul 2012
Location: Pittsburgh (Go Steelers!)
Posts: 2,366
I'm glad that at the very least you are covered for 18 months, too. That is good news.

Wow you got an appt fast. That's great, too. KUP!
__________________
Mirielle Margaret born 4/24
Reply With Quote
  #4  
July 9th, 2013, 05:39 PM
BabyBirdies's Avatar over the rainbow?
Join Date: Apr 2010
Location: Manhattan :)
Posts: 1,851
We had the appointment already - this was just getting it covered under insurance...yay jumping through hoops..
__________________

Thanks Jaidynsmum for the siggy!
My fertility blog: Only Infertile



NTNP since March 2012, TTC since August 2012, HSG = one blocked tube, SA = normal, 1st RE 7/11 - took a zillion tests, 2nd RE appt = Tubal issue with PCOS tendencies, possible polyp, August 2013 - possible polyp, September 2013 - new job, insurance change! January 2014 - new insurance, March 2014 - new RE appointment, then surprise BFP!

Reply With Quote
  #5  
July 9th, 2013, 07:18 PM
plan4fate's Avatar I may bend, but not break
Join Date: Mar 2008
Location: Wisconsin
Posts: 26,390
Send a message via MSN to plan4fate
stupid hoops.. but at least you got it sorted!
__________________
~TTC #1 together 2 years and counting ~


Awesome siggy made by Jaidynsmum
Matthew&Mark 08/24/2005 9w1d, Mattie Anne 04/07/2008 8w Mel&Dee 01/19/2010 (8 weeks) and 5 chemical pregnancies
Hope 07/22/2012@4w1d, Konnor 11/24/2012@3w6d,"Emmy"1/15/2013@ 3w6d, Ronen 02/10/2013@3w5d, Joy 07/19/2013@3w6d, "Pea" 09/06/2013@ 3w3d

Me: Hashi's, PCOS, Insulin resistant
175mcg Synthyroid, 1500mg Metformin
Colposcopy = CIN1+CIN2 cells Polypectomy - August 21st
Him: MFI low count, low morphology, low motillity
Seeing MFI specialist/RE in 2015. Vitamins started August 2nd
Trying a few cycles of clomid and progesterone. FX this is all it takes.
Reply With Quote
  #6  
July 10th, 2013, 03:31 AM
Mega Super Mommy
Join Date: Jan 2012
Location: Derbyshire, UK
Posts: 4,983
Glad you managed to get some answers before your appointment. It annoys me loads all the hoops you ladies have to go through to get the help you need to treat a medical condition!
__________________

Thank you Vicki for my amazing siggie!

Reply With Quote
  #7  
July 10th, 2013, 05:03 AM
Nicholle ttc's Avatar TTC our first!
Join Date: Oct 2011
Location: Ohio
Posts: 5,059
Sorry about the insurance, but I'm glad that you got some answers! GL and KUP about your appointment!
__________________
TTCing since August 2011
Me (33)-LP on the short side, but no other abnormalities
DH (37)-slightly subfertile morphology and motility


Natural cycles-August 2011-July 2012
August 2012-October 2012 clomid and progesterone
November 2012-IUI
December 2012, cysts from IUI, on bcp

January 2013-February 2013, long protocol IVF
15 eggs retrieved, 11 mature, 7 fertilized with ICSI
All 7 made it to 5 day transfer, 2 were transferred
Only 1 frozen snowbaby
1st IVF


May 10, 2013, lap sx, Stage 1 endo

June 2013 - MA Round 2
Femara + hcg shot
IUI # 2


FET tentatively scheduled for 10/31/13

Have never seen a bfp.






Reply With Quote
  #8  
July 10th, 2013, 07:06 AM
Super Mommy
Join Date: May 2013
Location: Texas
Posts: 669
Bummer about the lack of treatment coverage but otherwise that is some pretty good news about the appointment being cleared and covered. KUP on how it goes!
__________________


Reply With Quote
  #9  
July 10th, 2013, 07:51 AM
Cait&AngelAbove's Avatar Platinum Supermommy
Join Date: Feb 2010
Location: South Carolina
Posts: 10,629
Insurance can be such a pain! I'm glad you got everything figured out!
__________________


Thank you so much Bokkechick for the perfect siggie!!!
12-10-10 2-6-12
Reply With Quote
  #10  
July 10th, 2013, 10:32 AM
Mega Super Mommy
Join Date: Dec 2012
Posts: 1,227
I am still a little confused just from reading that lol! I don't understand why insurance companies are so ridiculous!
remisue16 likes this.
__________________


Married to my best friend





~*~**Proud Army Wife**~*~
Reply With Quote
  #11  
July 14th, 2013, 07:34 PM
epsilonbeta's Avatar Super Mommy
Join Date: Apr 2013
Location: California
Posts: 834
Sad that insurance companies tend to not be very supportive of infertility treatments
__________________


Excitedly Expecting #1 w/ PCOS around June 16, 2014
Adopted mom to DS (16)
Reply With Quote
Reply

Topic Tools Search this Topic
Search this Topic:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off



All times are GMT -7. The time now is 09:13 PM.



Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
Search Engine Optimization by vBSEO 3.6.0