Community› The Bump Message Boards› Infertility Veterans
Infertility Veterans
New Discussion

Health Coverage Question

rockpaperloverockpaperlove member
in Infertility Veterans
I recently switched my health coverage to WHA/UC Davis and I was told by Member Services that I might request a referral for ultrasound and blood work from my PCP. Has anyone had their cycle related bloodwork or lining checks covered under insurance? Should I attempt to phrase these requests from my PCP as non-infertility related somehow someway to get coverage? I will be needing same day results sent to CCRM and I have previously used Quest for cycle related blood draws (OOP) since Kaiser coverage was worthless! Looking for loop holes! Help!

Countless BFN(s)
Moving to IVF

IVF1 (ICSI): Long Lupron
6R. 3F. 3DT. 8Cell 1Grade 2Embies. 1Frostie.
Beta 1/22: 14 Beta 1/24: 24 Beta 1/26: 28
Round One Result: Chemical Pregnancy

Pressing Forward

IVF2 (ICSI/AH/ACU): Microdose Lupron Flare
13R. 11F. 5DT. 2TFR'ed. 1Frostie.
Round Two Result 4/30: Harsh BFN

FET. 2TFR'ed.
Round Three Result 6/25: BFN
Where do we go from here?

Moving forward with CCRM in 2013
ODWU revealed blocked tube(s). Lap 2/15.
Bilateral Tubal Ligation. Stage IV Endo.
Finally some (tough) answers.


IVF3 (ICSI/CCS): Antagonist with EPP
13R. We have 3 CCS Normal Embryos!


Lupron Depot: May 2013 to August 2013
Long awaited FET on 9/3. 2TFR'ed.
BFP on FRER 5dp5dt: IN SHOCK!
Beta1 9/10: 152.7! Beta2 9/12: 378! Beta3 9/14: 1224! 

1st ultrasound 10/1: TWO beautiful heartbeats!  Overjoyed!

