Happy Monday to everyone! I am going to start this blog off complaining..weird right? I never complain. When my infertility journey started last May, I called both my primary and secondary insurance companies to see if either would cover my acupuncture treatments. My primary said they didn’t cover it and my secondary said that they did cover it. All I had to do was pay out of pocket and then submit the receipts. It is now 10 months later and I have yet to see any of that money. For months, I would log on to view my account and see that the processing had been stalled because they needed a diagnosis code, or a letter from my primary insurance or my primary insurance information. I provided everything I could to them and after not receiving a check in January, I called them last Friday afternoon. What they neglected to tell me in May when I called is that acupuncture is covered, but only after my $3,000 a year deductible. So not only am I not going to get any of the $1,500 I spent in 2009 on acupuncture back, it will not be able to count towards my total in 2010 because it is a different calendar year which means….I am out that money. Moral of this story, when you are calling your insurance companies to see what they cover and don’t cover, please be sure to ask if the coverage is before of after you meet some kind of deductible. I don’t even care that I’m not getting the money back because my acupuncture has been my saving grace through this whole process. Carol, my acupuncturist, is incredible and she is very encouraging. In my experience, you rarely find doctors in the fertility field that are positive so you if you find one…keep them around you are going to need them. Right now, I am sort of getting my financial ducks in a row. I am trying to get insurance coverage for fertility treatments. My secondary insurance will cover up to $15,000 for life which is great but may not be enough. I have been doing some research and below is what I found on the Shared Journey website. Link is http://www.sharedjourney.com/costs/insurance.html.
There are three types of fertility insurance:
1. Standard Health Insurance: Standard health insurance requires that you pay a monthly premium in exchange for specific fertility coverage.
2. Refund Programs: With these types of programs, you pay up front for your fertility treatments. If you do not have a baby, between 70% and 100% of the money is paid back to you.
3. Financing: Loans can be taken out to cover infertility procedures. If you do not have a baby, these loans do not have to be repaid in full.
You need to ask what the insurance will cover. Medications, IVF, IUI, etc.
Who Can Get Fertility Insurance?
Unfortunately, not everyone can get fertility insurance. Though it varies from insurer to insurer, there are normally certain qualifications that you have to meet before being approved for fertility insurance. To qualify for infertility insurance, couples who already hold an insurance policy usually need to be: under the age of 40,struggling with fertility for a specific period of time (ranging from one to five years) and policy holders for at least one year.
Laws Governing Fertility Insurance
Depending upon where you live, there are different laws regarding fertility insurance. Some states have a mandate that requires all employers with more than 50 employees offer health care coverage that includes some type of fertility insurance. These states include: New York,New Jersey, Ohio, Montana, Massachusetts , Arkansas, California, Rhode Island, West Virginia, Texas, Maryland, Connecticut, Hawaii , Illinois. Other states have no mandate requiring employers to offer fertility insurance.
Are You Covered?
Before undergoing fertility treatments, it is important to check your insurance policy to see if any fertility treatments are included with your plan. Be sure to ask your employer for a copy of your full insurance policy, listing all inclusions and exclusions. If fertility treatment or testing is not specifically excluded in the policy, your provider is required to pay for the treatments. Write a letter to your insurance provider asking for detailed information regarding your infertility insurance or speak with your insurance broker. If you are not covered, you may be interested in investing in an infertility insurance policy. Call your local providers and ask for an insurance quote.
It is important to also remember that if you will have to get more coverage, not to come out and say you need fertility treatments. Insurance companies will be reluctant to cover anyone who already knows will need expensive treatments which can be costly to an insurance provided. I’m not telling you to commit insurance fraud, I am just saying to only give the necessary details. Hope this information helps! I am off to find out what my coverage on my primary is.
BeThankful....
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"Let us rise up and be thankful, for if we didn't learn a lot today, at
least we learned a little, and if we didn't learn a little, at least we
didn't ge...
12 years ago