Insurance Question

emu0013 · November 2011

Looking at the policy for my new job it says:

Infertility Treatment

Covered 100%; after deductible
Diagnosis and treatment of the underlying medical condition. We are debating me going on this policy to help with IF; anyone have a policy stated like this, and know exactly what it means/covers? I'm currnetly on DH's insurance, which is good but covers -0- of IF. I don't start till the 12th and so can't talk with benefits till then. Thanks!

KdgTeacher · November 2011

Do you know the name of the company offering the coverage? If so, call them directly and ask.

It sounds to me (and my very limited insurance educated self) that they'll cover testing and treatment of a medical problem as it relates to IF. But if you are unexplained, you may be SOL. However, again, I could be tooooootaly off!

emu0013 · November 2011

KdgTeacher:

Do you know the name of the company offering the coverage? If so, call them directly and ask.

It sounds to me (and my very limited insurance educated self) that they'll cover testing and treatment of a medical problem as it relates to IF. But if you are unexplained, you may be SOL. However, again, I could be tooooootaly off!

It's through Atena. I plan to call when I start and get more information before I switch from DH's. Just from being in HR, I know they won't talk to me until I am actually an employee, however insurance is not my speciality!

Thanks again, I am going for some testing tomorrow, my new RE things its PCOS.

genmalone · November 2011

I would definitely call before you switch. I have never seen IF coverage with no limit and I previously worked with health insurace through Aetna and United Healthcare.

Good luck!

emu0013 · November 2011

genmalone:

I would definitely call before you switch. I have never seen IF coverage with no limit and I previously worked with health insurace through Aetna and United Healthcare.

Good luck!

Thanks! Me neither. DH current says covers -0-. And my new company (one of the large accounting firms) has several different options and both offer IF coverage; I just need to get the specifics! One says covers 100% after deductable which is $250; the other says covers 90% after deductable which is $1000; its reasonable if we cover just me. But if we were to add me and DH its almost $600 per month; so we would just switch me, if I end up switching. DH only pays $120 for us both right now and we have BCBS.

MsGMChick · November 2011

Mine reads that way. It's pretty much a loop hole for them to look good and not have to cover sh!t. Mine also reads that it covers 2 IUIs at a lifetime max, does yours mention specifics? So far, what it's meant for me is they're covering my monitoring apts and bloodwork as long as it isn't coded IF because its only covering "underlying conditions". So your RE would have to code it... PCOS, DOR, Dysmenorrhea, Pelvic Pain, etc. Then it will be covered.

ETA: They've also covered all my femara and ovidrel scripts. We'll see soon if they cover my injects.

eponine7682 · November 2011

You should be able to call and find out. Usually a deductable means 1 of two things: It could mean you pay it once (a lot of them are 500, or a 1000.00) then everything after that is covered. Or it could mean that you have a deductable each time and after that everything is covered. I would call and find out. GL!

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