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Not Sure What To Do

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MrsWoods
LIF Adult

Member since 4/12

1461 total posts

Name:

Not Sure What To Do

So my insurance ent me a letter refusing to pay for IUI because it has not been a year trying yet. I had a pregnancy in May 2013 and MC in June 2013. So from my understanding a new year will be this June.

So my RE's financial advisor gave me the OOP cost for IUI which is $474 but i'm not sure if i should just wait till June to see if i can fix this with insurance by appealing or just go ahead and pay the money OOP. My RE said i can try another clomid cycle of just timed intercourse instead but i feel like i'm wasting time since i already did that the last cycle and it didn't help. I don't know what to do. Its not a long wait but i don't want to not try now and then insurance comes up with something else to refuse authorization. sChat Icon

Also, anyone appeal a insurance decision? How does it work and what was your outcome?

Posted 4/17/14 3:28 PM
 
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NYCGirl80
I love my kiddies!

Member since 5/11

10413 total posts

Name:

Re: Not Sure What To Do

I'm not really sure what your story is, so it's hard to give advice.

One month of Clomid and TI is not really a lot. How many follies did you have? Did you trigger? What's your dx?

IMO, $474 is not that expensive for an IUI, and I'm not sure what you've tried already, but if you were able to get pg on your own once, then trying on your own 1 more month may be worth it. Then go ahead with IUIs in June once they're covered.

Sorry if this isn't helpful, but I can't really give a solid opinion w/o knowing your back story.

Posted 4/17/14 5:30 PM
 

MrsWoods
LIF Adult

Member since 4/12

1461 total posts

Name:

Re: Not Sure What To Do

Posted by NYCGirl80

I'm not really sure what your story is, so it's hard to give advice.

One month of Clomid and TI is not really a lot. How many follies did you have? Did you trigger? What's your dx?

IMO, $474 is not that expensive for an IUI, and I'm not sure what you've tried already, but if you were able to get pg on your own once, then trying on your own 1 more month may be worth it. Then go ahead with IUIs in June once they're covered.

Sorry if this isn't helpful, but I can't really give a solid opinion w/o knowing your back story.



Thanks. DH and i are trying to decide since i'm going in 2moro morning and the nurse wants to know what route we are going down.
I was diagnosed unexplained so far. I had two follies with the last TI cycle and triggered when they were 18mm and 30mm. They then turned into cysts right after which was not fun.

Posted 4/17/14 7:23 PM
 

hazel2
LIF Infant

Member since 5/13

346 total posts

Name:

Re: Not Sure What To Do

Personally, I would pay the money to do it now. I wouldn't want to wait until June and who knows what could happen with the insurance ... Good luck to you!!

Posted 4/17/14 10:22 PM
 
 

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