I have Blue Cross Blue Shields and when I called they don't cover anything dealing with infertility BUT?

Question

my friend has it and they are covering her for all kinds of treatment.When I called the clinic they said they do take Maryland Blue Cross Blue Shields.What's the difference?My insurance is through my job BUT I pay $138.00 a PAY pd for this insurance.Can someone explain the difference to me please!

Answer 1

It is the type of Bluecross/BlueShield you have. Just because your employer has you pay for it doesn't mean that it covers it. They may not have that plan available to them for whatever reason or just didn't opt for it. I have "Bluecross/Blueshield Preferred PPO" in Florida and it covered everything, and our prescription plan covered all medications which many insurances don't cover. Sometimes in order to check coverage you need the procedure number. Your doctor can provide you with that. Also, some clinics offer flyers from companies that finance infertility treatments, or maybe you could look that up on line. I have seen the flyers at my doctor's office. Possibly, your employer offers more than one type of insurance, if you can find out what all the types cover and change your enrollment before you start treatment that may be an option. I would also check with your prescription coverage holder because the medications can be very expensive. Some are upwards of $6,000.00 for one cycle. I won't tell you that it is not worth it. It is worth it. I hope everything works out for you.

Answer 2

I work at the Blue Cross Blue Shield in my state. IVF Therapy is very expensive. There are a variety of reasons why your health insurance carrier may not cover these types of benefits. Our state only covers them as a result of my State mandating that we cover at least 80% of the members IVF Therapy including medications. However an employer can have blue cross blue shield - there be a mandate, but the group is 'self-insured' meaning they pay their own claims - not the insurance company and they may not want to incur that expense.

I know it stinks. Call Customer Service and make sure that you don't have the coverage. . . sometimes clinics/doctors 'assume' benefits, but your plan might be different.

If you confirmed with Customer Service that it is a contract exclusion, you have the right to file a complaint with your insurance carrier.

Unfortunately, it does not have anything to do with the amount you contribute to your benefits weekly through payroll deduction.

Answer 3

There are many different plans through Blue Shield. Some pay for part of infertility treatments, some pay for none.

Answer 4

You may have the same insurance but the company that you work for is the one who chooses the coverages that are on the insurance.

Answer 5

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