health ins. coverage denied...

emma9 · May 2009

I'm so irritated ! I just found out that my RE's request to my ins. company for my 3 past IUI's and to start injectibles has been denied !

of course, reading the reasons why I've been denied is like reading greek - I'm going to call my Dr.'s office and ask what to do next -

I could just cry - as if all this crap isn't hard enough!

ibis · May 2009

That sucks.

Definitely call and fight it if you have it in you. I was just listening to a health care expert on the radio talking about this problem... he was saying that most people just do not bother to argue bc it's a huge hassle & they can't deal, but if you try to fight the denial you can sometimes get somewhere. GL

VanessaRae9608 · May 2009

Emma, I would look into this - I think that Massachusetts has a state mandate law that requires them to cover infertility treatments - I work in Mass. and I know that is what my infertility NP said...

p.s are you meeting up with us Sunday???

emma9 · May 2009

Hi Vanessa -

They said I haven't been trying for 12 consectutive months ( and we have ) but I have to prove it - I'm also going to call my OB and see if she can give me a letter about when we started trying.

As for Sunday - yes, would love to meet up with you & Pachey!

What are the details?

texas77 · May 2009

ditto. i worked for an ins co for 2 yrs and some of them routinely deny claims. also where i worked a computer processed all of the claims and we saw a lot that were denied because of simple problems like coding errors or date errors.

one time a claim for over 100K for heart surgery was denied because the person in the billing dept for the hosp put the date wrong. well the computer doesn't know any better and if all of the info doesn't match up it just automatically denies it. the only way we caught it was when the policy holder called in to see what happened. we fixed it and paid the claim immediately.

GL...

yogisunam · May 2009

Huh. I'm in MA as well. When I told the RE I had to wait until after April 2 before I could start treatment since that was a year. She shrugged it off and said that we'll just say it's a year.

What kind of proof do they need? Who is your insurance?

I'm sorry, that blows.

emma9 · May 2009

I don't know what proof they need , I have Tufts - DH has Blue Cross /Blue Shield Luckily we have open enrollment for Health Ins. at my school -

so if Tufts gives me a really hard time, I'll check out BC/BS

Danielleee · May 2009

OMG...that SUCKS!! There's got to be a way around it. I hope your OB does whatever it takes for you. You don't deserve this!

(I like your new pic, btw. I haven't been on much lately, so this is the first time I've seen it.)

KateAndMark · May 2009

Oh man that really blows! So sorry hun.

islelily · May 2009

I don't know if all BC/BS is the same (I live in MD), but thats what I have and I LOVE it! ?I have PPO. Through all of the OB appts, D&C, followup bloodwork, genetic counseling, and fertility tests thus far, I've only had to cover a co-pay. I don't know what your DH's BC/BS insurance pays, but please look into it! This stinks -- I'm sorry!