My insurance is screwing me!!

jenbabe · March 2011

I'm so f*ing pissed. My plan says that services related to ARTs are not covered. My prescription plan says prescription drugs for infertlity treatment are covered but limited to a 6 cycle maximum. Their website says that Menopur and Bravelle are covered but prior authorization is required. They denied it saying since its related to ART it is not covered. But they covered all my other meds, like trigger shot, vivelle patches, PIO, everthing including all my lab work. But they won't cover the expensive ones. I read her what my plan said and asked her to define what "infertility treatment" means and all she kept repeating was the part about services related to ARTs not being covered. I told her I'm not talking about services, I'm talking about drugs. Ugh! We were definitely not communicating. It seems like they are determined to screw me based on some non descript clause and definition of "services related to" and "infertility treatments".

But they covered it for IVF #1 and my plan reads exactly the same way as it did when we did IVF #1. WTF!!! I'm so mad and no one will listen to me I can appeal it but I know they will just deny my appeal too. What should I do?

babystinkbreath · March 2011

that sucks, make copies of everything you have from stuff covered with ivf #1 and appeal it. including copies of the prescripitions, etc and everything they covered. Write down who you speak to on the phone and the time and date of those talks. Demand to speak with their supervisors. Many times the people you talk to don't know what they are talking about. And if you have the same coverage, they should pay for it. you can also ask your RE's office to send additional paperwork.

so sorry you have to deal, but insurance stuff blows.

mikeandangie · March 2011

babystinkbreath:
Write down who you speak to on the phone and the time and date of those talks. Demand to speak with their supervisors. Many times the people you talk to don't know what they are talking about.

Definitely this. You have to be very persistent with these guys. I am sorry though you have to deal with this on top of everything else.

vanessagorc · March 2011

mikeandangie:
babystinkbreath:

Write down who you speak to on the phone and the time and date of those talks. Demand to speak with their supervisors. Many times the people you talk to don't know what they are talking about.

Definitely this. You have to be very persistent with these guys. I am sorry though you have to deal with this on top of everything else.

Ditto, i hate them too!!!!!!!

apaige25 · March 2011

I hate insurance companies. Just such a pain. Maybe try calling back and hopefully you will get another person. You could also talk to someone in your HR department that is in charge of the health care plans. Good luck!!! I hope you get the response you need soon.

scooterq · March 2011

Ugh, how frustrating! I hope you can speak with someone who in charge and who knows what they're talking about. Good luck if you decide to appeal!

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