Report Reply to Post

Re: Health Coverage Question

  • J&D2007J&D2007 member
    Well, I have Aetna health insurance and the only thing they have covered for me is my blood work and u/s while cycling. I think that a lot of insurances cover 'diagnostic testing' with the code of infertility. I would think that you would have to use the infertility code though. I don't think the insurance company needs to know that it's for the purpose of ivf. But I'd call your insurance directly and see what the coverage is for diagnostic testing for infertility.
    Me: 37, DH: 38: ttc 7 years, dx: unknown
    10/11: after 2 years, saw a RE, FSH 5.4
    11/11: BFP! (surprise after thyroid & normal hsg),
    12/11: missed m/c after 7 week u/s, 1/12: D&C
    6/12 IUI#1-IUI #3: clomid = BFP!, C/P
    IVF #1(10/12) FSH 5.4, AFC: 16 long Lupron, 5R/5M/4F, all 4 made it to 5dt, 1 blast/1-8 cell transferred=BFN
    IVF #2(12/12)AFC 21, MD lupron, 4R/4M/3F, 5dt of 1 blast and 2-8cell. BFN.
    IVF#3(4/13) Natural start antagon protocol, 12R,11F. one PGS normal at day 6 transfer. BFN.
    IVF#4 (11/13) C.CRM (ODW.U normal 8/13 Still no Diagnosis) EPP/antagonist. ER 13R/7M/6F. Only 1 made it to freeze. Abnormal. Looking into options of DE, Fresh vs frozen.
    10/14 new local RE to look into what's next. CD3 FSH 4.7, AMH 0.9. Met with DE agencies and exploring options for feb/march 2015.
    Surprise natural bfp (4 days before donor is signed). Beta #1 at 9dpo: 51.8, 2nd beta: 195 (25 hours doubling) @11dpo. 3rd beta (12/15): 516 (35 hrs doubling) 4th beta(12/17): 895 (58 hours doubling) 5th beta(12/19): 2120. U/S at 5w0d(12/22): one gestational sac with yolk sac. U/S #2 (6w0d)12/29. One little bean measuring 6w0d with HR 124. 3rd u/s(1/4)7w0d: baby measuring 7w2d. HR 134. 3/30: A/S at MFM went great except for low lying placenta. Verifi results are normal! Team Blue! Please send any positive thoughts our way! EDD:8/24/2015
    Baby Will born 8/18. He's perfect.
    Report Reply
  • twistsandturnsto2twistsandturnsto2 member
    I'm not sure. My RE happens to be "in network" so I do get a discount on b/w and u/s even tho IF is not covered by my insurance. I think it would be worth the call to your insurance co at least.
    Me: 37, DH: 35 :: TCC since 2/11 SA: Perfect! CD3  HSG = Blocked Right Tube
    April- Femara 2.5mg + Trigger + IUI = BFN   May- Femara 5mg = CX - No Response on Left = BFN
    June- Femara 7.5mg + Trigger + IUI = BFN  August- Lap & Hysteroscopy = Blocked & Partially Blocked Tubes
    September- Femara 5mg = CX - No Response on Left = BFN  October- 100mg Clomid + Trigger + TI = BFN
    IVF # 1: Stims 11/30 ER 12/12/12! (10R, 10M, 8F, 2T, 6 F) :: Beta #1- 176  c/p @ 4w4d
    FET #1 February 26th :: Lost 4 to Thaw, Transferred 2 = BFFN
    IVF # 2 Stims 5/10 ER 5/21 (15R, 13M, 13F, 2T, 7F- 6d3 & 1d5) :: Beta # 1- 15 c/p @ 4w
    FET #2 Cancelled, Right Tube Developed a Hydro  8/28 Hydro & Scar Tissue Removed  Cleared for FET
    FET #2.2 Scheduled for September 20th
    2 Thawed, 2 Transferred! Beta #1- 96, Beta #2 906! :: EDD June 10th
    2015- 2 failed FET. We are done
    SURPRISE! BFP 8/8/16   EDD 4/1/17

     
    imageImage and video hosting by TinyPic

    Baby Birthday Ticker Ticker

    Pregnancy Ticker
    Report Reply
  • Loading the player...
  • rockpaperloverockpaperlove member
    Member Services said to request a referral from my PCP. I just don't know how to go about the approach to my PCP to guarantee the b/w and u/s referral from her. I wonder if I mention IF, the referral goes out the window?? Fun stuff...

    Countless BFN(s)
    Moving to IVF

    IVF1 (ICSI): Long Lupron
    6R. 3F. 3DT. 8Cell 1Grade 2Embies. 1Frostie.
    Beta 1/22: 14 Beta 1/24: 24 Beta 1/26: 28
    Round One Result: Chemical Pregnancy

    Pressing Forward

    IVF2 (ICSI/AH/ACU): Microdose Lupron Flare
    13R. 11F. 5DT. 2TFR'ed. 1Frostie.
    Round Two Result 4/30: Harsh BFN

    FET. 2TFR'ed.
    Round Three Result 6/25: BFN
    Where do we go from here?

    Moving forward with CCRM in 2013
    ODWU revealed blocked tube(s). Lap 2/15.
    Bilateral Tubal Ligation. Stage IV Endo.
    Finally some (tough) answers.


    IVF3 (ICSI/CCS): Antagonist with EPP
    13R. We have 3 CCS Normal Embryos!


    Lupron Depot: May 2013 to August 2013
    Long awaited FET on 9/3. 2TFR'ed.
    BFP on FRER 5dp5dt: IN SHOCK!
    Beta1 9/10: 152.7! Beta2 9/12: 378! Beta3 9/14: 1224! 

    1st ultrasound 10/1: TWO beautiful heartbeats!  Overjoyed!

    Report Reply
This discussion has been closed.
Choose Another Board
Search Boards
"
"