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MrsMessina
Thankful for our miracles!
Member since 2/07 7254 total posts
Name:
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Need insurance coverage help...
OK- I 'think' (thanks to my fellow LIFers) that we will get $10,000 IF coverage (excluding prescription drugs) from my DH's new job.  Not quite what I was hoping for- but it might still work out ok... I'm staying optimistic.
That being said- how do I figure out what to do about my upcoming FET? Do I pay it out of pocket ($4500) as originally planned, since our current plan doesn't cover FETs either?
Or do I opt for a fresh cycle instead? And how do I know what insurance they'll be using- my current one or his new one (once he starts)? I'm so lost- he hasn't picked a plan yet (he has a choice) but across the board they all seem to say the same when it comes to IF. 
We're supposed to be starting my FET cycle either on the same day that he starts or w/in a few days after... TIA! 
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Posted 11/6/08 5:17 PM  |
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Long Island Weddings
Long Island's Largest Bridal Resource |
Donna
1 year already!!
Member since 5/05 3360 total posts
Name:
Donna
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Re: Need insurance coverage help...
does your DH's coverage start immediately? some jobs make you wait a certain amount of time.
The best thing for you to do is to get the group numbers for his insurance plans so you know what is exactly covered.
Good luck!
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| Posted 11/6/08 5:24 PM |
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MrsMessina
Thankful for our miracles!
Member since 2/07 7254 total posts
Name:
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Re: Need insurance coverage help...
Thanks Donna. Yes, they said it starts on day 1- but he has up to 31 days to pick a plan from the day of employment. What if we just don't pick a plan for a month- would that work?  Sorry- I'm so confused.
And my DH won't call them directly to get group #'s. I'm a planner and he wants to wait until his first day when they give him his packet.  
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| Posted 11/6/08 5:28 PM |
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Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
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Re: Need insurance coverage help...
IF coverage is the same across all plans most of the time. It's a company mandate not a policy mandate.
Does the new insurance plan cover FETs?
You will need to talk to someone at the new firm for some clarity about the benefits. Also ask the clinic. I'm sure they have been there done that.
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| Posted 11/6/08 5:29 PM |
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MrsMessina
Thankful for our miracles!
Member since 2/07 7254 total posts
Name:
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Re: Need insurance coverage help...
Posted by Blu-ize
IF coverage is the same across all plans most of the time. It's a company mandate not a policy mandate.
Does the new insurance plan cover FETs?
You will need to talk to someone at the new firm for some clarity about the benefits. Also ask the clinic. I'm sure they have been there done that.
Thanks Susan. I was just looking at it again but I don't see anything about FETs- unless they're referred to as something else (what are GIFT and ZIFTs?). It says:
"(Limited to $10,000 Lifetime Maximum Benefit combined in-network and out of network)
Includes Correction of Infertility, In Vitro Fertilization, Artificial Insemination, GIFT, ZIFT, etc.
Excludes donor and prescription expenses. Coverage applies for employees and eligible dependent spouse/domestic partner.
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| Posted 11/6/08 5:36 PM |
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Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
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Re: Need insurance coverage help...
Posted by MrsMessina
Posted by Blu-ize
IF coverage is the same across all plans most of the time. It's a company mandate not a policy mandate.
Does the new insurance plan cover FETs?
You will need to talk to someone at the new firm for some clarity about the benefits. Also ask the clinic. I'm sure they have been there done that.
Thanks Susan. I was just looking at it again but I don't see anything about FETs- unless they're referred to as something else (what are GIFT and ZIFTs?). It says:
"(Limited to $10,000 Lifetime Maximum Benefit combined in-network and out of network)
Includes Correction of Infertility, In Vitro Fertilization, Artificial Insemination, GIFT, ZIFT, etc.
Excludes donor and prescription expenses. Coverage applies for employees and eligible dependent spouse/domestic partner.
wow, no drugs? GIFT and ZIFT are not FET. Sounds like it's out of pocket either way. Your clinic can call on your behalf but you need some numbers to give them. Their plan adminstrator may be able to help. Your DH needs to make the call. Maybe he's embarassed?
