Insurance Coverage

Not sure if this is where I need to be posting...but I figured someone might be able to point me in the right direction (or at least I hope some can )

We have no infertility coverage...nothing...so I guess I need to know where I need to start...are there any RE that will 'work' with you when you don't have coverage? DH & I both need testing done...I need a HSG & DH needs a SA...where do I go?

Sorry I am just so confused and overwhelmed.

I will add...that we have been trying a VERY long time (years) and I really want to get started on the next step...since I have waited so long already.

Thanks for any help you can give :)

Re: Insurance Coverage

From what I understand, Dr. Braverman is very cooperative. But he is the only one I know of who will "work" with you in regards to payments.
Other RE's do offer payment plans, but don't really offer discounts for OOP patients.

Re: Insurance Coverage

I would really look into what may be covered. I didn't have any infertility coverage, but my insurance did cover the HSG, polypectomy surgery, my RE visits, and my monitoring ultrasounds. It didn't cover my meds and if I had gone the IUI or IVF route, they would have stopped covering the monitoring ultrasounds, because they then considered that infertility treatments....so dumb.
So, maybe call them and see if there are any basic things they will cover, so you could at least get started...

Good luck!

Re: Insurance Coverage

Welcome, hope your stay here is short.


My suggestions if you havent already done so, call BOTH (dh and yours) insurance companies and ask exactly what is or isnt covered. Ask for them to send you their book on coverage. Sometimes certain things are covered (IUIs not IVFs)
Set up some consultations and ASK if they are willing to work with you. I know patients of Dr. B who have gotten donated meds. I also know that he is willing to set up payment plans. Not sure what other clinics offer. Perhaps sense everything is out of pocket, they can offer you a discount or work out some kind of payment plan for you. I would also inquire if anything (sonos, blood) could be billed under something other than infertility so your insurance can cover SOME cost.

Also, most RE offices have donated meds from past cycles i would ask in the consultation how reasonable of an expectation this is at their office. It is not something that all offices do. Another suggestion, POST here for meds, the women here are amazingly supportive and generous.

IF can get $$$ . doctors know this and usually are willing to work with a patient on some level, so ASK.

I know that IF is incredibly stressful alone, financial worries on top of it all are horrendous.

I wish you the best !!! Good Luck !

Message edited 6/24/2010 11:30:57 AM.

Re: Insurance Coverage

I agree wtih maybemommy10, u may not have Infertility coverage but I was told that a law was passed that all insurance companies have to cover the testing that helps determine the exact cause of infertility/diagnosis.

Please don't be overwhelmed. It is a lot to take it but take a minute to breath and take one step at a time.

Call ur insurance company and talk to them and ask them to tell u EXACTLY what is and isn't covered.

Good Luck with everything and I hope u stay on this board is short

Re: Insurance Coverage

some REs will let you pay out of pocket and will give you discounted rates if you pay out of pocket. Dr. Braverman will always work with you on cost if its a factor. he's very cognizant of cost if you dont have coverage.

if you are diagnosed with something after the testing, you can try and have the RE's office file the insurance claims under that code instead of the code for infertility. for example, i have PCOS, and for a while when i didnt have infertility coverage, dr. b's office filed everything under the PCOS code and most of my appointments and bloodwork were covered.

good luck!!

Re: Insurance Coverage

Posted by Nayia

I agree wtih maybemommy10, u may not have Infertility coverage but I was told that a law was passed that all insurance companies have to cover the testing that helps determine the exact cause of infertility/diagnosis.

Please don't be overwhelmed. It is a lot to take it but take a minute to breath and take one step at a time.

Call ur insurance company and talk to them and ask them to tell u EXACTLY what is and isn't covered.

Good Luck with everything and I hope u stay on this board is short

Re: Insurance Coverage

You might be able to have testing done through your ob/gyn also... so check on that!

We did our SA, CD 3 bloodwork, & HSG through our ob/gyn before going to the RE

Re: Insurance Coverage

Ask the REs you are considering about cost and paying OOP.

ALL of the ones I know will work out a discounted rate.

Re: Insurance Coverage

Posted by maybeamommy

Posted by Nayia

I agree wtih maybemommy10, u may not have Infertility coverage but I was told that a law was passed that all insurance companies have to cover the testing that helps determine the exact cause of infertility/diagnosis.

Please don't be overwhelmed. It is a lot to take it but take a minute to breath and take one step at a time.

Call ur insurance company and talk to them and ask them to tell u EXACTLY what is and isn't covered.

Good Luck with everything and I hope u stay on this board is short

That is not true unfortuntaely...

My insurance coverage does not even cover diagnostics!

Re: Insurance Coverage

Thank you for all of your input.
I will call my insurance again...last time i called was last summer and as of that time...we didn't have any coverage...not even for diagnostic tests

I will talk to my OB again...since it is time for my yearly check-up...I know she had run a battery of tests last year...but things happen and I never got the results....but I am ready to start this journey...and just needed some direction.

About RE's...does anyone have recommendations for anyone in Suffolk? Thank you!