Cigna ????

Ok- here I go again with questions LOL!!!!...I called my insurance company which is Cigna (We are on the HMO which stinks)...I asked the rep if ANY of the bloodwork, sono's , anasthesia etc.. would be covered because they are covering them now for IUI's and I know we don't have IVF coverage....She said that it will depend on how the dr's office puts through the ppwk (medical codes etc..)...If they put it through as infertilty and not as IVF procedure than some of it would most likely be covered..She also said if they don't pay it, I can send bills in for reimbursement and see if I get denied What the heck does that mean ???..Is the dr's office supposed to fudge the ppwk?...I can never get a straight answer out of them- I went through the same thing when I inquired about IUI's....Im going to ask the financial consultant next week at the dr's office

Re: Cigna ????

I have Cigna, but a PPO, not HMO. What is covered is largely based on your actual plan.

One of the easiest things that I was able to do is to call my doctors office and request a listing of ALL of the codes that they use for each procedure. Once I had that list, i spent 15 minutes on the phone with CIGNA going through each one and finding out if a) it was covered, and b) if I needed to be preapproved/ authorized for it. They actually had this generic letter for anyone to send to their insurance company. Im sure yours has something similar.

Also - I dont know if any of your medications are covered, but for speciality items I needed to go through their mail-order company, Tel Drug. This is very important, order ALL of your drugs as early in the process as you can. It took them 2-3 weeks to get my stims "approved". It was a nightmare. I was calling them everyday and every person I spoke to gave me a different story. It was worth it in the end, because it was approved and covered with my plan, but its been VERY frustrating. Then, your approval is only a one-time approval, so if you need a refill, they need to go through the approval process again. If your meds are covered I would ask for your doctor to prescribe a few (2-3) days extra worth of the stims so that you have them (if not covered, dont do that since they are so unbelievably expensive). I was in a situation where I was about to run out, but was day-to-day on whether or not I would trigger. I called to order the stims and they would not have arrived in time (it was okay because I ended up triggering).

Sorry for the novel, I've just been so frustrated with the mailorder pharmacy there and know i would have liked to know all this before the process.

ETA: EVERY time I have called them the person had no idea about anything infertility related.

Message edited 1/8/2008 9:40:22 PM.

Re: Cigna ????

Thank you so much for all the info !!!!,,,That is a great idea to get a list of the medical codes...I am almost positive I was told a while back that no injectable meds were covered- yet when I called yesterday the girl said it doesnt "specifically " state that- Whatever that means .....Thanks for tips !