GHI Insurance and help with my random thoughts please.

I spoke, finally, to the IVF coordinator, who told me that my insurance, GHI, is very strict on covering IVF. I wanted to go through IVF because I am a carrier of Fragile X and we would be able to do PGD. My DH also has motility rating of 4, but GHI considers 2 IVF worthy.

So although the coordinator says she is going to try after DH gets his second SA, I cannot help but wonder.....am I supposed to go through 6 months of IUI wondering if I get preggo my baby might have FRAGILE X and/or waste six months waiting because of the low sperm count.

6 IUIs is the recommendation for GHI.

ahhhhhh! Any advice? Has someone been through this?

Re: GHI Insurance and help with my random thoughts please.

I totally think you could get it covered. If they turn you down, I would write a letter. I've heard of insurance companies covering IVF and PGD because it is cheaper than covering a potentially sick child. I know that's awful, but everything comes down to money with the insurance company.

Re: GHI Insurance and help with my random thoughts please.

I too have GHI. I was told, although I did not wind up needing IUI or IVF when I started at the RE that they would cover unlimited IUI's. In regards to IVF I was told GHI would cover 75%. The RE told me we could have gone straight to IVF (with ins. covering) bc of DH's numbers. Namely 0% morphology. I think it depends on the specific issues.

Re: GHI Insurance and help with my random thoughts please.

Hi. I too have GHI. I did 3 iui's and Dr. B called GHI and did a peer to peer evaluation to try and get me approved for IVF. GHI denied it. I wrote a letter of appeal and then DR. Braverman did another peer to peer after the 4th IUI. Finally they approved my IVF!! Tomorrow is my ER. Your doctor can push for it and you can always appeal!

Re: GHI Insurance and help with my random thoughts please.

You have to apply for a waiver through your doctor. If that fails, appeal yourself. They wanted me to do 5 or 6 IUI's at the age of 43 which was INSANE especially since I had already had two chemicals to boot before they would approve IVF. After the 2nd IUI, my doctor wrote an appeal to them for teh second time explaining that IVF was a medical necessity at this point and they finally approved IVF. You may have to keep at it. They did not approve it after the first IUI but told us that we only had to do one more at that point, so it's worth a shot to have your Dr. appeal to them even if they do not approve you on the first request. GL.

Re: GHI Insurance and help with my random thoughts please.

Thank you so much! I will def. push the issue. I will wait for them to seek approval and see what happens first.