I hate Insurance companies!!

betheveh · January 2010

Let me start by saying I know a lot of people on here are completely OOP and I feel lucky to have some insurance coverage...

I am just so annoyed because my policy literally has IVF with ICSI under the list of covered fertility procedures, and I have even talked to them via email and they confirmed this. Well, turns out when the clinic bills them they don't cover it. They cover "diagnosis and work up" for it, but not ANY of the procedures involved the day of ER or ET, etc.

WTF? How is IVF with ICSI "covered" then?? I am just feeling stressed because we are having to pay over 60% plus now when we just weren't prepared for that much. I am trying to not stress, and I know it will all be worth it if successful, but that is a lot of unexpected money!!

nikinikinine · January 2010

Your finance person at your RE's office should be helping you navigate your insurance company. I would schedule an appointment with her next week and get them on board to help you. If IVF with ICSI is covered then you should have coverage for all aspects of IVF.

We have had issues with other things that should be covered, on a $400 charge from August we're still fighting. Can we pay for it? Yes, but the insurance is supposed to. As long as your RE is on the same page with you financially fight the bills.

betheveh · January 2010

Niki - Thanks for the advice, I unfortunately did talk to the financial person at RE's office and she is the one who said "your company never covers this." She called them and they said it is considered "experimental." Come on people it"s 2010!!

I printed copies of my correspondence with the insurance company and I will bring it to RE's office this week. Problem is, my clinic requires a check or CC # to hold - and they want it CD 3! I am gonna keep trying, but it sounds like my insurance company is just a bunch of liars who specialize in false advertising!

nikinikinine · January 2010

Ugh, that super sucks. I'm so sorry!

kthappy76 · January 2010

I am sorry they are giving you the run around, that's the LAST thing you need right now. I hope the documentation you have will be enough to placate your clinic and you won't have to put any money down. Post again or PM me if you have more problems, I used to work for BCBS, so I know how to navigate the system. But it sounds like you are doing the right things. Good luck!

betheveh · January 2010

KT - it is actually BCBS (of illinois) that I have! I work for a catholic company so I don't know if that is why that don't cover it. But I just don't understand how they can say they cover IVF with ICSi (up to 15k/lifetime) but they don't actually cover any IVF procedures or ICSI. I gave them all the codes and they said nope, nope, nope to all of them!

I don't know if there is anything else I can do??

KISSIES · January 2010

Did you call the insurance company yourself or did you just go by the RE's office saying your insurance said no? I know we called our insurance the other night they said everything was covered but only if we had proper proof showing it was medically necessary. We are still at the beginning stages but just wanted to be aware of what was covered. We will definately be calling in the future to see what exact tests we need done to prove it's medically necessary. They told us it's covered we'd just need to pay copays like office visits or day surgery. Hope they can get it fixed for you! It definately does suck that you are going through this IVF is stressful enough and you need to not be so stressed so those embies can stick!

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I hate Insurance companies!!

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