Insurance ? AGAIN...

Does anyone know what, if anything, Empire BC/BS POS in NY covers for infertility? I can't seem to get that level of detail anywhere...

Re: Insurance ? AGAIN...

I have Empire BC/BS Direct POS and they basically cover nothing as far as the procedures...but morning monitoring bloodwork and ultrasounds are covered in my plan.
Everything else is out of pocket.
For my FET the billing dept. at Columbia charged me the cost minus what they said my insurance would pay for...and I assumed they calculated it correctly. I had to prepay for it.
When I did my fresh cycle I used the state funds plan so I had to prepay for that too but my insurance wasn't really involved.
Hope this helps a little...but I'm not sure if our plans would be exactly the same.

Re: Insurance ? AGAIN...

Well, if my transfer on Saturday works, and is billed as of that date, it will be covered by the plan I am currently on - Oxford.

Problem is, that the Oxford plan coverage is ending in June. I am trying to decide whether to take my husband's company's plan or my new company's plan.

Empire it seems, covers nothing for IVF - which if this cycle doesn't work, I am screwed. Since my husband's coverage is originated in Illinois, IVF is mandated coverage so I would be covered under his. The problem there is that his plan offers less coverage and more expensive deductables, copays etc. than the empire one in general. Also, my OB/GYN does not take his insurance and that is a HUGE issue for me.

I am so confused...and I must make the decision by tomorrow!

Re: Insurance ? AGAIN...

I think your coverage would depend on your specific plan. You should call. You really cannot compare with anyone else's, unless they worked where you worked. Good luck. When I had a similar plan with that company they covered everything including 2 times on IVF (of course I left that job b/f we did IVF).

Re: Insurance ? AGAIN...

I have Direct POS as well-- it covers NOTHING (and they made that very clear to me) for IVF but everything for IUIs.
I think it might depend on how the labs/sonos/etc... were coded medically wise. I know several people (not with my insurance) get told they won't be covered for anything- and then get covered for the meds- and I have a feeling it's because of how the drs office is coding it.
The anestesia would be covered (according to BC/BS) as long as it's in a participating facility- because it's for a surgery, and it doesn't matter what kind of surgery it is (or whether it's covered or not).
HTH!

Re: Insurance ? AGAIN...

I agree on the codes. I think this makes a big difference.

Re: Insurance ? AGAIN...

Well, you can have double coverage. We did when I was pg with DD. You can sign up for yours, if you have to and your DH can also add you to his plan at the end of June, if need be. But I don't think you are going to need his plan.

Re: Insurance ? AGAIN...

I had BC/BS. What a nightmare. they covered nothing for infertility treatement of any kind, but they say the will cover diagnosis. Well we are still fighting with them for the HSG I got done. They are awful. I am grateful I was able to go under my husband's insurance which does cover IF but no meds.

Re: Insurance ? AGAIN...

You must call the insurance company directly. There are way too many variations of coverage from Empire for anyone on the boards to be able to tell you what is covered and what isn't.

Re: Insurance ? AGAIN...

Once again let me remind everyone that it makes no differnece if person a and person b have the same Plan, your EMPLOYER decides what covergae you have. When they buy the plan they buy the coverage. So you cannot compare two people unless you have the same emplyer.

I worked for BCBS for years.

Call them and ask for your info in writing!