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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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I better be pregnant by 9/29/2011
Because I got a stupid letter from Empire BCBS today saying that Dr. B won't be covered by them after that date!
I am sooooo sad about this, did anyone else with Empire BCBS get this?
When DH and I got married he insisted I switch to his insurance bc it is "so good", well my old covered IVF and his doesn't, my old insurace had $20 not $30 co-pays, which adds up as I have been going so much. And a specialist is $50.
This sucks. I can only change my plan back to my company's at the end of the year.
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Posted 5/27/11 6:31 PM  |
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LoLaBlue
PARTY OF 5
Member since 6/10 6900 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Posted by Leb
Because I got a stupid letter from Empire BCBS today saying that Dr. B won't be covered by them after that date!
I am sooooo sad about this, did anyone else with Empire BCBS get this?
When DH and I got married he insisted I switch to his insurance bc it is "so good", well my old covered IVF and his doesn't, my old insurace had $20 not $30 co-pays, which adds up as I have been going so much. And a specialist is $50.
This sucks. I can only change my plan back to my company's at the end of the year.
really??!! thats what I have 
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| Posted 5/27/11 8:45 PM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: I better be pregnant by 9/29/2011
It's nice to have the added pressure huh?
I am hoping for you that somehow your insurance is slightly different from mine and you're excluded?
I will be bringing the paper to Dr. B on Tuesday and seeing what the deal is.
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| Posted 5/27/11 8:49 PM |
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LoLaBlue
PARTY OF 5
Member since 6/10 6900 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Posted by Leb
It's nice to have the added pressure huh?
I am hoping for you that somehow your insurance is slightly different from mine and you're excluded?
I will be bringing the paper to Dr. B on Tuesday and seeing what the deal is.
yeh another bs to add to the mix
Im not home right now but DH said I have mail from Empire BCBS.
do you know what youre going to do?
I hope you get your BFP by then.
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| Posted 5/27/11 9:04 PM |
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prunepie
LIF Adult
Member since 7/06 4357 total posts
Name:
jennifer
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Re: I better be pregnant by 9/29/2011
I hope its not trUe!!!!!!! Ughssss. When u see him would u mind asking if this also includes the empire government plan?????? Baaahhhhhhh
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| Posted 5/27/11 9:54 PM |
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cateyemm
Twins!
Member since 7/10 8027 total posts
Name:
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Re: I better be pregnant by 9/29/2011
i didnt get a letter... i dont think i ever got a letter from an ins co proactively stating that a doc wont be covered.
i hope its not true
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| Posted 5/27/11 9:57 PM |
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InShock
life is good
Member since 10/06 9258 total posts
Name:
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Re: I better be pregnant by 9/29/2011
I hope this is a non-issue for you!!! 
Posted by prunepie
I hope its not trUe!!!!!!! Ughssss. When u see him would u mind asking if this also includes the empire government plan?????? Baaahhhhhhh
Dr. B told me that he plans on dropping the Empire plan. 
I am JUST beginning coverage with them as of June 1.
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| Posted 5/27/11 10:54 PM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: I better be pregnant by 9/29/2011
What insurances does he even take now? Hasn't this been going on for a while? I keep hearing about him and his dropping of insurances. Would have been nice if he mentioned this to me as I only started with him 2 months ago.
I have no idea about any other type of insurance plans, but mine is a direct HMO. I guess I will stick it out with him until then, and if I don't get pregnant I will probably do IVF OOP because my insurance doesn't cover it anyway. And I don't think I can wait Oct-Dec doing nothing.
The letter is weird, it says "This practitioner is no longer in empire's HMO provider network". There is a participation end date which is 9/29/11, and it says if I am in an ongoing course of treatment I can stay with them until the end date. If I am pregnant and in my 2nd or 3rd trimester I can continue with him through post partum care.
I guess unless I get pregnant I will be shopping around for a new doctor, how can I pay OOP for it all? Does anyone know if he takes United? I could possibly switch for 2012 back to my work insurance.
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| Posted 5/27/11 11:59 PM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Posted by LoLaBlue
Posted by Leb
It's nice to have the added pressure huh?
I am hoping for you that somehow your insurance is slightly different from mine and you're excluded?
I will be bringing the paper to Dr. B on Tuesday and seeing what the deal is.
yeh another bs to add to the mix
Im not home right now but DH said I have mail from Empire BCBS.
do you know what youre going to do?
I hope you get your BFP by then.
Thank you, I hope you do too!
I get stressed enough about leaving work for all these appts, now I have to worry about this. It's almost like the not getting pregnant part takes a back seat in the stress dept while I have to deal with something like this now.
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| Posted 5/28/11 12:00 AM |
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MCD0524
LIF Adult
Member since 4/10 1199 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Ugh, that's my plan too! I wonder what insurances he does take now?
