At what point is RE covered by insurance

jarbatz

Hello ladies - I am mostly a lurker but post occasionally.   Didn't post my BFP here b/c was too nervous and just started bleeding last night.  Expecting my HCG results to come back low - just waiting for confirmation from Dr.

This will be our 2nd m/c in the last 6 months.   

I posted on PgAL board and some of the responses said that additional testing is generally not covered until you've had 3 losses.   Seriously?  Is that true even if you are 35+? 

 

MelleTX

First, I am so sorry for your losses.

Every insurance is different so you will want to read about your plan, but generally most insurance carriers cover all diagnostic testing up to an infertility diagnosis. Mine covered all my testing and pre-work, but stopped short of covering IUIs, etc.

I think it really depends on the testing your RE wants to perform. You should be able to get a consult covered and then they can verify your insurance and will let yo know what is covered and at what amounts.  

MAtoNC

I am so sorry for your losses. 

I just had my first consult with the RE. They have a financial planning department that can help you figure out what is covered, what is not, and help you learn which questions to ask your insurance rep. 

tfkre8ive

You should really check out your own specific policy. I had my second loss when I was 36 and my OB started tests and sent me to specialists to interpret the tests. My insurance sucks and they covered (less deductible and copay) all the diagnostic tests. They even cover a portion of my many monthly ultrasounds at the REs even though they don't cover fertility treatments like IUI and IVF.

tfkre8ive

I should also add that my diagnosis is not so much infertility, but recurrent pregnancy loss. The way they code your diagnosis may affect what is covered.

njpabzy

I am very sorry for your loss. I agree with the pp, it really depends on your insurance plan. You should check directly with your insurance company. GL to you!