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Anyone have Aetna?

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  1. #1
    SeattleSuz
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    Anyone have Aetna?

    I am curious with MF, if Aetna's "infertility testing and treatment" applies to men.
    Has anyone had any experiences with infertility and Aetna??


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  3. #2
    abby26
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    Hi, I have Aetna- but what is covered in relation to infertility is up to your employer. When my DH had all his stuff done we had different insurance, aetna is actually a little better. Insurance usually pays for SAs, they paid for his testicular ultrasound and hormone level blood work. The urology office told us they would not pay for the testicular biopsy, but they did except for a $100 copay. Aetna pays for my u/s (for ivf) and I was surprised to find they paid for my meds, all but about $200. Always have everything submitted. just on case
    good luck


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    gsbanks
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    I have the Aetna PPO. I have had my varicocele surgery and follow-up embolization paid for almost 100%. Along with that I had 4 SAs done and I only had to pay a very small amount for each.

    My plan has a lifetime $25,000 maximum for fertility. It does, however, say that it excludes drugs.

    I am currently trying to figure out if they will pay for cyctic fibrosis carrier testing (our RE recommended this). The first time I called they said it was covered..the second time I called back with the CPT (procedure) codes and they said there had to be a reason for doing it (whatever that means). My RE is going to write a letter and we'll see what happens.

    Stacey


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    LSteele
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    My plan also has a $25,000 lifetime limit for IF stuff -- sounds like a lot, but essentially it covered two IVFs, that was it. Guess I was lucky any insurance plan covered any of it, though...


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    SeattleSuz
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    Abby, your DH had a testicular biopsy? My DH's urologist recommended that, but said it didn't have to be done. How did your DH deal with the biopsy?


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    SeattleSuz
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    Yeah I have the Healthfund PPO and I have read the Clinical Policy Bulletin on the Infertility "testing and treatment" and it looks as though so long as you qualify under their guidelines, that it's (treatment) covered.


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    abby26
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    As far as the CF testing, my insurance (cigna at the time, my employer changes or plan almost every year) paid since we had a reason-- azospermia. We just tested me, since if I am not a carrier it doesn't matter if DH is or not. I wasn't too worried about CF being the reason b/c DH is healthy and fathered a child with his first wife, so my thinking is it is not a genetic thing. Just make sure they code it right. My OB looked it up to make sure she put the right one.
    The testicular biopsy was necessary for us b/c it was the only way to get sperm. We didn't even know if they would get any, but thankfully they got a lot. I won't lie, DH was in pain as soon as he woke up. it was done on a Friday and he did go to work on Monday, but came home early. I think if they just do an aspiration, instead of actually cutting the scrotum open it's not as bad.
    Tomorrow we are meeting with another urologist who specializes in microsurgery to see if there is a blockage that can be repaired. I want to check this out before we sink anymore $$$$$$ into ivf.


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    SeattleSuz
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    Quote Originally Posted by abby26
    As far as the CF testing, my insurance (cigna at the time, my employer changes or plan almost every year) paid since we had a reason-- azospermia. We just tested me, since if I am not a carrier it doesn't matter if DH is or not. I wasn't too worried about CF being the reason b/c DH is healthy and fathered a child with his first wife, so my thinking is it is not a genetic thing. Just make sure they code it right. My OB looked it up to make sure she put the right one.
    The testicular biopsy was necessary for us b/c it was the only way to get sperm. We didn't even know if they would get any, but thankfully they got a lot. I won't lie, DH was in pain as soon as he woke up. it was done on a Friday and he did go to work on Monday, but came home early. I think if they just do an aspiration, instead of actually cutting the scrotum open it's not as bad.
    Tomorrow we are meeting with another urologist who specializes in microsurgery to see if there is a blockage that can be repaired. I want to check this out before we sink anymore $$$$$$ into ivf.
    So, did they knock him out to do it then??


  10. #9
    abby26
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    For the biopsy he was under heavy sedation, but not general anesthesia.


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    Just found out that my insurance DOES NOT cover ART under any circumstances..... Not sure what I am going to do now.


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