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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Any Insurance Experts?
I am trying to figure if I should switch insurance in January 2012. Currently under DH I have Empire a direct HMO, it covers unlimited IUI's, all the meds, Intralipids...$30 co-pay, $50 for specialist, no OON coverage.
I can switch to United HealthCare under my policy which will have OON 70%, but for the life of me I cannot figure out if IVF is covered. And say I switch and find out IUI's aren't even covered I'd be screwed.
I called UH obviously and they had no idea and I cannot ask HR (absolutely not). The only thing UH read to me over the phone was this which I do not understand, can someone translate?
"Health services and associated money for infertility treatments including assisted reproduction technology regardless of the reason for treatment.
This exclusion does not apply to services required to treat or correct underlying causes of infertility."
I may be being stupid but I read this and it means nothing to me.
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Posted 10/14/11 1:29 PM  |
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Jenn1621
<3
Member since 5/05 1728 total posts
Name:
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Re: Any Insurance Experts?
"Health services and associated money for infertility treatments including assisted reproduction technology regardless of the reason for treatment.
This exclusion does not apply to services required to treat or correct underlying causes of infertility."
If I am reading this portion correctly, to me it means that it is covered. When I was trying to find this information out with my insurance, UHC actually I was told that IVF is commonly called assisted reproduction technology. Now, all plans on are different so it would depend on the plan your company has. I know you can't ask HR specifically about this but can you ask them to provide you with the plan inforamtion so you can see what's covered? You can tell them you are thinking of switching insurance and just want to weigh your options. The paperwork they supply you with should indicate whether or not infertility is covered in your plan.
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| Posted 10/14/11 3:24 PM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: Any Insurance Experts?
Thanks for your help!
The papers I got were just copays, co-insurance, prices, in and out of network and it was like 2 pieces of paper. But I will investigate and ask further.
If IVF was covered I would dance!
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| Posted 10/14/11 3:52 PM |
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alli3131
Peanut is here!!!!!!
Member since 5/09 18388 total posts
Name:
Allison
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Re: Any Insurance Experts?
Posted by Jenn1621
"Health services and associated money for infertility treatments including assisted reproduction technology regardless of the reason for treatment.
This exclusion does not apply to services required to treat or correct underlying causes of infertility."
If I am reading this portion correctly, to me it means that it is covered. When I was trying to find this information out with my insurance, UHC actually I was told that IVF is commonly called assisted reproduction technology. Now, all plans on are different so it would depend on the plan your company has. I know you can't ask HR specifically about this but can you ask them to provide you with the plan inforamtion so you can see what's covered? You can tell them you are thinking of switching insurance and just want to weigh your options. The paperwork they supply you with should indicate whether or not infertility is covered in your plan.
No to me this says it is not covered. To me it says it is excluded except for treatments to correct infertility. And technically IUI and IVF do not correct infertility it is more a way around it.
I have united and my policy has a separate section that states fertility treatments are covered up to $50K lifetime max.
Fertilty treatments are not covered under the regualr copay stuff in our policy.
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| Posted 10/14/11 4:00 PM |
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OrganicMama
So in love with my little man!
Member since 6/08 5172 total posts
Name:
Mama
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Re: Any Insurance Experts?
We have United and out coverage gives us 3 IUI's or 3 IVF aatempts, but not both. We have saved our coverage for fresh cycles. They do cover all meds and monitoring for everything though.
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| Posted 10/14/11 7:04 PM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: Any Insurance Experts?
Posted by alli3131
Posted by Jenn1621
"Health services and associated money for infertility treatments including assisted reproduction technology regardless of the reason for treatment.
This exclusion does not apply to services required to treat or correct underlying causes of infertility."
If I am reading this portion correctly, to me it means that it is covered. When I was trying to find this information out with my insurance, UHC actually I was told that IVF is commonly called assisted reproduction technology. Now, all plans on are different so it would depend on the plan your company has. I know you can't ask HR specifically about this but can you ask them to provide you with the plan inforamtion so you can see what's covered? You can tell them you are thinking of switching insurance and just want to weigh your options. The paperwork they supply you with should indicate whether or not infertility is covered in your plan.
No to me this says it is not covered. To me it says it is excluded except for treatments to correct infertility. And technically IUI and IVF do not correct infertility it is more a way around it.
I have united and my policy has a separate section that states fertility treatments are covered up to $50K lifetime max.
