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Ridiculous (insurance related)

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Joann
LIF Infant

Member since 9/12

360 total posts

Name:

Ridiculous (insurance related)

Ok so my insurance covers NO IF treatments...only covers the diagnosis of IF like doctor's appointments and ultrasounds. But IUIs and IVFs are not covered at all.

I did a little research on the injectable drugs. My insurance will cover them only if they are used with timed intercourse. They won't cover the injectable drugs if you are using them with IUI or IVF.

Has anyone heard of this?

Posted 7/29/15 6:01 PM
 
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Peainapod
Peanuts are here!

Member since 1/09

13591 total posts

Name:
Diana

Re: Ridiculous (insurance related)

that sounds pretty ridiculous. But every plan and plan sponsor / employer is different.

however, I cant say I've heard of those kind of stipulations before regarding IVF treatment.

Posted 7/29/15 7:11 PM
 

BaseballWidow
*****

Member since 8/08

6657 total posts

Name:

Re: Ridiculous (insurance related)

How would they know? If the doc can't bill then say it's for TI.

Posted 7/29/15 8:43 PM
 

Joann
LIF Infant

Member since 9/12

360 total posts

Name:

Re: Ridiculous (insurance related)

Posted by BaseballWidow

How would they know? If the doc can't bill then say it's for TI.



The doctor has to get pre-authorization since the injectables are "specialty drugs." The pre-authorization form specifically asks if the patient will be undergoing an Assisted Reproductive Technology.

I'm baffled at it. I understand not covering IUI/IVF but how can they say the drugs will only be covered if you have timed intercourse (rather than pay for IUI/IVF with your own money)?

I don't work for a religious organization or anything like that..

Posted 7/29/15 10:07 PM
 

hmm
Sweet

Member since 1/14

7993 total posts

Name:

Ridiculous (insurance related)

I would call the insurance company again. Why pay for timed intercourse. Speak to a different person or ask if they have a fertility RN service/ program you can join. Oxford does.

Posted 7/29/15 10:16 PM
 
 

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