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U.S. Health Insurance Issue

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#1 Melissa182

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Posted 21 March 2016 - 05:12 PM


My insurance only covers the cost of one embryo being transferred. I am 40 and three different doctors recommend transferring 2-3 embryos. One doctor wrote a letter asking for BlueCross/BlueShield (BCBS) to cover the transfer of more than one embryo and it was denied. I spent literally 75 minutes on the phone with BCBS today going over coverage. It was exhausting and got me so mad. Here is why:

The first time I called, I was told that each part of the IVF process is considered a "service" and that I WOULD get coverage for everything BUT the multi-embryo transfer.

For example, ICSI is a "service", an ultrasound is a "service", and the actual embryo transfer is a "service".  So, all of the steps leading up to the actual transfer would be covered.

Last July, I did an FET and BCBS DID cover certain "services" like the ultrasound and thawing of the embryos and then they denied coverage of the actual transfer of more than one embryo (I transferred two).  I confirmed that the same thing would happen with a fresh IVF in April and was told "yes". That means that the drugs and assisted hatching would be paid for by BCBS and the embryo transfer would be paid by me. I was happy with that answer. 

Then, I called back to request to have it in writing and I was told that if I transferred more than one embryo then ALL services would be denied.  I spent forever trying to connect with the woman I had originally talked to, and never got her.  I am so angry and worried now.  There is a $10,000 difference in cost between the two scenarios. 

Has anyone been in this situation? Only having coverage for one embryo to be transferred under BlueCross/BlueShield?

#2 ladylazarus

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Posted 21 March 2016 - 07:33 PM

No advice - just sympathy. I assume the first person you spoke with was correct and the second person was wrong. It happens way too often with that sort of thing. I hope you are able to reach that original woman and get the answer in writing. Insurance companies are the worst.

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#3 Melissa182

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Posted 21 March 2016 - 08:27 PM

They are! Thanks, Ladylazarus