Question for ladies with Empire NYS insurance

I am researching REs a bit before we start IVF in November. I am very happy with my current RE who is not one of the well-known RE clinics, but both myself and DH really like him. I feel I get very personal one-on-one attention and he is only a couple of blocks from my office. He is an approved RE on Empire NYS insurance, but he is not a "center of excellence".

I am going to meet with some of the REs who are centers of excellence, but I am wondering what out-of-pocket expenses will we have if I do stick with my current RE? Will it just be office copays, or will my drugs be reimbursed at a different rate?

Basically, I feel if it's just the $20 copay every time I see the RE, then I would be quite happy paying $200 or so OOP. He has already done my 3 IUIs and has a protocol in mind for my IVF. Maybe, for me, it's a case of the devil you know being better than the devil you don't know.

Re: Question for ladies with Empire NYS insurance

I would call your insurance carrier and see what info they will give you over the phone.

Re: Question for ladies with Empire NYS insurance

I have the same insurance but am not sure how it would work for a non "Center of Excellence". I know that out-of-network doctors are only covered at 80%, but I would definitely call them and have them give you a detailed outline at what is and what is not covered. I know that some drs have a billing specialist, so maybe he/she can help you, too. Good luck!!

Re: Question for ladies with Empire NYS insurance

Thanks, ladies. Our insurance isn't effective until 11/1, so I don't want to call before that. Calling my RE's office is a great idea.

Re: Question for ladies with Empire NYS insurance

We went with a center of excellence just for that reason.

However, I need to see a perinatologist, and will go out of network. My deductable is $363.

Good luck!

Re: Question for ladies with Empire NYS insurance

i have Empire Govt. insurance and my RE is not a center of excellence either and is not covered. it gets a little expensive. my first appointment, i paid $50 bc my insurance covered 80% of it. i still havent gotten the bill from my other two appointments.

the reason i am sticking with my RE is bc i am doing PGD and he is very good when it comes to PGD. also, i feel really comfortable with him and that is really important to me

just keep in mind that the insurance company will pay 80% of what THEY think the procedure should cost, not $80 of your bill. so, in the end, it might end up being that you're paying MORE than 20%

BUT, that being said, it might be worth the extra money to go to someone you truly like and feel comfortable with

Re: Question for ladies with Empire NYS insurance

I saw Dr. Braverman, who is not a "center of excellence," althoug he is in my book, and I think I probably ended up paying around $200 or so for the entire cycle. That, of course, doesn't include medication copays, just office visits.

Re: Question for ladies with Empire NYS insurance