Intro and insurance question (long set up)

StephK

Hi ladies!  I'll be 35 in a few weeks (Feb 1st), and I have an insurance coverage question, so I figure I should intro while I'm at it.  We have been trying since April.  I have been charting since May, but no luck so far.  I went into the gyn today to discuss my options for the next steps and to get checked out because I think I may have a cyst.  No answers on the cyst until a sono.

My insurance covers infertility testing, oral meds and 3 cycles of IUI lifetime. 

The plan brochure says "Infertility is defined as the inability to conceive after 12 months of unprotected intravaginal sexual relations (or 12 cycles of artificial insemination) for women under age 35, and 6 months of unprotected intravaginal sexual relations (or 6 cycles of artificial insemination) for women age 35 and over."

I read that as their way of saying that they cover women under 35 trying for a year, or women trying for six months over 35.  I would think my 9 months of trying would count for the six months or at least towards the 12 months.  She read that (potentially) that we would need to keep trying for six additional months after I turn 35.  I'm in month 9 now.  It doesn't make logical sense for me to have to wait an extra six months past February just because I happen to turn 35 in the year I am TTC.  I'm OK waiting until April, but the idea that I would have to wait even longer makes me very sad.

I'm going to call the insurance company tomorrow to double-check.  Does anyone have experience with turning 35 while TTC and insurance coverage/interpretation?  Do you think I'll be covered when I hit 35, or should I wait until April to pursue testing?

Thanks so much!  I look forward to getting to know everyone.

ETA - to clarify my question

Mrs.McIrish

I didn't turn 35 while trying but here is my take:  wait until after your birthday and only say "I'm 35 and I have been trying for more than 6 months".   All of that sentence is true so that's my suggestion.  Also, you need CD3 testing so depending on when during your cycle you first see the RE, you will have to wait for that to happen. Then wait for the HSG etc.  So it could take a month or 2 to get it all done with the timing. It will be April before we all know it so you'll be set.  I have a smiliar issue with getting actual treatment ( I can get tested now) but my insurance says trying for a year. Well, we got married 7 months ago. Yes we could have started trying beforehand but I was naive back then and thought I'd get KU right away!!  Good luck!

mtlaurel

Sorry, no answers here. I would hope and think that by April you would have satisfied the definition under both clauses - not sure whether by your birthday. I'd be curious to know what you find out, though, as I'm in a similar situation.

Welcome and good luck.