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fricken insurance company re infertility

NicBNicB
in Infertility
I have coverage only for infertility testing with my insurance company. They have covered all of my baseline CD 1-3 testing up until about 2 months ago and have now started denying everything, stating that once a diagnosis of infertility has been established, the subsequent tests are considered part of the treatment for infertility. Asshats. How is a beta test so that I can start a new round of femara considered TREATMENT OF FERTILITY? Fricken insurance company.
After 2 years of IF, and moving forward with adoption we were thrilled to discover we were pregnant with no intervention in 2009. Miss Molly joined our family in February 2010 and we could not be more in love with our little angel. Lilypie Second Birthday tickers blog www.grumpysnickles.com
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Re: fricken insurance company re infertility

  • Mrs.T22308Mrs.T22308

    I had a beta denied too ($138!!!).... and got the same excuse.

     Can your doc re-code it as your diagnosis?? I know that since I have an underlying cause of PCOS, anything coded as "PCOS" is considered medically neccessary, vs infertility treatment which is not. Helps me slide under the radar, unfortunately they are starting to catch on :(

    Lilypie First Birthday tickers Lilypie Third Birthday tickers M: 31 DH: 34 Dx: PCOS, Endo, Uterine Septum Ovarian Wedge Resection - May 2009 BFP #1 - October 2009 = DS BFP #2 - June 2011 = DD (Total Surprise!) Tree nut allergy in DS diagnosed 4/2012. Currently working with EI for SPD and possible ASD.
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  • beacbabebeacbabe
    sounds like he has the dx as infertility.... bc if you were pg, and went for a beta.... it would be cvrd
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  • mybobblemybobble
    None of my negative betas were covered as they're considered "i/f related tests" WTF? So now that I have had 2 postitive betas we're fighting w/ the insurance company on whether they're going to cover them.
    Warning No formatter is installed for the format bbhtml
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  • Suzi-G-Suzi-G- member
    Mine is the exact same way.  It blows.  Except Aetna screwed up and told me and the billing girl at my RE's office (we actually talked to three different people at Aetna) that treatment was covered excluding IUI and IVF so I thought everything was dandy.  Then three cycles later Aetna comes back and says "Nope.  Sorry, we told you wrong, none of that was covered."  Fortunately I think the RE's office is going to write off the loss on what Aetna won't pay but I wouldn't be surprised if they try to bill me for it.  Tongue Tied
    My big boy is bounding towards 4! Baby brother coming in October!
      image
    Hipster dog is not impressed.
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