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Insurance drama. Need advice.

Fredifer1115Fredifer1115 member
in TTC after 35
So I got a new monkey wrench, this one may take the cake (and typically I love cake, but I am not happy about this sh*t at all).  Just got notification on Wednesday that my company is changing insurance to, you guessed it, a carrier that my RE doesn't accept.  AWESOME.  However, the new plan offers the same benefits, BUT I would have to find another doctor, UNLESS new carrier deems me eligible to receive continuity of care for 90 days after the effective date.  Oh, and the effective date is OCTOBER 1st.  Way to give us fair warning.  And the information seminar about the policies and such is not until September 8th.  So had I not done all this legwork myself, calling current carrier, new carrier, HR and the RE I wouldn't know anything pertinent for another week and a half, which as we know is the difference between a cycle and being benched for a month.  

I currently get $10000 lifetime for IVF, which I will get under the new plan as well, but I want to get the benefit with my current plan, and let the benefits reset under the new plan, but with only 5 weeks, being on CD9 right now, I have no idea how to make that happen.  I am going to see the RE on Monday (we are doing natural cycle and timed intercourse this month bc of a stupid cyst).  RE said he has no problem putting me on the IVF calendar for next month, but I just have to see how they work billing.  If any portion of the bill is submitted after October 1st it goes against my new insurance, AND could even be denied because it is out of network unless approved.  

I tried to find something that said a company has to give employees fair notice regarding insurance changes especially in the event of special circumstance, like current treatment, but apparently there is nothing specified.  I am also going to appeal to my HR to allow me to stay on the current plan for an additional month.  My boss suggested something abut COBRA, but is then unsure if I would be eligible for the enrollment of the new plan after open enrollment.

Does anyone have any suggestions or advice?
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Re: Insurance drama. Need advice.

  • ewennerewenner member
    Do you think you can get one cycle of IVF in before the switch?  It doesn't actually matter when the RE submits the bill, as long as the date of service is prior to October 1st.  Depending on how long your cycle is, you might be able to get a cycle in before everything changes.  Best wishes, whatever happens!
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  • Fredifer1115Fredifer1115 member
    Of course nothing in this process is easy, but since I supposedly ovulated already this cycle (hi, I am on CD12) and no one picked that up...me, RE, FF, BBT (wtf???), but my bloods indicated I did, I may get my period early enough to fit in an IVF cycle.  AF HAS to come by 9/8 or I am SOL.

    I did find out that my new coverage offers me the same benefits, but I am trying to double dip between policies.  I have also almost 100% confirmed that the benefits reset with the new policy.  Just trying to get that in writing.  Also, DH is in final stages of getting a new job.  At least one of the options has phenomenal health benefits, so that's a plus.
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