Insurance Issues... Please help...

Hi Ladies,

Sorry I haven't been on for a while! I have had some ongoing health issues to figure out... but I have the option to change my insurance and wanted to know your opinions!

I currently have Oxford Health Liberty Plan, which I need referrals and have a $25 copay reg dr., and $40 Specialist copay. Under Oxford Health the Dr. office advised me that I have $10,000 infertility coverage.

I have the option to switch to Horizon Blue Cross Blue shield. Where I do NOT need referrals, and only have a $10 copay, reg and specialist. It states that it has 100% coverage for infertility up to 4 egg retrievals per lifetime per NJ MANDATE...

#1 question... What does this mean "per NJ MANDATE"

#2 question... Which insurance coverage do you feel is better?

#3 question for those who have Horizon Blue Cross Blue shield, do you have difficulty finding Dr.'s in NY since this is more of a NJ plan... I have found by calling some of my Dr.'s that not all of them cover this plan because they say it is more of a NJ plan.

What's your opinions...

Thanks in advanced girls!
Renee

Re: Insurance Issues... Please help...

1) It's a law that requires insurance carriers to provide a certain kind of benefit. NJ must provide some level of fertility treatment benefit and in your case it will cover up to 4 retrievals.

2) I would go with the Second Coverage....b/c we know that it can take several cycles before we get pregnant and it could be over $10,000.

Good Luck!! I am waiting for DH's new insurance plan and I am hoping that there is a change with IF benefits. As of now, ours doesn't cover IF.

Message edited 1/16/2007 10:55:45 AM.

Re: Insurance Issues... Please help...

I am sure you can find Dr's through BCBS NY plan. I would call them and ask. The 2nd plan seems much better

Re: Insurance Issues... Please help...

i'm not an expert in this area, but i think the 2nd one sounds better. but i guess it's only really good, if your doctors take it!

good luck.
love ya, cuz!!

Re: Insurance Issues... Please help...

I have BCBS and it is based out of VA and I haven't had problems with Doctors in NY and TX accepting my insurance.

Re: Insurance Issues... Please help...

Thanks everyone for the help!

I have 1 issue... LISA listen up

my OBGYN Mesbah takes both which is good.
Levine (Columbia Dr.) takes both too
Brenner only takes BCBS, not the oxford plan.
and
Mckenzie doesn't take the 2nd plan... and most likely I would need to see him...


Should I just keep both insurances???

Does anybody actaully do that?

Love you too Lisa!

Message edited 1/16/2007 6:42:44 PM.

Re: Insurance Issues... Please help...

The second does sound better. I had Oxford and the 10K actually goes far (about 3 cycles) cause only the advanced procedures come out of that 10K.

Re: Insurance Issues... Please help...

The second is much better. The NJ mandate is awesome.

I work for Empire BCBS so I can tell you a "little" about Horizon.

You can see ANY of our NY dr's and they will be participating with Horizon, its just one large BCBS network...UNLESS its an HMO.

IF its an HMO the NY Dr's might not take it.....
The first plan is what I have now ( without the fertility benefits) and it stinks IMO.

If you have any other questions let me know.

The BCBS is definatly a better plan.

Re: Insurance Issues... Please help...

Thanks girls!

dm24ange you work for BCBS yet they give you oxford... that sucks... why is that?

Re: Insurance Issues... Please help...

Re: Insurance Issues... Please help...