couple facts: MC 5 times since 2008; BCBS/Anthem insurance through work, I live in Illinois, I am 33
Question: have anybody had any success asking Anthem for approval to pay for 2-3 cycles n IVF even though the treatment is not covered by insurance?
Where do I start, how do I ask them for the treatment?
They spent so much money on me so far it might be better for them to just go ahead and pay for in vitro rather then paying for another 5 MC. I have no intention to give up until somebody tells me that this is not going to work. I can't afford IVF and my options are very limited at this point. I am afraid that if I don't do anything fast I will loose a chance of becoming a mother.
Please help. If you have any positive stories, hints, ideas please share.
Thank you and good luck to you all. Be positive and be persistent!
if it's not covered, it's not covered. we had to switch insurance companies to get ours covered.
you would be better off discussing financing and payment plans with your local fertility centers than trying to convince an insurance company to pay for something they don't cover.
Have you had genetic testing done to try and come up with the reason for the MC's? I would start there if you haven't already. Almost all insurance companies will pay for genetic testing after multiple miscarriages. Mine did and it doesn't cover any fertility treatments at all either. Then I would try fertility drugs which are cheaper, followed by IUI's that are a lot less expensive than IVF. That is where we started since our insurance doesn't cover anything.
And happynifer is correct. Your chance of getting an elective procedure covered by insurance that doesn't cover it is nil. I am in insurance. Your plan doesn't consider the costs of fertility treatments in their overall pricing. Therefore, they will not be willing to cover it because it redcues their profit margins. Also, if you get pregnant, they are out a lot more money for the child. I know it ***** and is ridiculous not all cover it, but they are more concerned with profits than how it affects an insured.
You have gotten pregnant 5 times naturally since 2008? I agree with prayingforpatience - try to get tests done to determine why you are miscarrying. You might not need ivf at all - if there is a reason, then maybe it is more easily treatable. IVF may help you get pregnant quicker; but it is the prog (and estradiol?) support after the embryo transfer that helps you stay pregnant.
Look into clinical trials/studies. A friend enrolled in a clinical trial and it paid for everything for her 1st IVF. She had lots of eggs left over and she was able to use them for her 2nd and 3rd IVFs. Also, if you are willing, consider donating part of your eggs. The same friend did that and it paid for her 4th ivf. She got pregnant that time.
Thank you guys. I had the genetic testing done. I had been conceiving easily within a cycle or two. I had 1 ectopic pregnancy and I only have one tube left. I have a new doctor and I believe in her. I know that eventually I will get lucky and one of the pregnancies will come through.
I was asking about talking to the insurance company about covering the IVF only because they already spend a lot of money on me. It must be approx. $200k. I have no intentions on giving up so they might be better of paying for IVF.
I think my problem is in the lining of the uterus or extremely bad luck. Most pregnancies were chemical pregnancies. The best option for me would be IVF at this point. I am trying Viagra suppositories but never heard of anybody using them or having any success.
SO good to hear form somebody. I know I'm not in it alone and it helps.
Have you heard of anybody donating eggs at 33-34 y old? I think I am too old.
I will definitely look into grants. That's a good idea.
you are talking about an industry that won't pay for birth control pills but will pay for childbrith and viagra...
they refused to pay $150 for orthotics to prevent the $12k knee surgery they ended up paying for...
there is NO logic and i would be stunned if they would pay for IVF when it's not covered, no matter how much it would make sense...
I agree with these other ladies. If your plan doesn't cover it now, you can't convince them to pay for it. Next, as someone else mentioned, GETTING pregnant isn't your problem...STAYING pregnant long enough to actually hold a healthy baby in your arms IS the problem. I don't think IVF will solve your problem - it may, but unlikely.
IVF will get you pregnant every time (technically), but not all ivf procedures end up with the pregnancy sticking (in fact, it seems like most do NOT end up sticking and women have to do ivf over and over and over until one sticks). So in your case it seems like ivf might not be the best option. Try gentic counciling or teaming up with a good dr that can help determine why you can not hold onto the pregnancy.
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