Insurance coverage for fertility treatment?????

iVillage Member
Registered: 01-06-2005
Insurance coverage for fertility treatment?????
5
Wed, 11-02-2011 - 1:11am

So I found out yesterday that my insurance doesnt cover any fertility appointments...I went to a different doc a few months ago to get a second opinion in hopes that she would have some different ideas on my current situation and i just got the bill.....right on the bill says insurance will not cover any fertility related appointments. dang it..the doc didnt even do anything. I told her what was going on and she ran bloods, to test kindey and liver function???, and of course they were normal. So now I have a bill for 165.00 for absolutely nothing...this sucks!!! then I had plans to go see an RE in febuary and now those plans are going to be on hold till I can figure out if we can afford to go see him out of our own pocket.....I am hoping my regular obgyn will be able to do something...arg!!!

Have any of you ladies delt with this issue,

iVillage Member
Registered: 08-03-2011
I have this problem. My doc keys in my tests for something other than infertility. I'm not sure that every doctor will do this, I just have a really cool doc. I'm curious to see what he'll do about my HSG. I'm sorry you have to go through this. Health insurance sucks!
iVillage Member
Registered: 06-06-2011
Aw sorry you're going through this :( Sorry I don't have any insight into the US system. Here in Quebec even IVF is now free.
 BabyFruit Ticker
iVillage Member
Registered: 06-21-2006
I understand your frustration, I'm just starting to head down this road as well and trying to figure out how my insurance will work. What I've figured out so far is that whatever I can see my regular obgyn for is better for me financially, b/c it's less likely she'll use infertility codes (and you can ask them specifically what codes they are planning to use for any treatment they are going to do, which is usually a pain, but worth it because then you can call your insurance company and give them the code number and they should be able to look it up and tell you if it's covered or not and at what percent before you have anything done). Like I think if I have an hsg done through my obgyn it won't cost me anything but a co-pay for the office visit, but if I have an hsg done through the RE it will be far less covered (I live in a state that does have some mandated coverage for infertility). If you can figure out what testing you still haven't done that your RE will suggest as first steps anyway, you can try and get those done through your obgyn (assuming it's covered through your obgyn by checking codes) first before going to the RE. Like I know the RE is most likely going to suggest I do an hsg, sperm analysis, and some more blood work. If you haven't had an hsg or sperm analysis done yet those are usually first steps so you could at least try and do those now before seeing an RE. I am kind of giving up on my obgyn though....I seriously dislike her and don't have the time or patience right now to go see another one so I'm going to just go straight to the RE and see what they say.

Sorry it's all so complex. It's ridiculous. Sorry about that bill!! Unexpected bills as the worst.
iVillage Member
Registered: 07-29-2009

My insurance only covers diagnostic testing....that being said, it only covers diagnostic testing AFTER I've met my deductable. I have a deductable of like $750 so pretty much all of our diagnostic tests are paid out of pocket for us. Then all the treatments will be out of pocket too. We have (luckily) a nice little nest egg saved up for four rounds of treatment. After that, if we don't get pregnant we'll have to take a break to rebuild the infertility treatment savings account that I have set up.

iVillage Member
Registered: 01-06-2005

Thank you ladies for your insight.......I guess I will have to start asking more questions about billing issues. I am hoping my cycles even out and we dont have to go to the RE cause that will be really expencive so what ever I can do with my OB will be great.