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jbd2012
LIF Infant
Member since 6/14 76 total posts
Name:
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New Here...have an insurance question
Hello ladies, I'm new to this forum, Im 33, hubby is 35. We already have 1 beautiful boy (via FET) who will be 2 this year. We are starting the process again for baby #2. Here's my question. I know have 2 insurances. My secondary insurance has a great infertility coverage. However, being that I need to be preauthorized, and it is my secondary coverage..does anyone know if this will be an issue? My primary is already maxed out for IVF. Will the secondary still cover? Curious if anyone has dealt with this before. My primary is OXF, secondary is BCBS
thanks in advance ladies.
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Posted 6/5/14 1:57 PM  |
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Long Island Weddings
Long Island's Largest Bridal Resource |
GoodThoughts
Dreams do come true
Member since 2/12 2259 total posts
Name:
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Re: New Here...have an insurance question
We had this issue. What happened with us was that our RE had to put in the claim with my primary and then could bill the secondary afterwards. I had absolutely no coverage for IF with my primary, so it was merely a matter of going through the motions. Still, the secondary had to see the denial/rejection from the primary before they would pay anything out.
Primary was UHC. Secondary was GHI.
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| Posted 6/5/14 2:03 PM |
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jbd2012
LIF Infant
Member since 6/14 76 total posts
Name:
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Re: New Here...have an insurance question
Posted by GoodThoughts
We had this issue. What happened with us was that our RE had to put in the claim with my primary and then could bill the secondary afterwards. I had absolutely no coverage for IF with my primary, so it was merely a matter of going through the motions. Still, the secondary had to see the denial/rejection from the primary before they would pay anything out.
Primary was UHC. Secondary was GHI.
Yes that is what billing told me yesterday. Today she emailed me to confirm my coverage and that I have to call them and get preauthorized. So of course now Im scared that because they are my secondary, they won't do it? Should I just not tell them (BCBS) that they are my secondary and just call and get the authorization? I hate dealing with insurance companies, I get so stressed!
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| Posted 6/5/14 2:07 PM |
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Mrs&MrsK
i need sleep ;-)
Member since 2/14 2008 total posts
Name:
L
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New Here...have an insurance question
my primary doesnt cover, secondary does.
it's a pain because way pay my primary copay $20, then later will get billed for the difference $30. it's also a pain because we have to get pre-autorization. not for "referrals" which is no big deal, but for the prescriptions. which of course you need basically overnight. we are constantly getting screwed around. i am on a sample progesterone bc of it. still waiting for approval....
we havent gotten any bills yet but it's the first month.
my primary is umr/ united too. 2ndary is emblem.
ps you can't lie. be totally upfront. lying will cause more problems later.
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| Posted 6/5/14 3:12 PM |
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Mrs&MrsK
i need sleep ;-)
Member since 2/14 2008 total posts
Name:
L
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New Here...have an insurance question
and ps it is a *****!!! i had to make 1000 phone calls because no one knows what is going on w/ the insurance- from the RE office to the insurance companies, and beyond!!! just stay on top of it & everyone and it should be ok?
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| Posted 6/5/14 3:13 PM |
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jbd2012
LIF Infant
Member since 6/14 76 total posts
Name:
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Re: New Here...have an insurance question
Yes! I am learning this already. I spoke to billing from my drs office. And they told me I need a letter from primary (OXF) saying that my benefits are maxed out. Just called OFX, which apparently now has an infertility dept, and they said they couldn't. So now i have to write a letter requesting this confirmation (UGHHH!) because this new dept doesn't have any of my files, as the last time I did IVF was before they took over....and so it begins...
Good to know though, that you are able to get coverage through your secondary. I was nervous about that. Do you mind my asking who you see? Im in NY and go to CWRC
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| Posted 6/5/14 3:26 PM |
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Mrs&MrsK
i need sleep ;-)
Member since 2/14 2008 total posts
Name:
L
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New Here...have an insurance question
we go to LIIVF . Part of our problem is that we started @ the patchogue office then realized stonybrook has way better hours. so our "home office" is Patchogue and we end up going thru 2-3 people to get an answer on anything. on weekends when we go to melville they tell us we dont have a deductible cause we have 2 insurances.... even tho the primary doesnt cover. so weird!!
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| Posted 6/5/14 3:30 PM |
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jbd2012
LIF Infant
Member since 6/14 76 total posts
Name:
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Re: New Here...have an insurance question
We were going to change but CWRC is a preferred hospital or whatever for empire. So since they already had all my info we are staying with them.
Just got off the phone with Empire, We got approved! full coverage! I can breathe now!
