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Michelle1110
My family is complete
Member since 1/12 2338 total posts
Name:
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Update NYC PICA - FERTILITY MEDS NOT COVERED
I am not trying to start a panic - BUT - after PICA denied my PIO order and said it is no longer covered as of 2014, I went online to my account to price other meds I have taken.
Gonal F, Follistim, Ovidrel, etc. is no longer covered by PICA, either.
WTH ?!?!?!?!
NYC DOE ladies - go check your plan!!! Am I missing something?!
UPDATE: I called the number on the PICA page for a FOURTH time. Again they stated I have no coverage.
I got call waiting from Freedom - so I switched calls and Freedom said it went through "tentatively". I didn't switch back to pica Call. Clearly they are morons. This never happened in the year I've been on various drugs (of which ovidrel is the only drug I maxed out on).
I have NO IDEA what is going on - suffice it to say something is up. Be careful ladies when the RE places your order!
Message edited 1/23/2014 1:35:06 PM.
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Posted 1/22/14 1:16 PM  |
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PhyllisNJoe
My Box Is Broken
Member since 6/11 9145 total posts
Name:
Phyllis
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
Im telling you. When I spoke to a rep at BCBS - an insurance company that had plans that covered everything, they said they will no longer be giving ANY IF coverage as of 2014. I was shocked.
The coverage for IF is going backwards!
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| Posted 1/22/14 1:47 PM |
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AKD
LIF Adult
Member since 1/12 2637 total posts
Name:
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
Not covered at all??? WTF!! 
I don't get how they can make coverage even worst.
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| Posted 1/22/14 1:51 PM |
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NYC PICA - FERTILITY MEDS NOT COVERED
Did you call UFT/GHI? Perhaps it's not PICA anymore? Also, trying to be optimistic for those who need it...I certainly hope this is not the case as I know Gonal can be pricey for sure...
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| Posted 1/22/14 2:31 PM |
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Michelle1110
My family is complete
Member since 1/12 2338 total posts
Name:
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
Posted by TheDivaBrideandTeddyFrog
Did you call UFT/GHI? Perhaps it's not PICA anymore? Also, trying to be optimistic for those who need it...I certainly hope this is not the case as I know Gonal can be pricey for sure...
I called UFT, they couldn't help. The welfare fund specialist said PICA SHOULD be covering it, but the three people I spoke to at PICA said it's no longer in the plan to be covered.
GHI is still only covering diabetic medication.
I can't figure out who to talk to next!!
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| Posted 1/22/14 2:37 PM |
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Michelle1110
My family is complete
Member since 1/12 2338 total posts
Name:
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NYC PICA - FERTILITY MEDS NOT COVERED
PICA is still covering my lovenox bc it's a blood thinner. I just got it last week and paid $10
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| Posted 1/22/14 2:38 PM |
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NYC PICA - FERTILITY MEDS NOT COVERED
Weird!! I feel like there should have been some notification to someone!! UFT is saying PICA is doing it?! Frustrating!
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| Posted 1/22/14 3:29 PM |
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NYCGirl80
I love my kiddies!
Member since 5/11 10413 total posts
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
Posted by PhyllisNJoe
Im telling you. When I spoke to a rep at BCBS - an insurance company that had plans that covered everything, they said they will no longer be giving ANY IF coverage as of 2014. I was shocked.
The coverage for IF is going backwards!
FYI - it's not the insurance company that determines coverage benefits. It's the specific policy.
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| Posted 1/22/14 4:35 PM |
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Sweetlax22
LIF Adult
Member since 5/10 1904 total posts
Name:
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
The website does not say anything about this, hopefully you just talked to fools and this will work itself out!
PICA GHI LINK
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| Posted 1/22/14 4:37 PM |
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Michelle1110
My family is complete
Member since 1/12 2338 total posts
Name:
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
Posted by Sweetlax22
The website does not say anything about this, hopefully you just talked to fools and this will work itself out!
PICA GHI LINK
That was last updated in 2008. I've spoken with two supervisors. There doesn't seem to be coverage. :( :(
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| Posted 1/22/14 4:49 PM |
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Michelle1110
My family is complete
Member since 1/12 2338 total posts
Name:
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NYC PICA - FERTILITY MEDS NOT COVERED
I've had Freedom contact them as well - everything is denied
Eta: it was not my third fill either.
Message edited 1/22/2014 4:50:06 PM.
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| Posted 1/22/14 4:49 PM |
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jessnbrian
Only God knows His plan for us
Member since 4/13 7238 total posts
Name:
Jessica
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NYC PICA - FERTILITY MEDS NOT COVERED
If you have access to Flex Spending accounts max them out, this way at least you're using untaxed money for the OOP expenses.