Fertilty treatments are not covered under the regualr copay stuff in our policy.
What would be a treatment to correct infertility?
How do I go about finding out if it covers it for sure or what it does cover?
Also what plan do you have? This is UHC choice plus 250 or 500, both plans have that statement.
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| Posted 10/14/11 11:48 PM |
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littlebeanz
LIF Adult
Member since 7/10 1667 total posts
Name:
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Re: Any Insurance Experts?
get the name of the person you spoke to date ands time of the call. Also ask for a supervisor. Ive called sooo many times and gotten wrong info!!!
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| Posted 10/14/11 11:58 PM |
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littlebeanz
LIF Adult
Member since 7/10 1667 total posts
Name:
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Re: Any Insurance Experts?
Posted by Leb
Posted by alli3131
Posted by Jenn1621
"Health services and associated money for infertility treatments including assisted reproduction technology regardless of the reason for treatment.
This exclusion does not apply to services required to treat or correct underlying causes of infertility."
If I am reading this portion correctly, to me it means that it is covered. When I was trying to find this information out with my insurance, UHC actually I was told that IVF is commonly called assisted reproduction technology. Now, all plans on are different so it would depend on the plan your company has. I know you can't ask HR specifically about this but can you ask them to provide you with the plan inforamtion so you can see what's covered? You can tell them you are thinking of switching insurance and just want to weigh your options. The paperwork they supply you with should indicate whether or not infertility is covered in your plan.
No to me this says it is not covered. To me it says it is excluded except for treatments to correct infertility. And technically IUI and IVF do not correct infertility it is more a way around it.
I have united and my policy has a separate section that states fertility treatments are covered up to $50K lifetime max.
Fertilty treatments are not covered under the regualr copay stuff in our policy.
What would be a treatment to correct infertility?
How do I go about finding out if it covers it for sure or what it does cover?
Also what plan do you have? This is UHC choice plus 250 or 500, both plans have that statement.
hmmm, maybe a surgery to unblock tubes or ovarian drilling, not really sure but those mitt correct some stuff....
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| Posted 10/14/11 11:59 PM |
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PitterPatter11
Baby Boy is Here!
Member since 5/11 7613 total posts
Name:
Momma <3
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Re: Any Insurance Experts?
I know you said you do not want to contact HR, but can't you just ask them for the group number that they have with UH and then contact UH with the number. Each plan is going to be different.
Currently we have 2 insurances. BS, which does not cover IVF and United, which covers up to $15K for IVF, but our UH has a high deductible.
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| Posted 10/15/11 8:17 AM |
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alli3131
Peanut is here!!!!!!
Member since 5/09 18388 total posts
Name:
Allison
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Re: Any Insurance Experts?
Posted by Leb
Posted by alli3131
Posted by Jenn1621
"Health services and associated money for infertility treatments including assisted reproduction technology regardless of the reason for treatment.
This exclusion does not apply to services required to treat or correct underlying causes of infertility."
If I am reading this portion correctly, to me it means that it is covered. When I was trying to find this information out with my insurance, UHC actually I was told that IVF is commonly called assisted reproduction technology. Now, all plans on are different so it would depend on the plan your company has. I know you can't ask HR specifically about this but can you ask them to provide you with the plan inforamtion so you can see what's covered? You can tell them you are thinking of switching insurance and just want to weigh your options. The paperwork they supply you with should indicate whether or not infertility is covered in your plan.
No to me this says it is not covered. To me it says it is excluded except for treatments to correct infertility. And technically IUI and IVF do not correct infertility it is more a way around it.
I have united and my policy has a separate section that states fertility treatments are covered up to $50K lifetime max.
Fertilty treatments are not covered under the regualr copay stuff in our policy.
What would be a treatment to correct infertility?
How do I go about finding out if it covers it for sure or what it does cover?
Also what plan do you have? This is UHC choice plus 250 or 500, both plans have that statement.
I have choice plus but that doesn't mean you have the same coverage as me. I would ask your benefits person. Anything you talk to them about is confidential so its not like they can run to your boss and say hey this person is going for IVF.
I talked to UHC about what was covered. You cant just talk to customer service because they will only read you that section. Ask for a supervisor or nurse.
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| Posted 10/15/11 8:42 AM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: Any Insurance Experts?
Posted by PitterPatter11
I know you said you do not want to contact HR, but can't you just ask them for the group number that they have with UH and then contact UH with the number. Each plan is going to be different.
