Insurance!!!!!!!!! Updated

Hello ladies -

So I am schedluled to have a hysteroscopy this Friday. The office calls to tell me I need to register with the infertility hotline on my insurance in order to be covered. I call my insurance and sure enough I do not qualify for this benefit since i am "succesfully" getting pregnant. The fact that I have had 3 miscarriages and not carried a pregnancy to term does not matter. The dr and most bloodworks will be covered (under specialist) but certain procedures etc will not!
We are going to go ahead with these of course because we want to find out what is going on but I just can't belive they won't cover it on this technacality.

I think I was partly in shock over the phone but once i get more info from dr's office tomoroow i think I will be making another not so nice call to my insurance!!!
Anyone else experience this?


** Updated..the insurance will cover it..they just had to put in my diagnosis as reccurent miscarraige or "habitual aborter" as they have it..isn't that a terrible name....anyway they said they will cover anything related to that so that is good news. I guess whoever i spoke to yesterday just didn't know I guess..

Message edited 3/29/2007 3:08:55 PM.

Re: Insurance!!!!!!!!!

I haven't had the insurance problem - but I have heard that until a certain # of m/c happen certain procedures are not considered "medically necessary" and because of that insurance won't cover them.

I would talk to the MD about writing a letter saying the procedure is medically necessary and having the office try to get preapproval.

Re: Insurance!!!!!!!!!

Im gonna stand up for the insurance companies once again and say that its not the company that you get insurance through that makes these rules, its your EMPLOYER.

Your employer gets to choose what they want covered and HOW when they join the insurance. Then they pass those benefits on to you as an employee.

Most people dont think they will ever need the benefits so dont research if their job is providing good, fair or bad benefits.

I feel for you, thats actually a rare thing these days ( the hotline) and so its an old policy.

Why are they diagnosing it as infertility ?


Make sure you write down exactly who you spoke to everywhere, and what they say word for word.

Many things are a matter of wording and can be easily fixed.

GOOD LUCK!!

Re: Insurance!!!!!!!!!

I thought hysteroscopy is considered "diagnostic". In my opinion, they should cover it or at least part of it! Sorry about your frustration. I had a deductible and had to pay 20% for my hysteroscopy.

Good Luck with the Hysteroscopy on Friday! Make sure to take pain relievers prior to the procedure.