Hello! Trying to figure out what my insurance is going to cover

[Harleyquinn]

It's been awhile since I've been here- January I started having a lot of abnormal bleeding- I bled almost the entire month, so I decided to go ahead and make a DR appointment earlier than planned. I called early Feb and the earliest they could get me in was March 9th - so the appointment is coming up.

Today they called to verify what the appointment was for- apparently the girl didn't put a reason in the system....so I told her again about the bleeding and also told her I also wanted to discuss with the dr that I've been ttc for almost a year now with no luck and I'm in my mid-thirties.

The girl said I needed to check with my insurance to make sure anything fertility related would be covered- but that she confirmed the appointment for the bleeding. Now, I am 33 years old and have always held insurance through my employer- but rarely use it- I go to the dr way less than I would like to admit- so I have not spent a lot of time learning what everything means........but I checked at my health insurance website and it says:

Infertility:

Covered Health Services for infertility services and associated expenses including:
● Diagnosis of an underlying medical condition that causes infertility when provided by or under the direction of a Physician;


Diagnosis covered with copay depending on the provider type.


Genetic Testing and Counseling is covered

Lifetime max equals 6 treatments for Artificial Insemination. Only the following services applies to 6 treatment maximum: Artificial Insemination; Intra Cervical; Artificial Insemination; Intr (IUI); Sperm Washing for Artificial; Sperm Isolation, Simple; and Sperm Isolation, Complex

The following services are not covered:
associated expenses for infertility treatments including:
● In vitro fertilization
(IVF);
● Gamete intrafallopian
transfer (GIFT);
● Zygote intrafallopian
transfer (ZIFT);
● Embryo transport; and
● Donor ovum and
semen and related costs including collection, preparation and storage of.
● Infertility Services
and Treatment.

So I get what it's saying about what's not covered - but a little confused about what it's saying IS covered. Anyone good at translating insurance? Haha also, should the dr office be helping me figure out what's covered and what's not or is it normal for them to say go figure it out ?

 

[Flueky88]

It sounds like your insurance covers the testing to diagnose any possible infertility issues. Blood work, hsg, etc. You may just want to call your insurance to verify if that's correct though.

 

[Harleyquinn]

thanks =) I'm going to try calling them today just to be sure =)

 

[Flueky88]

No problem, good luck and

 

[2ducks]

Dude, where have you been?!?!?!?!

I can never figure out insurance stuff BUT the good news is that if you do end up with a bill your doctor can't charge interest. Most offices are good at having payment plans.

 

[Harleyquinn]

Hi 2ducks!!

When I started having that unexplained bleeding in Jan we put a hold on ttc until I see a dr. And they had no availability until March! It felt like forever when I made the appointment but now it's coming up next week =)

Hopefully I can convince the Dr to be aggressive- I'm 33 and don't want to take a slow approach at this point haha

I'm glad to be back here now tho!! ❤️

 

[2ducks]

So sorry for your troubles, keep us posted on your appointments.

 

[Harleyquinn]

thanks =) I definitely will.

 

[Mrs. Atole]

What insurance? if I may ask?

 

[Harleyquinn]

Hi Mrs Atole =)

United Healthcare