Can my IVF Cycle be approved by insurance ?

Can my IVF Cycle be approved by insurance ?

Joined: December 14th, 2011, 8:57 pm

June 7th, 2012, 2:35 am #1

I live in MA and has Blue Cross Blue Shield PPO Plan. My Doctor submitted my IVF cycle application last Thursday, since I am turning 40 this year, I also had a CCCT Test. All the tests result meet their Requirements now. But I used to have a high FSH, and the insurance know about it . My application is still pending now. Will my application be approved? Please help!!!
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Mrs McIrish
Mrs McIrish

June 7th, 2012, 2:51 am #2

My understanding is that if you are under 40, they will approve initially. For me, I got approved for IVF 1 in MA even with my FSH being over the 15 "cutoff". I had more trouble for IVF 2 as I had responded poorly in terms of only getting 3 eggs with the first. The RE had to write a letter saying my chances were at least 5%. So they approved it. After that my RE at Brigham kicked me out... These approvals were from Tufts as my secondary. BCBs RI is my primary and they are still covering me with FSH at 25 since I am 38. They don't even have a preapproval process. It is amazing. Not sure if the MA ppo has an approval process but I can't say enough about the RI version. Good luck!
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Joined: December 14th, 2011, 8:57 pm

June 7th, 2012, 1:46 pm #3

I never do IVF cycle before. Do I need submit application every time when I do IVF? I wish I could move to RI.I also see Dr. Check now. Good luck with your treatment.
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Mrs. McIrish
Mrs. McIrish

June 7th, 2012, 2:26 pm #4

When I cycled in MA with my T.ufts insurance, they would only approve 1 cycle at a time so it had to be sent it each time. As for the RI coverage, it is at 80% so your MA coverage is better at 100%. I just don't need preapproval for BCBS RI for some odd reason but I pay 20%.
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Joined: December 14th, 2011, 8:57 pm

June 7th, 2012, 3:13 pm #5

It is still pending. But they pass to another physician to review now. It usually only takes 3 days. Hope I can pass.
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Mrs McIrish
Mrs McIrish

June 7th, 2012, 3:23 pm #6

For some reason, mine always took forever as they fell over holiday weekends so they took like 12 business days to go through. It was torture waiting:-)
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Joined: December 14th, 2011, 8:57 pm

June 7th, 2012, 6:11 pm #7

you usually can have 3 eggs per cycle, and your FSH level is not that high. Do you still need this? I am taking Estradiol pills, and my period is still odd. I may start my first IVF cycle when AF shows up. Good luck!
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Mrs. McIrish
Mrs. McIrish

June 8th, 2012, 2:30 am #8

I only got 3 eggs on IVF#1 and one was immature. Both embryos got the worse possible grade for fragmentation. For IVF2, I only got 2 eggs and the resulting embryos were highly fragmented and really didn't grown (1 and 2 cell for a 2dt). For IVF#3, I got 2 eggs but one was dead and the other was immature and the embryo didn't grow past one cell. My FSH is almost 25 without "help". It was 10.5 on CD2 this cycle only because of the estrogen patch and the estinyl from Dr. Check.. Without estinyl, it would likely be in the 20's, if not higher at this stage. The last time it was tested without estinyl was in February when it clocked in at 24.3.
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JP
JP

June 8th, 2012, 6:30 pm #9

I live in MA and has Blue Cross Blue Shield PPO Plan. My Doctor submitted my IVF cycle application last Thursday, since I am turning 40 this year, I also had a CCCT Test. All the tests result meet their Requirements now. But I used to have a high FSH, and the insurance know about it . My application is still pending now. Will my application be approved? Please help!!!
I'm in MA. For me, I was approved when my FSH was below 15 but then went it went up to 23 I was cut off from insurance coverage. I tested every month at my clinic after that reading and they didn't send the results to the insurance company untill it was just below 15 again which took a few months. Once it went back down I was covered again. I'm sure each plan is different but hopefully you can do the same. It's a good idea to becone friendly with the insurance coordinators at your clinic. I had Tufts and I was 38. Good luck!
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JP
JP

June 8th, 2012, 6:30 pm #10

I live in MA and has Blue Cross Blue Shield PPO Plan. My Doctor submitted my IVF cycle application last Thursday, since I am turning 40 this year, I also had a CCCT Test. All the tests result meet their Requirements now. But I used to have a high FSH, and the insurance know about it . My application is still pending now. Will my application be approved? Please help!!!
I'm in MA. For me, I was approved when my FSH was below 15 but then went it went up to 23 I was cut off from insurance coverage. I tested every month at my clinic after that reading and they didn't send the results to the insurance company untill it was just below 15 again which took a few months. Once it went back down I was covered again. I'm sure each plan is different but hopefully you can do the same. It's a good idea to becone friendly with the insurance coordinators at your clinic. I had Tufts and I was 38. Good luck!
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