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| Posted 5/28/11 12:05 AM |
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InShock
life is good
Member since 10/06 9258 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Posted by Leb
I guess unless I get pregnant I will be shopping around for a new doctor, how can I pay OOP for it all? Does anyone know if he takes United? I could possibly switch for 2012 back to my work insurance.
He negotiated some out-of-network coverage with United Healthcare. That's what I have now (switching to Empire Plan next week) and we've been using out-of-network benefits. You should ask him directly about this - he was very forthcoming when I talked to him about all this!
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| Posted 5/28/11 12:06 AM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Posted by InShock
Posted by Leb
I guess unless I get pregnant I will be shopping around for a new doctor, how can I pay OOP for it all? Does anyone know if he takes United? I could possibly switch for 2012 back to my work insurance.
He negotiated some out-of-network coverage with United Healthcare. That's what I have now (switching to Empire Plan next week) and we've been using out-of-network benefits. You should ask him directly about this - he was very forthcoming when I talked to him about all this!
I am clueless about insurance, so with your empire plan you can use out of network coverage?
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| Posted 5/28/11 12:11 AM |
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InShock
life is good
Member since 10/06 9258 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Posted by Leb
Posted by InShock
Posted by Leb
I guess unless I get pregnant I will be shopping around for a new doctor, how can I pay OOP for it all? Does anyone know if he takes United? I could possibly switch for 2012 back to my work insurance.
He negotiated some out-of-network coverage with United Healthcare. That's what I have now (switching to Empire Plan next week) and we've been using out-of-network benefits. You should ask him directly about this - he was very forthcoming when I talked to him about all this!
I am clueless about insurance, so with your empire plan you can use out of network coverage?
Yes! With UHC right now, we get 70% reimbursed, and with Empire Plan, I believe it's going to be 80%. So it's not terrible (of course 100% coverage is always better!).
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| Posted 5/28/11 12:15 AM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Posted by InShock
Posted by Leb
Posted by InShock
Posted by Leb
I guess unless I get pregnant I will be shopping around for a new doctor, how can I pay OOP for it all? Does anyone know if he takes United? I could possibly switch for 2012 back to my work insurance.
He negotiated some out-of-network coverage with United Healthcare. That's what I have now (switching to Empire Plan next week) and we've been using out-of-network benefits. You should ask him directly about this - he was very forthcoming when I talked to him about all this!
I am clueless about insurance, so with your empire plan you can use out of network coverage?
Yes! With UHC right now, we get 70% reimbursed, and with Empire Plan, I believe it's going to be 80%. So it's not terrible (of course 100% coverage is always better!).
Do you know if that is an option for me with Empire BCBC direct HMO?
When people start explaining insurace to me I just stop listening, it is just so boring and I don't get it all, I should probably try to learn.
Because 80% would be okay. I would just hate to switch doctors, I don't like change that much lol.
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| Posted 5/28/11 12:17 AM |
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MCD0524
LIF Adult
Member since 4/10 1199 total posts
Name:
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Re: I better be pregnant by 9/29/2011
I have BCBS PPO/EPO and you can't go out of network. My husband has a plan that you can, but of course we took my insurance because it was cheaper 
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| Posted 5/28/11 12:19 AM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Posted by MCD0524
I have BCBS PPO/EPO and you can't go out of network. My husband has a plan that you can, but of course we took my insurance because it was cheaper
Hopefully for you you'll never need to see him again after your next few appointments!
I am hoping we can just get this done within 4 months! I picked DH's insurance because I figured if we had a baby and I didn't want to go back to work that the insurance thing would be set. I never thought I'd be in this situation so I never checked their fertility coverage out.
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| Posted 5/28/11 12:24 AM |
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ReRe17
LIF Infant
Member since 1/11 305 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Girls with the Empire Government Plany
FYI
We do have out of network coverage but please be aware that it uses a lot more of your $50,000 lifetime max. I learned the hard way and have exhausted a lot more money than if I would have went with an in network doctor. Spoke with insurance company and they explained that in network doctors have contracted prices and the insurance will only pay that certain amount. Out of Network can charge whatever and will get that and once you reach your out of pocket deductible they willl pay out of network 100% which then uses more money.
Unfortunately, this happened to me. Now I'm scrambling to find an in-network docotor.
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| Posted 5/28/11 9:16 AM |
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LoLaBlue
PARTY OF 5
Member since 6/10 6900 total posts
Name:
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Re: I better be pregnant by 9/29/2011
YUP I got the letter! I have Empire BCBS HMO. It would have been nice of him to mention something
I haven't been too happy w/him lately so maybe this is a blessing in disguise.
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| Posted 5/28/11 10:47 AM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: I better be pregnant by 9/29/2011
Posted by LoLaBlue
YUP I got the letter! I have Empire BCBS HMO. It would have been nice of him to mention something
I haven't been too happy w/him lately so maybe this is a blessing in disguise.
Well we have 4 months left with him then. Let's hope that is all we will need and if not then we find new doctors. It's soooo annoying.
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| Posted 5/28/11 5:55 PM |
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