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| Posted 6/5/14 4:44 PM |
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jbd2012
LIF Infant
Member since 6/14 76 total posts
Name:
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Re: New Here...have an insurance question
Posted by Mrs&MrsK
we go to LIIVF . Part of our problem is that we started @ the patchogue office then realized stonybrook has way better hours. so our "home office" is Patchogue and we end up going thru 2-3 people to get an answer on anything. on weekends when we go to melville they tell us we dont have a deductible cause we have 2 insurances.... even tho the primary doesnt cover. so weird!!
ugh! thats so annoying, good luck! If its one thing I remember from doing this process last time, is we have to be ON TOP of all our visits, cuz they just start charging you for anything. last time they sent me to collections for a bill, only to find out they OWED me money! So Im extra prepared now
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| Posted 6/5/14 4:45 PM |
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nyranger81
LIF Zygote
Member since 4/14 20 total posts
Name:
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New Here...have an insurance question
Did you buy separate insurance to cover Infertility? My insurance doesnt cover it and I have to pay out of pocket, any suggestions?
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| Posted 6/6/14 8:10 AM |
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jbd2012
LIF Infant
Member since 6/14 76 total posts
Name:
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Re: New Here...have an insurance question
Posted by nyranger81
Did you buy separate insurance to cover Infertility? My insurance doesnt cover it and I have to pay out of pocket, any suggestions?
We didn't buy insurance on our own but we did get on my husbands insurance through his job. My oxford is through my job. We maxed out those benefits when we were trying to have my son. So this year we signed up for my DH's insurance through his job. We researched first if they covered ivf which they did (we just weren't 100% sure
How much). So far (we haven't actually started yet but) there doesn't seem to be an issue. I called my secondary told them I need authorization and they gave it to me. I also told them they were my secondary and they said because of my diagnosis (I have pcos) i was approved. I would def look into that as an option. We are extra blessed that both our jobs cover our insurance 100%. But honestly if his costed anything, it still would be cheaper than paying out of pocket. Also, look into ivf clinics. I was researching that also before this new insurance kicked in. Their cost for a cycle is much less than going through a large name clinic. Hope that helps def let me know if you have more questions. It's def possible as I'm learning now to have two insurances just make sure the second one covers ivf
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| Posted 6/6/14 8:47 AM |
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PitterPatter11
Baby Boy is Here!
Member since 5/11 7619 total posts
Name:
Momma <3
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Re: New Here...have an insurance question
Posted by GoodThoughts
We had this issue. What happened with us was that our RE had to put in the claim with my primary and then could bill the secondary afterwards. I had absolutely no coverage for IF with my primary, so it was merely a matter of going through the motions. Still, the secondary had to see the denial/rejection from the primary before they would pay anything out.
Primary was UHC. Secondary was GHI.
Same here, but my primary was Empire BC and my secondary was UHC.
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| Posted 6/6/14 1:19 PM |
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PitterPatter11
Baby Boy is Here!
Member since 5/11 7619 total posts
Name:
Momma <3
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Re: New Here...have an insurance question
Posted by Mrs&MrsK
on weekends when we go to melville they tell us we dont have a deductible cause we have 2 insurances.... even tho the primary doesnt cover. so weird!!
This is correct. If you have 2 insurances you should not pay a deductible.
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| Posted 6/6/14 1:21 PM |
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Mrs&MrsK
i need sleep ;-)
Member since 2/14 2008 total posts
Name:
L
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Re: New Here...have an insurance question
Posted by PitterPatter11
Posted by Mrs&MrsK
on weekends when we go to melville they tell us we dont have a deductible cause we have 2 insurances.... even tho the primary doesnt cover. so weird!!
This is correct. If you have 2 insurances you should not pay a deductible.
not if one doesnt cover the RE! i'll wait for the bills to pile up
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| Posted 6/6/14 1:39 PM |
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PitterPatter11
Baby Boy is Here!
Member since 5/11 7619 total posts
Name:
Momma <3
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Re: New Here...have an insurance question
Posted by Mrs&MrsK
Posted by PitterPatter11
Posted by Mrs&MrsK
on weekends when we go to melville they tell us we dont have a deductible cause we have 2 insurances.... even tho the primary doesnt cover. so weird!!
This is correct. If you have 2 insurances you should not pay a deductible.
not if one doesnt cover the RE! i'll wait for the bills to pile up
Mine didn't cover the RE and I never owed a co-pay.
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| Posted 6/7/14 1:06 PM |
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Mrs&MrsK
i need sleep ;-)
Member since 2/14 2008 total posts
Name:
L
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New Here...have an insurance question
dammit then they owe me $60 or $80! :-P
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| Posted 6/9/14 12:26 PM |
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jbd2012
LIF Infant
Member since 6/14 76 total posts
Name:
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Re: New Here...have an insurance question
Posted by Mrs&MrsK
dammit then they owe me $60 or $80! :-P
def be on top of that. They'll be quick to charge you, but then take forever to ever pay you back! Thats the only bad thing.
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| Posted 6/9/14 12:35 PM |
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