I have now been ttc for 14-15 months now, I live in texas and am under blue cross blue shield. I'm now starting to book for regular blood test with my Gyno, and was wanting a Hsg test done as well, anyone know the price range, or if insurance covers?
Below is some info about infertility mandate in texas. It doesn't say anything about infertility testing however, and talks only about IVF. Its best to call your insurance company and see if its covered. Some states require insurance to cover IF and some dont.
Tex. Insurance Code Ann. Section 3.51-6, Sec. 3A
Definition of Infertility/Patient Requirements
* Requires group insurers to offer coverage of IVF. Employers may choose whether or not to include infertility coverage as part of their employee health benefit package
* If an employer chooses to offer the benefit, patients must meet the following: the patient for the IVF procedure is the policyholder or spouse of the policyholder; the patient’s eggs must be fertilized with her spouse’s sperm; the patient and the patient’s spouse have a history of infertility of at least five continuous years or associated with endometriosis, DES, blockage of or surgical removal of one or both fallopian tubes or oligospermia; the patient has been unable to attain a pregnancy through less costly treatment covered under their policy; the IVF procedures must be performed at medical facilities that conform to ACOG and ASRM guidelines
* No coverage is required. Insurers are only required to offer IVF
* Does not require religious employers to cover infertility treatment
* Employers who self-insure are exempt from the requirements of the law
I read that same article last night, and i looked into my husbands benifits in BCBS and it said it does not cover IVF. And doesnt say if it covers any testing. I know it covers blood test and such, just can't figure out for HSG testing.
I have BCBS (california) and my doctor wanted me to get a HSG test so I made some calls. If the reasoning for the test is submitted under Infertility it will most likely not be covered at all. Most insurance companies don't cover that. I called the place where the test is done and they told me it was $850.
If I were you I would call your doctor and ask what diagnosis they are submitting the test under, then call your insurance to verify. It is really the only way to know for sure.
I assumed it was submitted under infertility but my doctor actually gave me a different diagnosis so as it turns out I am partially covered for the test. (gonna hold off for now though)
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