NLIC.org

Debra Said:

Does this sound like insurance would cover fertility monitoring?

We Answered:

What it states is that they will pay for test and procedures to find out why you can't conceive but will not cover procedures that directly help your conceive like IVF and IUI's.

You are also covered for the Endo treatment and management. PCOS is considered infertility so going to your doctor for PCOS won't be covered unless he is strictly diagnosing it. That's because a women can basically like with PCOS and usually only has problems with fertility in relationship to PCOS. Funny how insurance companies don't see our ovulation process as having errors but they will cover heartburn, etc. There are some high up people working to change that but who knows what the changes in healthcare will do to infertility treatment.

Clomid monitoring won't be covered because it's not directly related to diagnosing or treating a covered disease however, if you get a nice doctor like the one I had who was willing to code the monitoring sonogram as checking for ovarian cyst than it would be covered because it would be for treating a covered issue and not a means to help you get pregnant.

The good new is that PCOS has issues which cause infertility such as insulin resistant and thyroid issues so you will be able to get those treated no matter what because they affect your body not just fertility. Also, when I was on Clomid, I found a pharmacy who only charged $12 for 5 (50 mg) pills and that was with zero insurance coverage.

If you have questions about your insurance, call the insurance enrollment dept and just act as if your are interested in getting insurance with them but have some questions about coverage.

Rose Said:

Insurance plans in PA that cover infertility??

We Answered:

There is currently no federal laws in place requiring that insurance companies cover fertility issues . . . but groups like Resolve are trying to push things forward. Right now it is up to the state.

It depends on the state that you live in, where your employer is located etc . . . Currently 15 states in the US mandate some sort of fertility coverage. You can refer to the Resolve Website for info on the states that require coverage. Unfortunately, Pennsylvania is not on the list . . .

http://www.resolve.org/site/PageServer?p…

Be warned even if your state required it - some businesses are headquarted in other states and offer their coverage through another state that may not offer benefits. If they are self-insured it is not covered, and you must meet their qualifications for infertility.

If you cannot find insurance coverage - this might help:
As to paying for treatments - here are some tips:

1) Start with the RE - most doctors have a team that can help you with finding ways to pay for your treatment - they are amazing at figuring out your insurance benefits, coming up payment plans and may even be able to recommend medical studies / clinical trials that you may be able to participate in.

2) Grants -there are groups out there that fund raise for fertility treatments - you need to apply and cross your fingers.

3) Loans - banks and credit card companies (my friend used Capital One) offer fertility loans with fair interest rates and payment plans. Maybe see if you can borrow from a family member.

Here is a great link for you about all types of funding for fertility treatments:
http://www.nobabyonboard.com/options.htm…


Hope this helps!

Cynthia Said:

What do liberals think of my "free market" healthcare plan?

We Answered:

Your plan is very bad and is detrimental to consumers. Insurance companies would love it though.

The insurance companies want to be able to operate like the credit card companies and have their domiciles in states with few regulations. That would enable them to sell to individuals in states with high regulatory standards. That is how credit card companies are currently able to bypass state usury laws and charge consumers outrageous interest rates. Insurance companies would operate similarly and engage in “a race to the bottom” i.e., to operate out of a state with the most minimal consumer protections. That does not help anyone, except the insurance companies.

Most people would not realize how defective their coverage was until they become ill or injured. That is one reason why so many people who currently file bankruptcy due to medical bills are actually people who have health insurance.

In order for selling across state lines to work decently, the federal government would have to institute strict minimum standards of coverage in order to protect the insured. The new legislation addresses this issue.

In addition, I find it interesting that conservatives who are always babbling on and on about state’s rights would support such suggestions which clearly strike down the states’ authority to set minimum standards for the coverage protection of their own residents.

Also, your argument concerning preexisting conditions does not make sense. Of course the insurance companies don't want to cover such people because they anticipate paying out a lot of money in claims. The individual mandate is included in the new legislation in order to try to offset the insurance costs by including more people who tend to be younger and healthier.

You're also confusing the preexisting condition situation with insurance companies dropping insured people after they become ill. They do it all the time. That is well documented. They stay in business, so I don't know what you're talking about. The new legislation addresses that situation also.

Nora Said:

Has anyone used theyre insurance for infertility? Was it a good insurance? Whats the best insurance for that?

We Answered:

i worked for aetna and based and IVF IUI was usually covered based on plan sponser (employer) guidelines.

Harry Said:

california medical insurance?

We Answered:

health-quotes.isgreat.org - my family have this health insurance. It is affordable and has good coverage for dental issues.

Becky Said:

Anyone have health insurance that does not cover testing/treatment?

We Answered:

Pretty much all health insurance companies cover this. It's just a matter of being on the right plan that actually covers it. I'm guessing you're on group. Ask your director of human resources if the company offers other plans than the one you are on.