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Question on how to get Insurance to pay for infertility treatment
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Question on how to get Insurance to pay for infertility treatment

Hi everyone, I just came back from my first RE appt.  Good news is that he said he is very confident that I will get pregnant soon. Bad news is that I have Aetna insurance and it seems that they only pay for diagnosis not treatment.  Is there anyway to have them pay for atleast a portion of the treatment?
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151928_tn?1275710937
Hi there,
Are you sure they won't cover IUI as we have Aetna and they cover 6 IUI's.  Did you call them and ask for their infertility telephone number as they have a seperate division that manages that.  They are about to pay for mine if I don't get pregnant this month.
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Avatar_n_tn
Sometimes, if you can have the doctor's office or the doctor himself write a letter stating all the facts, then the insurance might cover. We have had that success before and it was with another insurance. Good luck.
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Avatar_n_tn
What is a good insurance place?  We don't even have maternity or anything to do with pregnancy/giving birth on outs.  Anthem blows!!!!!!!!!!  Obviously we are switching (before I get pg hopefully) and don't know what company to try.  We are in Indiana.  THANK YOU!
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Avatar_n_tn
I'm in Indy...my husband was really dreading and putting of his SA.  He waited until the last minute...my dr prescribed clomid for me on a monday to start on Wed, but said I couldn't start until my husband had his SA done....sooo....I called the place for him, set it up, and he was able to do his business at home and drop it off on his way to work.  He is such a shy guy about stuff like that, and of course, the girl he dropped it off with was "good-lookin" as he put it, so that made him more embarrassed.  I'm terrible cause I just laughed.  We women go through so much and have everyone and there momma looking at us, so I think that is the least they can do...although, I must say, I would be so embarrassed too...poor guy-  I don't know about your insurance because ours doesn't cover ANTHING, not even diagnosing, to do with infertility.  Like I said, majorly stinks!
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Avatar_n_tn
My insurance doesn't cover anything with treatment, but it covered diagnosis (thanks alot!).   But I needed a laparoscopy done and I told my doctor to submit it as a necessary procedure to rule out endometriosis for pelvic pain.   I told them, truthfull, that my cycles are painful.   The insurance company should cover it, if you need that, for the pain.   Hope that helps a little.
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Avatar_n_tn
Where are you in Indiana, hawki... that's where I live too! I have horrid insurance for babymaking as well :o) After this month (if no success) my husband has to have a SA... how much does this cost and does insurance cover THAT at all that you know of?? He's really looking forward to it *wink*... how did your husbands do?
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Avatar_f_tn
I called this morning and they said that I only have basic infertilty coverage and it covers only diagnosis, but I will call again and ask for the infertility number. thank you for the tip.
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Avatar_n_tn
I also have Aetna insurance...and all you have to do is have your doctor recommend things as a last resort...due to infertility and they should cover at least some of it...that is what my Dr did with me...the covered 75%...which is def better than nothing.
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Avatar_f_tn
I think that is what I'm going to have the doctor do, pass it on as diagnoses...etc. so they can atleast help with some of it, at least with the ultra sounds etc and hopefully the iui's...
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Avatar_f_tn
Thank you I called that number and they said I only have basic, and that they only cover diagnosis no treatment or inseminations, I wonder if once the doctor says that its the only way for me to get pregnant if they would appove medications and iui.
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151928_tn?1275710937
I wonder why if you have Aetna and so do I that I have it covered and you don't?  Weird.  I live in Arizona...maybe it's a state thing?? If your doctor can get it covered, then I would ask them as anything will help!!!
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Avatar_f_tn
Yeah maybe a state thing.  Well I will ask the doctors office to see in which way they can help...no matter what I will try to find the way to go on with our plans of conceiving....thank you so much for your tips.
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151928_tn?1275710937
The Aetna Fertility number is 800-575-5999.  If your policy is part of this, they cover all testing, meds (clomid or injectables) and up to 6 iui's (if your FSH is 19 or less) and that is why I had to do the clomid challenge test.  Thank god it came back good.  Hope this helps!  I wouldn't have even known this but someone on this board previously wrote about it so then I did some research and found out we were covered!
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Avatar_n_tn
IT IS A STATE THING THERE ARE CERTAIN STATES THAT MAKE IT MANDENTORY TO COVER INFERTILITY. I LIVE IN MISSISSIPPI IT IS NOT COVERED BY AETNA, BUT ARKANSAS IS COVERED BY AETNA SO IS MARYALND. THE REASON BEING IS THESE STATES HAVE MADE IT A LAW TO COVER INFERTILITY COST (IVF AND IUI) AND THERE ARE OTHER STATES BESIDES THE ONES I MENTIONED I THINK IT IS 13 STATES THAT HAVE REQUIRED INSURANCE COMPANIES TO PAY FOR INFERTILITY TREATMENTS NOT SURE HOPE THIS HELPS.
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Avatar_f_tn
Wow. I have Aenta PPO, and I live in California. Now I'm wondering if my insurance will cover IUI's. I'm about to have one done after my U/S this coming Saturday, 1/16/07. My RE told me that if the follicles are mature enough, they will give me a shot to make me ovulate, followed by doing the IUI.

Thank you for providing the number. I will call them and find out if I too, am covered for IUI and such.
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Avatar_f_tn
Thanks for the phone number for Aetna.  My wife and I have two boys, but have been trying to add #3 for 5 years.  Unfortunately, I am a procrastinator, and am finally getting around to professional medical help.  

I was hoping things would change, and a pregnancy would happen naturally.  Now, I am sad that I let so much time slip away. I would encourage other couples out there that want a baby not to wait so long, but to find a way to afford it.  I wish I had.

Matt  
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Avatar_f_tn
Even if it won't pay for the medications and the insemination, it should pay for the office visits, ultrasounds and blood work.
The insemination isn't that expensive in the scheme of things, between $100 on the low side and $300-400 on the high side. The ultrasounds add up bc you go multiple times to have your follicles checked (at around $175-250 an ultrasound) so if they submit the ultrasounds, office visits and blood work as diagnostic, you can save a bunch. And they are diagnostic-- the only actual treatment is the insemination and fertility meds.
I had one dr tell me I had to buy a cash package because insurance wouldn't pay but then they also submitted it to my insurance (I got the statement) and my insurance paid so I was reimbursed (after a few phone calls).
Good luck!
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Avatar_f_tn
Hi,  We just met with Dr Henry in the Indianapolis area and our Insurance is with Anthem.  My husband is a pipfitter, so I was curious as to which Anthem you have.  I havent checked to see if any IVF cost will be covered by our Anthem Plan.
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