A Million Questions..Need Some Guidance


#1

My DH and I have been trying to conceive for just over a year and recently had our first IUI and just got my :bfn: a couple of days ago. Its a little frustrating considering all of our test results have come back normal, they cannot find anything wrong with either of us, but we still can’t get pregnant. One test they have [B]not[/B] done is the HSG; my insurance will pay for the procedure, but since they are using the diagnosis code of infertility, they won’t pay for it. So my first question is, has anyone found a way to get their insurance to cover this procedure? The office said w/o insurance the cost is about $2500, is that what most of you have seen? Are there many women out there that have [B]not [/B]had this test done, but were still successful with IUI? After having the first IUI come back negative the thought of IVF has now come into play, and we are very nervous to move to IVF (if it comes to that) because we have heard the cost can be astronomical. Can anyone give me an estimate for IVF costs? To top all of this off, literally ALL of my friends are pregnant or just had kids. I put on a happy face, just threw one friend her baby shower, but how do you continue with the happy face month after month, negative after negative…any advice? Thanks everybody for your help! Sorry for the giant list of questions!!


#2

What is your insurance’s stance on covering fertility? Mine will pay for diagnosis but not treatment. At first they refused the HSG bill ($600), but after the doctor wrote them a letter and explained it was part of getting me a diagnosis for infertility they covered it. It took several months and a bunch of phone calls, though.
I paid 15k for my ivf. I saved up for a year before doing it, and once I did it I didn’t miss the money at all. I’m glad I did it that way rather than charging it, because then I wouldn’t have had any money to buy stuff for my pregnancy and the baby! Good luck to you :slight_smile:


#3

[QUOTE=Kat1983]My DH and I have been trying to conceive for just over a year and recently had our first IUI and just got my :bfn: a couple of days ago. Its a little frustrating considering all of our test results have come back normal, they cannot find anything wrong with either of us, but we still can’t get pregnant. One test they have [B]not[/B] done is the HSG; my insurance will pay for the procedure, but since they are using the diagnosis code of infertility, they won’t pay for it. So my first question is, has anyone found a way to get their insurance to cover this procedure? The office said w/o insurance the cost is about $2500, is that what most of you have seen? Are there many women out there that have [B]not [/B]had this test done, but were still successful with IUI? After having the first IUI come back negative the thought of IVF has now come into play, and we are very nervous to move to IVF (if it comes to that) because we have heard the cost can be astronomical. Can anyone give me an estimate for IVF costs? Toe top all of this off, literally ALL of my friends are pregnant or just had kids. I put on a happy face, just threw one friend her baby shower, but how do you continue with the happy face month after month, negative after negative…any advice? Thanks everybody for your help! Sorry for the giant list of questions!![/QUOTE]

Well I would first call your insuance company to see if they cover testing up until your official diagnosis of infertility. Normally, the very first test besides bloodwork ( which should include transmitted diseases, thyroid, etc.) begin with the HSG and sometimes the RE does a hysterscopy with a biopsy to look at uterus and fallopian tubes. My insurance covered all of this testing.
We did several IUIs which all failed and moved onto IVF. It was the best thing we ever did because time could not be wasted due to my age. I got pregnant on my first ivf transfer with two blasts currently in cryo.

I must say it cost $7500.00 plus $450.00 for anesthesia then the meds were covered under my insurance so we paid $295.00 for the meds. However meds can cost up to $8000.00 depending on what protocol your doctor wants to put you on.

I never wanted to do the ivf injections. However it was the best thing I ever did to have my little one! It all looks scarey at first but it really is just the journey to get your little one.

I remember talking to my Mom and looking at all the the needles. My Mom piped up and said " I could not do what you are doing, I hate needles. I can not even look at them". Then she said this, “Keep your eyes on the prize and you will get there”. The best advice ever because thru it all I did get there and YOU will too!
Everything takes time and try not to stress yourself out too much.

If you need to chat private message me. I will give you any info on my journey that may help you!

Good luck and much baby dust to you!:flower:


#4

Thank you both for the info! It is very helpful! My insurance said they will pay for diagnosis but not treatment unless it is medically necessary for myself. The fertility place I’m going to gave me the diagnosis and procedure codes that would be placed with the insurance company so I could call and see if they would cover it. They said the procedure code they covered but since it was coupled with the diagnosis code of infertility that they couldn’t do it. I called the fertility doc and asked if they could couple a different diagnosis code but they said they couldn’t. I may see if they’ll write a letter like you did…maybe that would work! I just want to make sure they’ve checked everything I guess. When you are spending this kind of money you want to cover everything! Thanks again !!


#5

[QUOTE=Kat1983]Thank you both for the info! It is very helpful! My insurance said they will pay for diagnosis but not treatment unless it is medically necessary for myself. The fertility place I’m going to gave me the diagnosis and procedure codes that would be placed with the insurance company so I could call and see if they would cover it. They said the procedure code they covered but since it was coupled with the diagnosis code of infertility that they couldn’t do it. I called the fertility doc and asked if they could couple a different diagnosis code but they said they couldn’t. I may see if they’ll write a letter like you did…maybe that would work! I just want to make sure they’ve checked everything I guess. When you are spending this kind of money you want to cover everything! Thanks again !![/QUOTE]

I find it hard to believe that they do not have a code which can indicate testing for a dx. Could they use a code which could relate to not ovulating or possible endometriosis? Just something to cover a reason why you are having the test. For instance, if someone needed and MRI done and the insurance company denies it, there are diagnosis codes which they add to original diagnosis to have it covered.