Community› The Bump Message Boards› Infertility
Infertility
New Discussion

Insurance Question

greenhillgirlgreenhillgirl member
edited March 2017 in Infertility
Hi Everyone, 

It's Friday- TGIF  :p  I have a simple insurance question and can't find the answer anywhere on the internet or in these forums. Am I correct in understanding that if I have one insurance and my husband has another that if his insurance covers IVF (mine doesn't) they will in no circumstances pay for the procedure because it's for "me"? Recommended for IVF and had been told my insurance pays and thought so for months. Just found out I'm on a rare small group plan. Devestated. I could have been on his the whole time if I'd known- even as secondary. And he's union so it's cheap too! Now I will
have to wait until November 2017 to enroll in his and January 2018 to have coverage. Just seems so weird in this modern and diverse world that our egg and sperm is mine and our pregnancy is mine only. Thanks! And please treat me gently- I've searched everywhere for this!!!
Report Reply to Post

Re: Insurance Question

  • krenee124krenee124 member
    Unfortunately yes, I believe they will not pay for you. The only thing they billed under my husbands name was sperm washing and semen analysis. They wouldn't even cover ICSI! We have 10k max each and he will never reach his! One round and I'm already almost there! I'm sorry - it's such a bummer!
    Report Reply
  • wifeinraleigh28wifeinraleigh28 member
    I do not have experience with insurance since our insurance doesn't cover IVF and we were completely out of pocket. However, judging solely based on the fact that at the RE's office the woman is considered the patient, it makes sense. All the procedures are done on the woman and the woman receives all the treatment. So only her insurance would be able to be used. It is definitely a bummer though and I'm sorry you're looking at a long wait!
    ***BFP & Child Warning***

    Me: 34, DH: 38 ~ TTC since 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF ER (July 2016) = 7 PGS normal embryos
    FET #1 (Sept 2016) = BFP! DD born 5/30/17
    FET #2 (April 2019) = BFN
    FET #3 (July 2019) = BFP! DS born 3/27/20
    Report Reply
  • Loading the player...
  • HillpowHillpow member
    You are correct. His insurance will only pay for it if you are on his plan. 
    Report Reply
  • greenhillgirlgreenhillgirl member
    Thank you @wifeinraleigh28  and @Hillpow !  I guess I'll look for forums of people dealing with long waits!


    Report Reply
  • katherindkatherind member

    @greenhillgirl There are some circumstances that allow you to join his plan outside of the open enrollment period. These are usually "life changing events" such as a job change, marriage, divorce, and I think there are a few others that usually qualify. There's usually a short window (30 days usually) from the date of the occurrence to make the change.

    This is how I was able to obtain full coverage. My husband changed jobs in October and I was able to join his plan that covers fertility treatment and is a lower cost. Otherwise, I would have been fully out of pocket since my employer doesn't cover anything.

    I would check with his human resources department if you think you might have a qualifying event or to see if there are any options to get you onto his plan sooner.


    *km*
    me 29  |  him 32  |  married: 4/27/2013

    TTC#1 (2/14/2017 - 4/7/17):
    Menopur = 19.66mm (R) & 17.02mm (L)| Ovidrel: 3/14/2017 | TIC 3/14-3/17/17 | *TWW* | Beta #1 3/30: 7.27 | Beta #2 4/3: 11.94| Beta #3 4/5: 8.02 | Beta #4 4/7: 2.24 | Ended as chemical pregnancy.

