Anyone use Aetna for their insurance?

I have a question about IUI coverage.

TIA!

Re: Anyone use Aetna for their insurance?

I have Aetna PPO. I have $20,000 lifetime Infertility coverage. It covered my IUI, any sono's, bloodwork...the only thing I paid was my $15 copay

Re: Anyone use Aetna for their insurance?

Thanks!

I don't have PPO, but rather POS. I don't have a co-pay.

If anyone else uses Aetna, here's my situation:

Per Aetna, I get 6 lifetime attempts at IUI. After meeting with the financial department at my RE's office on our first visit, all the paperwork and our conversation with the financial person said that it's 6 cycles of IUI, so if we had 2 IUI's per cycle, it's still 6 cycles, not 3 months (hope I'm making sense). Anyway, I had 2 IUI's with my OB/GYN before going to the RE. We just did 2 back to back IUI's within the same cycle. So based on what the RE office told us, and what I have on paper, I should have 3 IUI cycles left. However, my statement from Aetna shows I only have 2 IUI's left (not 2 cycles, just 2 inseminations), which would mean that this month would be the last IUI's the insurance would pay for.

So, I'm wondering if anyone else has this coverage with Aetna, and was my RE office wrong with the information they gave us?

TIA

Re: Anyone use Aetna for their insurance?

I have Aetna and have 6 iui lifetime no ivf "rider" on my plan.
While I hope for your sake I'm wrong it looks like you might have only 2 inseminations left.

My question ( especially since I might be there one day) to RE which would give you the "most" chances? one iui per cycle or 2 back to back?

Hope your journey is short.

Re: Anyone use Aetna for their insurance?

Every policy is different, it depends on what the employer chooses for the policy.

Re: Anyone use Aetna for their insurance?

I have aetna choice pos. I have $20000 lifetime coverage for fertility treatments.

Re: Anyone use Aetna for their insurance?

I had Aetna at the time we were doing IUI's. I also had 6 lifetime IUI's that were covered (IVF was not...and it's a NJ state mandate, but that's a whole other story ). Anyway...I'm not sure how the RE's office worked it out...but I had to get a pre-authorization for each IUI cycle in order to get the IUI and the meds covered. During at least 2 of the IUI's, I had 2 inseminations back to back...but they were covered under the 1 cycle. I had a total of 5 IUI cycles with the RE (#5 was my magic number). I was going to use #6 if I needed before moving onto IVF, since insurance didn't cover IVF.

For NJ, IVF is a state mandate and should be covered. However, my employer had what is called a "self-insured" policy. What that means is that they bought the policy from Aetna for a certain amount of money, and then the employer gets to choose what is covered and what is not. They choose IVF to NOT be covered which goes through the loophole of the state mandate. You will have to check with your insurnace to see if it's covered for you or not.

Good luck

Re: Anyone use Aetna for their insurance?

Thanks Kim..that's helpful!

I have to call RMA today about another billing issue, so I'll talk to them about the IUI stuff. I think Aetna may have it wrong on my explanation of benefits. I do have IVF coverage (thank heavens!) I get 3 lifetime attempts.