RE ? regarding insurance

lavril · October 2011

My insurance is pretty good, but doesn't cover any assisted reproductive techniques (IUI, IVF, etc). For that reason, I'm thinking about switching at the start of next year to either another option I have or my husbands just in case we need that route.

Is it fine to start doing testing at the end of this year and then switch to better coverage in Jan? Sorry for my total ignorance - but the new insurance can't legally deny my claims next year if i'm DX this year on my current insurance right?

I wish this was all easier!

GuppyAmy · October 2011

My understanding is that an insurance company can no longer deny a claim due to preexisting conditions. I could be wrong though.

Rawr08 · October 2011

GuppyAmy:
My understanding is that an insurance company can no longer deny a claim due to preexisting conditions. I could be wrong though.

This. I am not sure about this whole new health care reform shiz though. When you go to your appointment make sure you stop and talk with the financial lady (or man). I am guessing that every RE's office has one since treatment is so expensive. Stop by and talk to them about it, they would probably have a lot more (and a lot better) info than I.

lavril · October 2011

K, I'll definitely ask. Thanks!!

kellbelle618 · October 2011

GuppyAmy:
My understanding is that an insurance company can no longer deny a claim due to preexisting conditions. I could be wrong though.

::lurking::: siggy warning

This is true as long as it is a group insurance plan (ie from work). If you purchase an individual insurance plan then they don't have to cover preexisting conditions for the 1st 12 months you are on their plan and they also don't cover pregnancy (at least in Texas) just so ya know.

lavril · October 2011

kellbelle618:

GuppyAmy:
My understanding is that an insurance company can no longer deny a claim due to preexisting conditions. I could be wrong though.

::lurking::: siggy warning

This is true as long as it is a group insurance plan (ie from work). If you purchase an individual insurance plan then they don't have to cover preexisting conditions for the 1st 12 months you are on their plan and they also don't cover pregnancy (at least in Texas) just so ya know.

I'm considering switching from my work insurance plan to another work insurance plan OR my DH's work insurance. Would that be the same if it's his employer and not mine?

Thanks!

kellbelle618 · October 2011

lavril:
kellbelle618:

GuppyAmy:
My understanding is that an insurance company can no longer deny a claim due to preexisting conditions. I could be wrong though.

::lurking::: siggy warning

This is true as long as it is a group insurance plan (ie from work). If you purchase an individual insurance plan then they don't have to cover preexisting conditions for the 1st 12 months you are on their plan and they also don't cover pregnancy (at least in Texas) just so ya know.

I'm considering switching from my work insurance plan to another work insurance plan OR my DH's work insurance. Would that be the same if it's his employer and not mine?

Thanks!

You should be perfectly fine switching to DH's insurance. An individual plan is like if you went to the insurance company and signed up for a plan by yourself. If you are signing up for a plan with your workplace or DH's workplace, that's group insurance and it's my understanding that they do have to cover preexisting conditions as well as pregnancy regardless of when you switch insurance. HTH!

lavril · October 2011

kellbelle618:
lavril:
kellbelle618:

GuppyAmy:
My understanding is that an insurance company can no longer deny a claim due to preexisting conditions. I could be wrong though.

::lurking::: siggy warning

This is true as long as it is a group insurance plan (ie from work). If you purchase an individual insurance plan then they don't have to cover preexisting conditions for the 1st 12 months you are on their plan and they also don't cover pregnancy (at least in Texas) just so ya know.

I'm considering switching from my work insurance plan to another work insurance plan OR my DH's work insurance. Would that be the same if it's his employer and not mine?

Thanks!

You should be perfectly fine switching to DH's insurance. An individual plan is like if you went to the insurance company and signed up for a plan by yourself. If you are signing up for a plan with your workplace or DH's workplace, that's group insurance and it's my understanding that they do have to cover preexisting conditions as well as pregnancy regardless of when you switch insurance. HTH!

