insurance question

[magzs1112]

i have blue cross blue shield, and wow have they been good to me!!  they covered all the tests i've had to do, including the HSG, sonohystergram(had it done twice), all ultrasounds, bloodwork, injections, etc.  nothing major was found and they classified me as a "pre-existing condition"  where my uterine lining doesnt sluth off after my peroid.  so my question is how come they wont cover the iui's?  has anyone's insurance covered this?  in nebraska the iui is 350, and i think i can only handle like 5 rounds!!!  think i should give them a call?  any inputs?

[maybebaby29]

Check your state. In some states, procedures are required (up to 4 IVF lifetime) and yes, that includes IUI. If your employer has over 50 employees and is part of this manditory state requirement, then you're all set. I got lucky. Mine was covered.

I saw the original bill, I think the IUI (including washing, etc) was $800.

[mim181]

I have Blue Cross HMO and after 2 years ttc was refered to a RE.  BCBS gave me a referal to WIN Fertility-I think they are a subunit of Blue Cross? and ALL of my fertility expenses have been covered 100%-IUI's, labs, hystercopy, lap, It also covers 3 IVF attempts if needed.  I pay a RX copay of $15 for my follistim injections/progesterone and they are mailed to me monthly.  WIN Fertility may be worth checking into.      

[rene67]

I have Blue Cross and my plan does not cover treatment (like IUI or IVF), just diagnostics (so yes, bloodwork, ultrasounds, etc.).  Its about $400 for IUI (haven't done one yet).

They did cover my Femara.  And although I was supposed to pay 50% of a hysterscopy, I paid nothing.  It all depends on how your doc codes the procedure I guess.

[dnikki0928]

We have insurance through the military, and although they are awesome for regular doctor visits, surgery, etc... I have to pay out of pocket for my bloodwork (estradiol and beta), ultrasounds until they send me a check to reimburst it, fertility meds (triggers, clomid - whatever they are) and the IUI's.  The IUI's are 195 each time and the bloodwork is 60 each time. I think u/s is 90 or 95... When I resigned from my job (we had bcbs - freaking awesome!) we just wanted to go independant on bcbs - OVER 1200 A MONTH due to "pre-existing" conditions and because we have sealed health documents at our RE's office. So.... hopefully something works SOON!

Good Luck!!

[MamaTina89]

We have BC/BS too and BOY let me tell ya....thay rock!!! I was told they would not pay for the HSG trigger shot so, I was prepared to pay $80.00 for it and "Tada"...it only costed $12.25!!! Love them!!!

[alikat1205]

my ins. covered all the diagnostic testing, but no fertility treatments.

[Cheesecake7]

I used to have BCBS. It depends on the plan of course, and what your employer has opted to cover.  But here was my experience, they covered exactly what you described that they covered for you, but those things are all considered diagnostic. The HSG, SHG, bloodwork, ultrasounds, all diagnostic. IUI's and IVF are treatments, treatmeants for a diagnosed condition (infertility).

When I was being treated each monthly cycle I had an IUI and an ultraound. The insurance paid for the ultrasound each month, but not the IUI, that was out of pocket.

I know it sounds wackier than taffy, but that is how it was explained to me. Each time that I called BCBS to question this they explained to me that they do not decide whether something is covered by the actual name of the procedure, but by the diagnosis code that your doctor uses when billing it. Everything the doctor does is billed using a numerical sequence that is code for a diagnosis. For example, all of my ultrasounds were billed under the numerical sequence that stood for the diagnosis "habitual aborter unspecified" and "ovulatory disfunction."   Never was a billing code used for "infertility" when they billed my ultrasounds, if they had used that code it wouldnt have been paid for because I dont have infertility coverage. Does that make any sense? I feel like that is masivly confusing. Bottom line: it cant hurt to call BCBS.

[BabyBlue07]

My insurance does not cover for any fertililty treatment.  Some medicines they cover, some they are not.  IUI or IVF is out of the question.  

I did have IUI done and it's cost $350.

[basill1970f]

I would most certainly get the billing or hckpck codes for the iui procedure, then i would call your blue cross provider and inquire into the circumstances etc.  If its not a covered benefit you can ask the associate if there is anything your dr can do like a letter of recomendation for the procedure etc.. i wish u all the luck in the world. i paid cash for my ivf and for my tubal reversal, but now blue cross should pick up anything else..