Btw-congrats on the job!
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| Posted 11/6/08 6:01 PM |
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MrsMessina
Thankful for our miracles!
Member since 2/07 7254 total posts
Name:
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Re: Need insurance coverage help...
Posted by Blu-ize
wow, no drugs?
Btw-congrats on the job!
Is that what that means?    I thought it meant that they were included but not in IF benefits, just in regular prescription benefits. 
Thanks.  I think I will be forcing him to call tomorrow- I'm getting a tummy ache just thinking about this........ 
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| Posted 11/6/08 6:03 PM |
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Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
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Re: Need insurance coverage help...
It may cover it but not under IF. If that's the case then there may be no limit.
I hope so.
He has to call. You have imminent decisions to make.
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| Posted 11/6/08 6:21 PM |
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DRMom
Two in Blue
Member since 5/05 20223 total posts
Name:
Melissa
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Re: Need insurance coverage help...
You can probably call and say you are his wife and would ilke the group number to make some decisions about family healthcare-I've done it before. I would also do the FET as it is MUCH cheaper than a full cycle. Lastly I am pretty sure your meds are covered under your prescription plan-you can get their numbers too and find out from yoru doc what meds he will use in thsi FET and call the company and aks if they are covered meds. Good luck
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| Posted 11/6/08 8:04 PM |
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dm24angel
Happiness
Member since 5/05 34581 total posts
Name:
Donna
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Re: Need insurance coverage help...
FET is considered IVF in insurance terms.
The clinic will handle ALL of this for you. They will call your insurance with codes etc and tell you much more then you investigating ever could.
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| Posted 11/6/08 8:12 PM |
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rose825
Best Friends
Member since 6/05 10228 total posts
Name:
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Re: Need insurance coverage help...
you will also have to go through your insurance first and his as secondary. I would explain to the clinic, hoping the will bill your primary first and by the time they get the denial back you will have your new secondary policy
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| Posted 11/6/08 9:03 PM |
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ihilani
LIF Adolescent
Member since 9/07 858 total posts
Name:
alias
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Re: Need insurance coverage help...
Read the prescription drug part of his coverage to learn about any available prescription drug coverage. It wouldn't necessarily be explained in the same section that explains which procedures are covered.
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| Posted 11/7/08 8:57 AM |
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MrsMessina
Thankful for our miracles!
Member since 2/07 7254 total posts
Name:
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Re: Need insurance coverage help...
Posted by ihilani
Read the prescription drug part of his coverage to learn about any available prescription drug coverage. It wouldn't necessarily be explained in the same section that explains which procedures are covered.
Thanks! I actually couldn't sleep last night b/c my brain was on overdrive so I finally gave up trying, got out of bed and went thru the paperwork.
IF meds are covered, both oral ones and 'self-injectable' ones- and they don't take away from the lifetime max.   So I'm feeling much better this morning.
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| Posted 11/7/08 10:28 AM |
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Blu-ize
Plan B is Now Plan A
Member since 7/05 32475 total posts
Name:
Susan
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Re: Need insurance coverage help...
that's great!!!! Yay!!! Good benefits.
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| Posted 11/7/08 10:34 AM |
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kahlua716
3 Girls for Me!
Member since 8/07 12475 total posts
Name:
Keri
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Re: Need insurance coverage help...
Wow! Looks like my friend was wrong! Sorry bout the mis-info! Great news though!
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| Posted 11/7/08 11:10 AM |
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MrsMessina
Thankful for our miracles!
Member since 2/07 7254 total posts
Name:
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Re: Need insurance coverage help...
Posted by kahlua716
Wow! Looks like my friend was wrong! Sorry bout the mis-info! Great news though!
No problem!! Thank you so much for helping me! I was able to get my hands on their insurance documents thanks to a good friend of mine and her DH who works there!
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| Posted 11/7/08 11:13 AM |
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