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Consult with RMA today

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Peainapod
Peanuts are here!

Member since 1/09

13591 total posts

Name:
Diana

Consult with RMA today

So I went to RMA (Philadelphia) and all went well. Dr was soo nice. we chatted for a little while about what has been going on, did an internal ultrasound. He showed me the follicle I have that is ready to ovulate. He said a mature follicle is about 20mm, mine was 22. Everything looked normal.

even though my uterus is tilted back he says its totally fine and normal.

So when I get my next AF I have to call to schedule day 3 testing, HSG test. DH is doing a SA test this week.

They took a shit ton of blood today too.

I have Aetna POS plan and while I have $15000 in coverage towards IVF and everything but freezing of the embryos would be covered, I have to do 6 IUI's. Their rule is 37 yrs or under have to do 6. I've already done 3 with my OB, although those never were billed to Aetna. His code was not billable or some shit like that. However, the RE says that if I can show documentation it shouldnt be a problem. So i technically have to do 3 more IUI's before I can move to IVF.

the RE said if it were him he would go straight to IVF but Im bound by these rules. He said he's even showed Aetna studies about the age group and success of IUI's and they dont care...lol.

but the last IUI's I did were not monitored as my OB did it. at least these will be monitored.

So we'll see what the blood work on day 3 shows, the HSG, etc.

Posted 7/17/15 8:33 PM
 
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Sweetlax22
LIF Adult

Member since 5/10

1904 total posts

Name:

Re: Consult with RMA today

Good Luck!

My dr pretty much said the same thing about my iui insurance requirement, basically he said who ever did the math that determined that doing all of these iuis is saving them money got it very wrong.

Posted 7/18/15 11:57 AM
 

DaisyGirl
LIF Adult

Member since 2/08

1650 total posts

Name:

Re: Consult with RMA today

That's great! Best of luck to you!

Posted 7/20/15 9:14 AM
 

MaeDe
LIF Adult

Member since 4/11

1169 total posts

Name:

Re: Consult with RMA today

I have the same insurance problem, maybe with your next three you'll be more successful. Good luck!

Posted 7/20/15 9:37 AM
 

MrsB612
LIF Adolescent

Member since 12/12

784 total posts

Name:

Consult with RMA today

I was at RMA NY - we did 3 IUI's and none worked. We were diagnosed as unexplained and 27 at the time. My RE felt we were just wasting our time and wrote a compelling letter to our insurance company (Aetna) so we wouldn't have to do 3 more IUI's and go straight to IVF. Not sure what exactly the letter said but I am pretty sure it was a template bc he was confident they would not reject the request. Maybe your RE can do the same for you? Good luck!

Posted 7/20/15 11:31 AM
 

Peainapod
Peanuts are here!

Member since 1/09

13591 total posts

Name:
Diana

Re: Consult with RMA today

Posted by MrsB612

I was at RMA NY - we did 3 IUI's and none worked. We were diagnosed as unexplained and 27 at the time. My RE felt we were just wasting our time and wrote a compelling letter to our insurance company (Aetna) so we wouldn't have to do 3 more IUI's and go straight to IVF. Not sure what exactly the letter said but I am pretty sure it was a template bc he was confident they would not reject the request. Maybe your RE can do the same for you? Good luck!



I will ask. He did mention he's provided a peer review report on studies showing the success rates of IUI's in people over 35 and they still insist on doing 6.

I have to call Aetna today for a few things anyway. I may ask about this nonsense.

Posted 7/20/15 1:33 PM
 

babydreams21
LIF Adult

Member since 12/12

3656 total posts

Name:

Consult with RMA today

Best of luck. I hope iui works for you. I have ghi and had to do 6 iuis before ivf. My RE was ready to move to ivf after 3 iuis but we had to keep on going bc of insurance.

Posted 7/22/15 1:16 AM
 
 

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