Thanks!! I really appreciate it!!

damabo80 · October 2011

Do they cover testing or meds? Many insurance companies won't cover the PROCESS for IUI/IVF, but will cover the meds/monitoring/testing.

At least for IUI, the IUI itself is fairly cheap: a few hundred dollars for the wash and a few hundred dollars for the injection. Where it get costly is the meds (if you do injectables, it can run anywhere from $800-$3k, depending on how well you respond), and the monitoring ultrasounds ($200-$300 a pop).

SAs are pretty cheap; HSGs are not.

Unless DH is shooting complete blanks, most REs usually want you to give IUI a few tries before going to IVF.

lavril · October 2011

Below is my current plan. I intend to switch in January before we get into any IUI/IVF or whatever is in my future. I wanted to start the testing now though if I could to not waste the next 3 months. It sounds like my testing should be covered right?

Here's what it says:

Covered: Diagnosis and treatment of infertility.
Preferred primary care provider or other health care professional: $25 copayment per visit Preferred specialist: $35 copayment per visit
Note: You pay 30% of the Plan allowance for agents, drugs, and/or
supplies administered or obtained in connection with your care.

Not covered:
? Assisted reproductive technology (ART) procedures,
including but not limited to:
- artificial insemination (AI)
- in vitro fertilization (IVF)
- embryo transfer and Gamete Intrafallopian
Transfer (GIFT)
- Zygote Intrafallopian Transfer (ZIFT)
- intravaginal insemination (IVI)
- intracervical insemination (ICI)
- intracytoplasmic sperm injection (ICSI)
- intrauterine insemination (IUI)
? Services and supplies related to ART procedures,
such as sperm banking
? Infertility drugs used in conjunction with ART
procedures

damabo80 · October 2011

lavril:

Below is my current plan. I intend to switch in January before we get into any IUI/IVF or whatever is in my future. I wanted to start the testing now though if I could to not waste the next 3 months. It sounds like my testing should be covered right?

Here's what it says:

Covered: Diagnosis and treatment of infertility.

Not covered:
- artificial insemination (AI)
- in vitro fertilization (IVF)
? Infertility drugs used in conjunction with ART
procedures

Will drugs/ART be covered under your new plan next year? If so, you may want to hold off on the appts or testing (since it's less than 3 months) until next year so it will count towards your deductable. (Unless you already met the deductable this year, then get as many tests in that you can by dec 31, and maybe try some femara/clomid +TI just for sh!ts and giggles.)

Nothing helps you burn through your deductable like IF.

lavril · October 2011

damabo80:
lavril:

Below is my current plan. I intend to switch in January before we get into any IUI/IVF or whatever is in my future. I wanted to start the testing now though if I could to not waste the next 3 months. It sounds like my testing should be covered right?

Here's what it says:

Covered: Diagnosis and treatment of infertility.

Not covered:
- artificial insemination (AI)
- in vitro fertilization (IVF)
? Infertility drugs used in conjunction with ART
procedures

Will drugs/ART be covered under your new plan next year? If so, you may want to hold off on the appts or testing (since it's less than 3 months) until next year so it will count towards your deductable. (Unless you already met the deductable this year, then get as many tests in that you can by dec 31, and maybe try some femara/clomid +TI just for sh!ts and giggles.)

Nothing helps you burn through your deductable like IF.

Thanks so much for your advice! I'm researching other plans at this point but I believe they will cover ART. I'm waiting on DH to get me his plan info to know for sure (we both have a couple options at our jobs). As for deductible, I don't have one at the moment, so I'd love to get some testing out of the way (not to mention my impatience lol). As long as it won't restrict me next year on a new plan, I think I'm going to press ahead. My cycles are so long anyways it might take 2? months just to get to cd3 testing. Now if the RE would just call me back!

sgrobste · October 2011

I do not know a lot about insurance, but I just wanted to wish you good luck...:)

RE ? regarding insurance

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