Is it difficult to get Medica to approve infertility tests and procedures?

Question

Just wondering about everyones stories?

I have insurance through my husbands employer, not the State.

Also, it states in our provider manuals that they will cover infertility treatment, but you need prior authoriaztion first, I was wondering how difficult it will be to obtain this authoriazation.

I have Medica, which is a brand of insurance through my husbands employer, not Medicare, which is a federally funded program. We are financially sound. Again, we have MEDICA. Which is similar to Blue Cross, but is is a different provider. Medica.

Answer 1

Usually it's difficult to get Medicare to approve anything they deem unnecessary. For example they include a lot of dental work to be cosmetic and unnecessary including missing teeth (unless they are the first four teeth in the front!)

Infertility tests and procedures may be considered unnecessary, depending on what you are talking about. They may pay for some exams and blood tests but I'm sure they won't pay for IVF or fertility drugs. And I must ask this question - if you are in a financial position where you need help from the state - maybe it's not the best time to plan to have a baby and all the added expenses that go with babies and parenthood?

Edited to say: OK Medica...not familiar with them. You will have to call them I guess to find out for sure. Prior authorization usually means you have to meet their criteria like: you've been trying for so long and failured, you've tried certain other things first, they may even have age and health requirements.

Answer 2

Do you mean Medicare? Or is Medica your brand of insurance?

No offense, but if you're on Medicare, you probably shouldn't be having children. Wait until you can pay for yourself before you bring others into this world.