Doctors & Testing Questions

JReyB

We've been trying for only 4 months, but I am worried and already getting discouraged. I do have health insurance, but it isn't very good. I want to see a doctor to be sure there isn't anything wrong. Any of you who have been through this - How do I start? Is fertility testing covered by most insurance carriers and how do I find out if it would be? Do I ask the clinic or the insurance? We don't have much money, and I'm nervous about spending it if it isn't necessary. Thanks!

ladydc78

If you are over 35, most ob/gyn will let you try for 6 Mos. before starting to run tests to look for problems and /or refer you to a specialist. Depending on your insur you may need to ask for a referral from your gyn before you go see a reproductive endocrinologist - RE. They specialize in infertility. In the meantime you can temp and chart if you haven't already started and it will vastly improve your chances and it's free! Most of us use fertility friend.com for temping and charting-it's free. Also recommend buying opk's to pinpoint your ovulation to make sure your timing for bd is perfect. If you have fairly regular cycles, already know your o date and have no luck in 6 months of trying while bding around that time I would ask your gyn for referral to an RE. It took us about 12 mos to get a bfp but once I figured out my o using a monitor and timed bd it happened pretty quickly. Wish I had been doing that from the start! Good luck

emsmama15

What @ladydc78 said.  Four months seems like an eternity when you're trying to get pregnant, but in actuality, it's not that long.  If you are charting and know when you ovulate using OPKs and temping, I'd make an appointment with my OBGYN after 6 months.  A lot of the preliminary testing may be covered, especially if your OBGYN orders it (labs, HSG, semen analysis for your partner).  And also ask for a referral to a RE.  It is very tempting, especially when you're frustrated and impatient, to take the fertility meds your OBGYN will no doubt offer. Please don't.  Go to a RE for any medicated cycles!  You can call your insurance company and ask them about your coverage.

JReyB

Thank you! I needed that encouragement. I have charted my cycles & am very regular. I check some symptoms but haven't done the temp thing because I don't understand how it works. Guess I'll do more reading for this month.

suziq1978

@JReyB - I second what pp's have said.  But to respond directly to your question about insurance - you would need to contact your insurance provider and ask them specifically what is and isn't covered in regards to fertility/infertility.  I have worked in Benefits for several years and have seen many different insurance plans.  My current insurance covers all fertility/infertility testing and procedures including up to 6 rounds of IVF in a two year period.  My insurance at my previous employer covered absolutely nothing in regards to fertlity/infertility.

If your insurance does not cover anything coded for fertility/infertility there is a possibility that some procedures can be coded differently.  I understand that an HSG can be coded as a regular procedure and not coded for fertility/infertility.

Unfortunately, this is something that you have to speak with your insurance company about.  The doctor's office will not be able to give you specifics about what your insurance does and doesn't cover.  However, once you know what will be covered you can talk to your doctor's office and ask them to code procedures appropriately so that you can get as much covered as possible.

Sorry this is so long.  I hope the information helps a little!

ladydc78

my insurance covered testing for infertility but no treatment (i.e. IVF), but in some states (like maryland) they are required to cover IVF so you never know.  i wouldn't worry about that too much until you get there.  def consider the opk's (ovulation predictor kits) pretty cheap from CVS - you might be missing your o but just a half a day.  when i switched from bd at night to the morning it seemed to help us.  

JReyB

Thanks. That's reallt helpful. It's all so confusing.