    TTC#2: (4/10/2017 - 5/12/17):
    Menopur = 13.59mm (R) & 21.68mm (L)| Ovidrel: 4/27/17 | TIC 4/27-4/30/17 | *TWW* | Beta #1: 0.1 = BFN

    TTC#3: (5/16-present)
    Menopur = 17mm + 13.5mm (L) 19.5mm (R) | CD11 Ovidrel 5/26/17 | TIC 5/26-5/28/17 | *TWW* | Beta #1 6/12: 9.91 | Beta #2 6/14: 13.89 | Beta #3 6/16: 20.81 | Beta #4 6/19: 41.46 | Beta #5 6/21: 24.50 | Beta #6 6/30: TBD - Will test until numbers reach zero.
    Report Reply
  • greenhillgirlgreenhillgirl member
    Thanks! @katherind unfortunately I don't think we have any qualifying events. The one thing I was trying to figure out is if I dropped my coverage completely when we have our enrollment period in May if that would qualify me to be uninsured and add his coverage but that is far-fetched and it doesn't sound like it.  Mine does say it covers Artificial Insemination, which I can image could mean IUI but with 2 million count, 10% motility, and not enough for info on morphology that is doubtful.  Waiting, waiting :( 
    Report Reply
  • katherindkatherind member
    @greenhillgirl It might not hurt to ask?

    *km*
    me 29  |  him 32  |  married: 4/27/2013

    TTC#1 (2/14/2017 - 4/7/17):
    Menopur = 19.66mm (R) & 17.02mm (L)| Ovidrel: 3/14/2017 | TIC 3/14-3/17/17 | *TWW* | Beta #1 3/30: 7.27 | Beta #2 4/3: 11.94| Beta #3 4/5: 8.02 | Beta #4 4/7: 2.24 | Ended as chemical pregnancy.

    TTC#2: (4/10/2017 - 5/12/17):
    Menopur = 13.59mm (R) & 21.68mm (L)| Ovidrel: 4/27/17 | TIC 4/27-4/30/17 | *TWW* | Beta #1: 0.1 = BFN

    TTC#3: (5/16-present)
    Menopur = 17mm + 13.5mm (L) 19.5mm (R) | CD11 Ovidrel 5/26/17 | TIC 5/26-5/28/17 | *TWW* | Beta #1 6/12: 9.91 | Beta #2 6/14: 13.89 | Beta #3 6/16: 20.81 | Beta #4 6/19: 41.46 | Beta #5 6/21: 24.50 | Beta #6 6/30: TBD - Will test until numbers reach zero.
    Report Reply
  • FuzzyDustFuzzyDust member
    greenhillgirl - all insurances are different, but maybe call them?
    I know that my insurance has 3 options for my H:
    - Spouse not working, or working but with no insurance offered: he's covered for free
    - Spouse working, insurance offered, but he waves is to have my insurance instead: I have to pay some ridiculous amount every months to cover him
    - Spouse is working, has insurance, and my insurance is his secondary: it's free

    So maybe your H can check if he can add his insurance as your secondary? My husband covered by my insurance as his secondary. I'm still not covered by his as my secondary, as he can't do updates to his policy as easily as me.
    -----------------------------------------------------------------------------------------------------
    My story in signature spoiler. Children mentioned.
    Me: 37 DH: 45
    I don't produce FSH, so no natural menstrual cycle. DH has reduced morphology.
    Summer 2014 IUI (with first husband): cancelled after almost a month of stims due to too many follicles
    Time off to divorce, get back on my feet, find a new hubby and get married again 💑
    March 2017 IVF#1: ~70 follicles, 13R, 10M, 7F, 3B = 2 PGS Normal (both XY) - no transfer due to ohss
    Sept 2017 FET#1: BFP, Beta#1 (10dpt) - 253, Beta#2 (12dpt) - 528, DS born 05/31/2018 👨‍👩‍👦
    Dec 2019 FET#2: BFN
    Changed clinic, planning March 2020 IVF#2 - postponed due to the pandemic
    April 2020 IVF #2: ~30 follicles, 24R, 12M, 8F, 4B = 2XY & 2XX, all normal  <3
    Sept 2020 FET#3: one XX embryo, BFP, Beta#1 (9dpt) - 161, Beta#2 (11dpt) - 519, Beta#3 (19dpt) - 7174, Due date 05/30/2021
    DD born 05/23/2021 👨‍👩‍👧‍👦 - My family is now complete <3
    Report Reply
Sign In or Register to comment.
Choose Another Board
Search Boards
"
"