My insurance doesn't cover IUI or ART, now what? (children + pg mentioned)

**BC-pepper** · 09-23-2009, 12:05 PM

We are ttc #3, have had infertility problems all the way back to 2001. We went through 3 failed IVFs, then gave up and chose to adopt. Then we were surprised with a healthy pg. Now I would like another, and have had no luck in the past 1.5 or so years of active ttc. We had insurance before and hardly spent a dime. Now it's different - I just found out there is NO coverage for anything but the treatment of underlying conditions. What does that mean? Can anyone explain?

I am torn, because up until now I was fine with ttc naturally. I have an appointment tomorrow morning with an RE. I was going to refuse SAs, IUIs, IVFs, etc. because dh doesn't want to be involved. It was very heartbreaking to have IVF fail 3 times. I have been having issues with my cycles that GYNs and an Oncologist have poo-poo'd away. I am hoping that the RE can help clear up the problems and I can have normal cycles with balanced hormones which will hopefully lead to a natural pregnancy. Will they even listen if I tell them I don't want any part of the high-tech options?

Thanks for listening,
Kelly

CrystalAZ · 09-23-2009, 12:20 PM

I don't know the answers, but if you have unblocked tupes and can get pg, you should be able to just do Clomid to help you produce follicles so there is a higher possiblity of getting pg.

As far as treatment of underlying conditions, I would assume that means if you have pain from endometriosis or other problems related to infertility, that the insurance covers resolving the pain, but not addressing the infertility.

I hope you get some answers at your appointment. Hopefully the RE understands your concerns and has some options for you.

Crystal

**BC-pepper** · 09-23-2009, 12:40 PM

Thanks Crystal. I am trying a special Infertility Services phone number, from the doctor's website, for my insurance company. I'm sure I won't get a different answer but maybe they know more than the general line. My tubes are unblocked as of February 2009, but one was blocked or spasm'd in November 2001.

Hopefully I won't have to pay an outrageous amount for tomorrow's consult. My cycles have been on the heavier/longer side and come 2-3 weeks apart. Hopefully I can get some really extensive blood testing to see if there's something they can fix.

**BC-pepper** · 09-24-2009, 07:38 AM

Dern, they won't cover anything and going to the RE sucked. I'm sure she is very good but not for low-tech/no-tech. At least I got a list of blood tests they wanted done. I can have them done at my GYN and go from there. My insurance won't even cover clomid! Too bad it's not on the $4 list at Walmart... I really hope there is something out of whack with my hormone levels and can be fixed with something simple. If nothing else, I hope my cycles can get back on track.

futuremother · 09-24-2009, 10:04 AM

Good luck with it. I sympathize. Our insurance only covered "diagnostics" and it sux big time. We are looking at maybe affording injectibles, a single IUI and lots of prayer...

Look into the many infertility herbs and alternative treatments out there too. Depending upon the trouble, they might help to regulate your hormones. You never know!

**BC-pepper** · 09-24-2009, 10:12 AM

I have tried herbs on and off, not consistently though - taking multiple pills a day makes me want to yack LOL. I am going to be calling a holistic medicine practice close to me to see if they take my insurance and if they can help get my cycles back on track. I will be having the bloodwork done at the beginning of my next cycle, just not sure where.

Lilitik · 09-25-2009, 10:56 AM

I have the same problems. I have amenorrhea (no/irregular menstruation cycle). Last time when I went to see my new RE, I told him to use a different verbage as far as the diagnoses concern because my insurance does not cover anything associated to the IF. I said, in fact I am not infertile because I did get pg twice. He said ok i'll use the dx amenorrhea, but when we do the IVF, IUI, I won't be able to. I said that's fine because I want my ins to cover at least the labs, u/s, etc before the procedure since the IUI is only $300. I heard of caremark insurance, which covers most of the prescribtion drugs for IF. I am going to look into that more closely. I think that's so unfair from ins side. I don't know what else to do either.

Good luck...
Lil

**BC-MomZ** · 09-27-2009, 11:17 AM

I completely understand your frusteration. Our ins changed years ago and we are not able to ttc again. Luckily we have one child, and he is our world. Good luck!
Julie

09-23-2009, 12:05 PM	#1 (permalink)
BC-pepper 5000-9999 post king of hearts Join Date: Mar 2002 Location: GA Posts: 8,921 Blog Entries: 100	My insurance doesn't cover IUI or ART, now what? (children + pg mentioned) We are ttc #3, have had infertility problems all the way back to 2001. We went through 3 failed IVFs, then gave up and chose to adopt. Then we were surprised with a healthy pg. Now I would like another, and have had no luck in the past 1.5 or so years of active ttc. We had insurance before and hardly spent a dime. Now it's different - I just found out there is NO coverage for anything but the treatment of underlying conditions. What does that mean? Can anyone explain? I am torn, because up until now I was fine with ttc naturally. I have an appointment tomorrow morning with an RE. I was going to refuse SAs, IUIs, IVFs, etc. because dh doesn't want to be involved. It was very heartbreaking to have IVF fail 3 times. I have been having issues with my cycles that GYNs and an Oncologist have poo-poo'd away. I am hoping that the RE can help clear up the problems and I can have normal cycles with balanced hormones which will hopefully lead to a natural pregnancy. Will they even listen if I tell them I don't want any part of the high-tech options? Thanks for listening, Kelly Last edited by BC-pepper; 09-24-2009 at 10:15 AM.

