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Topic: Insurance won't pay (Read 540 times) |
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shelley31
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I'm a llama!
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I was hoping someone in the forum could help me. I had a tubal ligation 11 years ago and I now regret it. So I have been looking into IVF procedures. Well when I called my insurance company they will not pay for it if the patient has had a tubal ligation. If anyone has had a similiar case please share and let me know what you did.
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meridithhasfaith
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Hi Shelley,
I am afraid I don't have any experience with this but I just wanted to say I am sorry it's happening to you now and I hope you can find a solution. Take care
Meridith
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36 years old. Married for 17 years. 1 son, 7 years old, conceived w/ ICSI. 2nd IVF w/ ICSI in June=No Fertilization. August cycle cancelled for poor response. Considering options.
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HeatherMac
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Shelley,
Though I haven't had the same experience as you, my experience is similar in that my insurance wouldn't pay for anything during my infertility treatment.
Nothing.
They would pay for ALL my infertility treatments had they been used to PREVENT pregnancy. HELLO??!!??!
We paid for EVERYTHING out of our pocket. I have to admit, things were a little tough financially for us, and we decided we could not go the IFV route...we just didn't have the resources.
I also had two major surgeries during my treatment that I thankfully didn't have to pay for because my doc said the surgeries were for endometriosis and not infertility.
So, I know my experience isn't the same as yours, but in a way it was similar...we paid for everything out of pocket and decided as we went just how much we could do. It made the pressure of all the treatments much more intense, but it was the only choice we had...and we did what we could with what we had.
A friend of mine chided me for spending all our money on fertility treatments. No one I know has ever had any infertility problems, so they have no idea the things they say are so incredibly rude. Anyway, when we were finally successful with our treatments she said to me that babies were expensive. I asked her if she had ANY CLUE what we were spending on doctor bills, blood draws, tests, drugs and treatments...that a baby would actually be a cost savings to us.
No one understands more than the women here how expensive it is to go through infertility...not only in money, but in the emotional costs, mental costs, physical costs...all of it. Just remember to come here often and get the support of the women here. Meridithhasfaith reached out to give you support and hope...the women here are incredible! And that is the one thing here that is truly invaluable.
Good luck to you, and know that you have support here!
HeatherMac
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38, Cincinnati, OH, DH of 7 years, TTC 4 years, BFP 3/9/05,
Healthy Beautiful Miracle Son born 11/10/05, 2nd BFP 10/12/07!!!
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Sylvia
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Shelley,
Unfortunately most insurance companies do not see infertility as a health problem they need to cover. With more and more people seeking treatment and demanding coverage some good things have happened. 15 states have passed laws that insurance companies have to cover or offer coverage for infertility treatments to its consumers. They are:
Arkansas-Requires employers that are not self insured to cover up to 15,000 of IVF treatment. HMO's are exempt.
Hawaii-Requires employers who are not self insured to provide one cycle of IVF but couples must prove 5 years of infertility.
Illinois-Requires employers who are not self insured to cover up to four cycles of IVF. Group policies with 25 or fewer employees are exempt.
Louisiana-Requires employers who are not self insured to cover some infertility treatment but not IVF.
Maryland-Requires employers who are not self insured to cover up to 100,000 of IVF treatments but there are several restrictions. HMO's and group policies with 50 or fewer are exempt.
Massachusetts-Requires employers who are not self insured to provide comprehensive IVF coverage.
Montana-Requires HMO's to cover some infertility treatments but not IVF.
New Jersey-Requires employers who are not self insured to cover up to four cycles of IVF. Group policies with 50 or fewer employees are exempt.
New York-Requires employers who are not self insured to cover some infertility treatment but not specifically IVF.
Ohio-Requires HMO's to cover infertility treatments but not specifically IVF.
Rhode Island- Requires employers that are not self insured to cover IVF treatments. Candidates may be subject to 20% copay.
West Virginia- Requires HMO's to cover infertility treatments but not specifically IVF.
To Offer:
California requires insurers to offer infertility benefits to employers but not specifically ivf.
Connecticut- to offer infertility benefits to employers including ivf .
Texas-to offer infertility benefits to employers including ivf .
Hope this helps, I have a great book that explains all the in and outs including how to maximize your insurance coverage. It is called "The couple's guide to Invitro Fertilization" written by Liza Charlesworth. It was 9.00 on Amazon. It is a great resource from everything to the treatments themselves to funding the treatments and what to do if they do not work. Don't give up!!!!
Best of Luck,
Sylvia
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32 yr old with 36 yr old dh been married 4 years, I. First IVFw/ICSI scheduled January 2006..... BFP on Feb 6, 2006. Due October 14th...It's TWINS!!!!! Babies arrived 14 weeks premature, boy 1lb 11 ounces and girl 1 lb 9 ounces
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shelley31
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Thank you for the support. It discourages me a little that they will only pay if I did not get myself sterlized. I mean don't get me wrong if I did not have that done I would be able to have more childern. I have 3 beautiful children. When your young and there is really no one to talk to you my make life changing decisions that you may regret later. I just wish someone would have talk to me a little more about it. Sad to say my Ob/GYN was a man. Not saying that is a probelm but a woman would have told me different. But I will figure something out. The battle has not been defeated.
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