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| Posted 1/22/14 4:50 PM |
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starr
little whale on the way
Member since 6/10 1288 total posts
Name:
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
wow reading this makes my blood boil. so sorry these meds aren't covered for u 
still boggles my mind that IF isnt a fully recognized medical condition and they are treating it as an elective as if we are looking to get our boobs done 
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| Posted 1/22/14 5:00 PM |
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Sweetlax22
LIF Adult
Member since 5/10 1904 total posts
Name:
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
Posted by Michelle1110
I've had Freedom contact them as well - everything is denied
Eta: it was not my third fill either.
Oh man! I was going to ask you these two questions in hopes this is a mistake.
Did you ask if they had anything in writing either online or that they could send you ?
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| Posted 1/22/14 5:22 PM |
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PhyllisNJoe
My Box Is Broken
Member since 6/11 9145 total posts
Name:
Phyllis
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
Posted by NYCGirl80
Posted by PhyllisNJoe
Im telling you. When I spoke to a rep at BCBS - an insurance company that had plans that covered everything, they said they will no longer be giving ANY IF coverage as of 2014. I was shocked.
The coverage for IF is going backwards!
FYI - it's not the insurance company that determines coverage benefits. It's the specific policy.
That's what I asked and the rep I spoke to said all policies. I am hoping he was wrong. I went though 5 people until I found someone who can answer me. We purchase our own insurance and are willing to buy a policy with the coverage and he said it did not matter as of 2014
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| Posted 1/22/14 5:37 PM |
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CindySN23
Stop, Think & Breathe...
Member since 8/11 3550 total posts
Name:
Cindy
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NYC PICA - FERTILITY MEDS NOT COVERED
That doesn't make any sense unless there is a change in the pica plan they can't deny coverage. I would ask to see that in writing cause this sounds like bs!!!
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| Posted 1/22/14 5:54 PM |
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babydreams21
LIF Adult
Member since 12/12 3656 total posts
Name:
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NYC PICA - FERTILITY MEDS NOT COVERED
Uhh this is bad news. Especially since I will be doing my last IVF this year. Uhhh, they should at least honor any refills. Our good coverage is not so good anymore. Sucks.
Message edited 1/22/2014 9:10:09 PM.
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| Posted 1/22/14 6:58 PM |
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
doesn't coverage for specific treatments depend on the employer? I know that I have United but my employer's policy is unique to my workplace. Therefore my coverage with united may not necessarily be the same as someone else with united. Isn't this how it usually works?
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| Posted 1/22/14 7:03 PM |
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BabyLove08
Love her!
Member since 2/08 3673 total posts
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NYC PICA - FERTILITY MEDS NOT COVERED
OMG, how can this be? No more fertility medicine coverage with GHI/PICA? We would have gotten an informational mailing about this, something doesn't sound right!
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| Posted 1/22/14 8:05 PM |
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Lillies
Grateful for my babies!
Member since 2/12 4571 total posts
Name:
<3
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
DH is calling about thus tomorrow bc we we're never notified via mail or email about he chance. Maybe GHI NYPD is different?
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| Posted 1/22/14 9:10 PM |
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Sweetlax22
LIF Adult
Member since 5/10 1904 total posts
Name:
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
Posted by Lillies
DH is calling about thus tomorrow bc we we're never notified via mail or email about he chance. Maybe GHI NYPD is different?
Pretty sure pica is pica no matter the city agency.
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| Posted 1/22/14 9:32 PM |
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Lillies
Grateful for my babies!
Member since 2/12 4571 total posts
Name:
<3
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
Yes, we have PICA but I have not used it yet. RS never asked for the PICA info and said that they processed my prescriptions via GHI and caremark only.
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| Posted 1/22/14 10:28 PM |
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Michelle1110
My family is complete
Member since 1/12 2338 total posts
Name:
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NYC PICA - FERTILITY MEDS NOT COVERED
I'm going to call again today and demand to see the policy change in writing
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| Posted 1/23/14 6:11 AM |
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Michelle1110
My family is complete
Member since 1/12 2338 total posts
Name:
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
Posted by BabyLove08
OMG, how can this be? No more fertility medicine coverage with GHI/PICA? We would have gotten an informational mailing about this, something doesn't sound right!
This is my thought. I don't get it !!
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| Posted 1/23/14 6:12 AM |
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journey22
LIF Toddler
Member since 7/13 374 total posts
Name:
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Re: NYC PICA - FERTILITY MEDS NOT COVERED
This is so ridiculous
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| Posted 1/23/14 9:17 AM |
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