09-25-2009, 10:56 AM	#7 (permalink)
Lilitik 300-399 post 5 of hearts Join Date: Oct 2008 Location: New York Posts: 344 Blog Entries: 1	I have the same problems. I have amenorrhea (no/irregular menstruation cycle). Last time when I went to see my new RE, I told him to use a different verbage as far as the diagnoses concern because my insurance does not cover anything associated to the IF. I said, in fact I am not infertile because I did get pg twice. He said ok i'll use the dx amenorrhea, but when we do the IVF, IUI, I won't be able to. I said that's fine because I want my ins to cover at least the labs, u/s, etc before the procedure since the IUI is only $300. I heard of caremark insurance, which covers most of the prescribtion drugs for IF. I am going to look into that more closely. I think that's so unfair from ins side. I don't know what else to do either. Good luck... Lil __________________ ♥♥Lil 26♥♥DH 33♥♥ TTC on and off for 5 years 4 Clomid cycles 2008- BFN Simple IUI 2008- BFN M/C January 2008 IUI #2- 10/22/09 with Clomid and Ovidrel shot BFP on 11/4/09 (HPT) Beta #1- 5.2 Beta #2- 41 Beta #3- 239 U/S on 11/14/09- 5w4d- 1 lil bean Every baby begins the world again.

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09-23-2009, 12:20 PM	#2 (permalink)
CrystalAZ 10000-15000 post ace of hearts Join Date: Nov 2004 Location: Phoenix AZ & Flagstaff, AZ Posts: 10,835 Blog Entries: 455	I don't know the answers, but if you have unblocked tupes and can get pg, you should be able to just do Clomid to help you produce follicles so there is a higher possiblity of getting pg. As far as treatment of underlying conditions, I would assume that means if you have pain from endometriosis or other problems related to infertility, that the insurance covers resolving the pain, but not addressing the infertility. I hope you get some answers at your appointment. Hopefully the RE understands your concerns and has some options for you. Crystal

09-23-2009, 12:40 PM	#3 (permalink)
BC-pepper 5000-9999 post king of hearts Join Date: Mar 2002 Location: GA Posts: 8,921 Blog Entries: 100	Thanks Crystal. I am trying a special Infertility Services phone number, from the doctor's website, for my insurance company. I'm sure I won't get a different answer but maybe they know more than the general line. My tubes are unblocked as of February 2009, but one was blocked or spasm'd in November 2001. Hopefully I won't have to pay an outrageous amount for tomorrow's consult. My cycles have been on the heavier/longer side and come 2-3 weeks apart. Hopefully I can get some really extensive blood testing to see if there's something they can fix.

09-24-2009, 07:38 AM	#4 (permalink)
BC-pepper 5000-9999 post king of hearts Join Date: Mar 2002 Location: GA Posts: 8,921 Blog Entries: 100	Dern, they won't cover anything and going to the RE sucked. I'm sure she is very good but not for low-tech/no-tech. At least I got a list of blood tests they wanted done. I can have them done at my GYN and go from there. My insurance won't even cover clomid! Too bad it's not on the $4 list at Walmart... I really hope there is something out of whack with my hormone levels and can be fixed with something simple. If nothing else, I hope my cycles can get back on track.

09-24-2009, 10:04 AM	#5 (permalink)
futuremother 0-99 post 2 of hearts Join Date: Aug 2009 Posts: 12	Good luck with it. I sympathize. Our insurance only covered "diagnostics" and it sux big time. We are looking at maybe affording injectibles, a single IUI and lots of prayer... Look into the many infertility herbs and alternative treatments out there too. Depending upon the trouble, they might help to regulate your hormones. You never know!

09-24-2009, 10:12 AM	#6 (permalink)
BC-pepper 5000-9999 post king of hearts Join Date: Mar 2002 Location: GA Posts: 8,921 Blog Entries: 100	I have tried herbs on and off, not consistently though - taking multiple pills a day makes me want to yack LOL. I am going to be calling a holistic medicine practice close to me to see if they take my insurance and if they can help get my cycles back on track. I will be having the bloodwork done at the beginning of my next cycle, just not sure where.

09-27-2009, 11:17 AM	#8 (permalink)
BC-MomZ Board Coordinator Join Date: Jan 2002 Location: New England Posts: 7,583 Blog Entries: 385	I completely understand your frusteration. Our ins changed years ago and we are not able to ttc again. Luckily we have one child, and he is our world. Good luck! Julie