Currently we have 2 insurances. BS, which does not cover IVF and United, which covers up to $15K for IVF, but our UH has a high deductible.
I did get the group number and called UHC and that statement above is the only thing they could tell me.
Can I keep DH's insurance and pick up my own at UHC?
I don't care how much it costs because it'll be cheaper than having no IVF and paying OOP.
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| Posted 10/15/11 11:52 AM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: Any Insurance Experts?
Posted by alli3131
Posted by Leb
Posted by alli3131
Posted by Jenn1621
"Health services and associated money for infertility treatments including assisted reproduction technology regardless of the reason for treatment.
This exclusion does not apply to services required to treat or correct underlying causes of infertility."
If I am reading this portion correctly, to me it means that it is covered. When I was trying to find this information out with my insurance, UHC actually I was told that IVF is commonly called assisted reproduction technology. Now, all plans on are different so it would depend on the plan your company has. I know you can't ask HR specifically about this but can you ask them to provide you with the plan inforamtion so you can see what's covered? You can tell them you are thinking of switching insurance and just want to weigh your options. The paperwork they supply you with should indicate whether or not infertility is covered in your plan.
No to me this says it is not covered. To me it says it is excluded except for treatments to correct infertility. And technically IUI and IVF do not correct infertility it is more a way around it.
I have united and my policy has a separate section that states fertility treatments are covered up to $50K lifetime max.
Fertilty treatments are not covered under the regualr copay stuff in our policy.
What would be a treatment to correct infertility?
How do I go about finding out if it covers it for sure or what it does cover?
Also what plan do you have? This is UHC choice plus 250 or 500, both plans have that statement.
I have choice plus but that doesn't mean you have the same coverage as me. I would ask your benefits person. Anything you talk to them about is confidential so its not like they can run to your boss and say hey this person is going for IVF.
I talked to UHC about what was covered. You cant just talk to customer service because they will only read you that section. Ask for a supervisor or nurse.
Thank you I am definitely going to try and call again.
Our HR situation at work is weird and unprofessional. There is currently no person in HR, and the manager taking over I would rather pay OOP than talk to his creepy gossipy a$$.
My work acts like a bunch of 8th graders, nothing stays secret there.
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| Posted 10/15/11 11:54 AM |
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PitterPatter11
Baby Boy is Here!
Member since 5/11 7613 total posts
Name:
Momma <3
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Re: Any Insurance Experts?
Posted by Leb
Can I keep DH's insurance and pick up my own at UHC?
Yes you can. That is what we are doing. I am covered under both plans. They will use yours as the primary - whatever is not covered they will run through your DH's insurance company. We also do not have to pay any copays because of the double insurance.
Message edited 10/16/2011 2:01:41 PM.
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| Posted 10/16/11 2:01 PM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: Any Insurance Experts?
Posted by PitterPatter11
Posted by Leb
Can I keep DH's insurance and pick up my own at UHC?
Yes you can. That is what we are doing. I am covered under both plans. They will use yours as the primary - whatever is not covered they will run through your DH's insurance company. We also do not have to pay any copays because of the double insurance.
Are you serious? If so that would be awesome! DH's co-pays are $30/$50 with a $30 extra co-pay for sonos, so at Dr. B's sono days were $60! And now at LI IVF they're considered a specialist and so a reg appt is $50 plus $30 sono days is $80!
Also DH's job pays our insurance, so for me to pick up a single person (me) at my job it's like $40 a month or something, not a big deal.
At least with DH's insurance I can get unlimited IUI's forever. I am just hoping my work covers something related to IVF because I definitely need it with 9 natural failed cycles and 7 failed IUIs, praying my 8th is working so I can be done with this nonsense.
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| Posted 10/16/11 3:33 PM |
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Puppy-Love
LIF Adult
Member since 7/10 1394 total posts
Name:
J
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Re: Any Insurance Experts?
Hmm I am skeptical bc it is not listed anywhere as definitely being covered - I would want to see it in writing. My last plan had 100% coverage for IUI, IVF, etc and it stated that under a category labeled "Infertility"
My DH's plan that I just switched to lists nothing of the sorts. I ofcourse was skeptical bc it wasnt written anywhere where as my last plan was. We called twice and they told us visits and diagnosis is covered but not any treatment. Since he has the plan already we were able to ask. Maybe try calling again and raise it to a supervisor if you cannot get a straight answer.
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| Posted 10/17/11 1:19 AM |
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