When an insurance company (such as Kaiser) covers infertility treatments (such as IUIs) do you have to be diagnosed "infertile" or does it also cover alternative relationships wanting to have IUIs (when you dont have infertility problems)?
2007-08-07 05:37:29 · 6 answers · asked by lori and cassi s 1 in Pregnancy & Parenting ➔ Trying to Conceive
Some do, some don't. I know that isn't really a straight answer, but it's a really tricky situation. However, for the most part, it shouldn't be a problem. The billing codes will be the same for the IUI reguardless of why it is being done. However, if the insurance company asks for additional info then the dr will have to give a medical reason or say it was nonmedical reasoning. They may or may not pay, but you can always appeal. Also, get a copy of your helathcare certificate and read it very carefully for wording.
2007-08-07 05:45:58 · answer #1 · answered by jilldaniel_wv 7 · 0⤊ 0⤋
That is tricky. Most insurance companies only cover treatments when a fertility issue is diagnosed and a couple has been ttc for over 1 year. I don't think they will cover alternative relationships wanting to get pregnant. Same as they wouldn't cover adoption. There are alot of companies that don't cover any fertility issues and there are a lot of specifics to get the ones that do cover some procedures to pay. I would look through your inurance policy or their website or call them to find out for sure. Good luck
2007-08-07 05:45:41 · answer #2 · answered by HONEYB1 6 · 1⤊ 0⤋
I understand your frustration. we are on the beginning up of our fertility treatments with our expert and our coverage does not conceal any fertility finding out, treatments, recommendations or medicaitons. not something in any respect!! We additionally stay in a sort of states that mandates infertility coverage yet guess what there are loop holes. Your coverage employer's considerable workplace ought to be placed interior the state the has this regulation. nicely our coverage employer is placed in PA so it does not could conceal absolutely everyone for infertility. I called our wellness branch in our State Capital and that they reported this mandate helps very few people easily through fact the extra beneficial coverage companies will in simple terms circulate their workplaces out of those states. So the lady reported till each and every of the state mandate coverage then there isn't something which would be achieved. I understand to an volume why coverage companies do not conceal through fact it is not a medical necessity to reproduce yet I do think of they might conceal the finding out to ascertain the reason/prognosis. on the grounds that's a medical condition. the excuses they don't choose to conceal is first they have little potential to computer screen who does and does not want fertility treatments. as an occasion if a pair is impatient they are in a position to lie and say they have been ttc for over a year while they have not and then undergo unneccesary finding out and coverings. additionally there is extra danger of multiples being born and which could upload hundreds of hundreds of greenbacks in medical expenses and fees in the event that they are born early. So if the healthcare expert's and coverage companies ought to artwork out a plan of action as to a protocal of diagnosing and treating sufferers for infertility then it ought to artwork extra acceptable. we've spent around $3,000 out of pocket and we've in simple terms had one medical care cycle so a techniques. that's a stressful concern for some to handle. terrific desires to you!!!
2016-10-09 10:10:02 · answer #3 · answered by ? 3 · 0⤊ 0⤋
with my insurance, they had to provide documentation as to testing that they have done to prove that there was an issue. the insurance company needed a lot of background paperwork. you may want to check with where you're going for the IUI to see what they say. they will usually call up your insurance to check what is covered.
2007-08-07 06:01:56 · answer #4 · answered by techgirl2007a 3 · 0⤊ 1⤋
Well, since lack of sperm is a definite medical problem that many infertile couple face, and that is the problem you are having, I don't see why it should be a problem. If the insurance company asks what the issue is, your doctor can report it is azoospermia.
2007-08-07 06:35:03 · answer #5 · answered by MissM 6 · 0⤊ 1⤋
Clomid is an non-steroid anti-estrogen. Mechanism of its action consists in a specific binding with receptor for estrogen in ovary and hypophis. In patients with low estrogen levels in organism it causes estrogen effect and in ones with high estrogen levels it causes anti-estrogen effect. Its small doses increase secretion of gonadotropins (prolactin, Follicle stimulating hormone, FSH and interstitial cell-stimulating hormone), stimulates ovulation; in large doses slows secretion of gonadotropins. In the whole action of Clomid consists in stimulation of ovulation to occur and prepares the body for pregnancy. This medication may be used for male patients with infertility caused by low production of sperm.
Clomid is administered to stimulate ovulation 50 mg 1 time a day at bedtime, starting from 5th day of the menstrual cycle during 5 days (in the absence of the cycle - at any time). In case of no effect (ovulation does not occur within 30 days) increase the dose to 150 mg / day or lengthen the course to 10 days. Take exactly as prescribed, do not take the medication in larger quantities.
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2014-10-27 10:09:53 · answer #6 · answered by ? 3 · 1⤊ 0⤋