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monkeybride
My Everything
Member since 5/05 20541 total posts
Name:
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Has Anyone fought an insurance 6 months of trying rule?
I should have lied but I had my IUD out (which apparently they don't have record of b/c it was at my annual) and figured if they wanted to they could trace back the truth.
So I told the truth and said 2 months.
I was DENIED for all my benefits until the 6 months pass.
I am 35 and DH is 41. It took 8-9 months to conceive DS. I had started with an RE and just happened to end up pregnant.
We want #3 but don't really want to waste time. My RE recommended Femara, trigger and IUI. We were all set to do it and then $^%*@ AETNA denied me my benefits.
Any chance of getting around this?
I am having short cycles on top of it (25 days) and about a 10 days LP which I think is going to be an issue as well.
Thanks for any input. I'm just very frustrated since I just got AF today and I just know something is not right with my body. 
Waiting for the nurse to call back so I can at least get my CD 3 blood work done and go from there.
Message edited 11/29/2010 3:39:52 PM.
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Posted 11/29/10 3:39 PM  |
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MrsKS
Thank You St. Gerard.....
Member since 12/09 8306 total posts
Name:
Kerri
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Re: Has Anyone fought an insurance 6 months of trying rule?
Just wanted to say... I'm so sorry for your stresses. I know this must be just another thing on top of everything else.
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| Posted 11/29/10 4:15 PM |
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monkeybride
My Everything
Member since 5/05 20541 total posts
Name:
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Re: Has Anyone fought an insurance 6 months of trying rule?
Posted by MrsKS
Just wanted to say... I'm so sorry for your stresses. I know this must be just another thing on top of everything else.
Thank you.
I just keeping trying to tell myself if we are meant to have another child it will happen it's just hard to think of the alternative right now. 
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| Posted 11/29/10 4:24 PM |
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SummerMom
Now a mom of 2!
Member since 6/07 4970 total posts
Name:
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Re: Has Anyone fought an insurance 6 months of trying rule?
Correct me if I'm wrong, but isn't the famous Dr. Braverman not a RE? He's an OB-GYN that focuses on infertility but not an RE? So I wonder if you went to him, if Aetna would code it as "infertility" since he's not a fertility doctor?
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| Posted 11/29/10 4:27 PM |
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prunepie
LIF Adult
Member since 7/06 4357 total posts
Name:
jennifer
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Re: Has Anyone fought an insurance 6 months of trying rule?
i am very sorry...but confused why having an iud out would cause them to deny benefits????? are they saying iud is preexisting or something?
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| Posted 11/29/10 4:28 PM |
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MrsKS
Thank You St. Gerard.....
Member since 12/09 8306 total posts
Name:
Kerri
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Re: Has Anyone fought an insurance 6 months of trying rule?
Posted by DavaDay
Correct me if I'm wrong, but isn't the famous Dr. Braverman not a RE? He's an OB-GYN that focuses on infertility but not an RE? So I wonder if you went to him, if Aetna would code it as "infertility" since he's not a fertility doctor?
I'm not sure if this is right... because if he were an OBGYN wouldn't he then be able to deliver?? I know he doesn't deliver for a fact.
I'm perplexed by this. I'm not saying what you wrong is right or wrong, bc I don't really know. But I thought he was an RE and not an OBGYN.
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| Posted 11/29/10 4:29 PM |
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MrsKS
Thank You St. Gerard.....
Member since 12/09 8306 total posts
Name:
Kerri
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Re: Has Anyone fought an insurance 6 months of trying rule?
Posted by prunepie
i am very sorry...but confused why having an iud out would cause them to deny benefits????? are they saying iud is preexisting or something?
They want her to wait for the 6 month mark. It's pretty common protocal with insurance companies.
Hopefully there is a loophole.
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| Posted 11/29/10 4:30 PM |
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prunepie
LIF Adult
Member since 7/06 4357 total posts
Name:
jennifer
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Re: Has Anyone fought an insurance 6 months of trying rule?
dr b is not an re..he is an obgyn..who specializes in fertility...he chooses not to deliver. thats my understanding
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| Posted 11/29/10 4:31 PM |
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CraftyGirl
LIF Infant
Member since 9/10 141 total posts
Name:
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Re: Has Anyone fought an insurance 6 months of trying rule?
Posted by prunepie
dr b is not an re..he is an obgyn..who specializes in fertility...he chooses not to deliver. thats my understanding
BTW he's my dr and I didn't even know that lol!
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| Posted 11/29/10 5:17 PM |
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monkeybride
My Everything
Member since 5/05 20541 total posts
Name:
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Re: Has Anyone fought an insurance 6 months of trying rule?
Posted by DavaDay
Correct me if I'm wrong, but isn't the famous Dr. Braverman not a RE? He's an OB-GYN that focuses on infertility but not an RE? So I wonder if you went to him, if Aetna would code it as "infertility" since he's not a fertility doctor?
I'm not in NY so he's not an option.
I've got an RE out here so I'm going forward with CD 3 bloodwork and an ultrasound b/c they aren't supposed to deny that.
RE: the IUD. If I lied and said 6 months of TTC and did all this stuff and somehow they find out I only had it out 2 months I worried they could reject everything and I'd have all these unexpected expenses...KWIM?
If it hadn't taken 9 months to conceive my son after only 1 month for DD I would give it the 6 months but I have having short cycles (25 days) and my LP is about 10 days give or take 1 day.
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| Posted 11/29/10 10:39 PM |
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MrsKS
Thank You St. Gerard.....
Member since 12/09 8306 total posts
Name:
Kerri
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Re: Has Anyone fought an insurance 6 months of trying rule?
Posted by prunepie
dr b is not an re..he is an obgyn..who specializes in fertility...he chooses not to deliver. thats my understanding
Oh WOW!! I didn't know this.
I wish he did deliver!! I'd stay with him for sure!!!!
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| Posted 11/29/10 11:13 PM |
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