Bills for IVF

[snair1271]

Hello,

My wife had IVF treatment 3 years ago. During the time of the cycle, the provider's office informed us that we were covered under our insurance. Our IVF insurance limit was $25,000 for lifetime and this was our second or third time doing IVF. We have now received multiple bills from the provider stating that we owe for a number of visits during that cycle back in 07.

The provider called the insurance company who stated to them that they are auditing our account as our lifetime maximum was only $15,000. To me this is ridiculous, as my plan clearly stated that our coverage was $25,000. My questions is how can the insurance company get away with this? Also, why weren't we informed at the time that we weren't covered? The fertility clinic called the insurance company at the time of service (back in 07) and confirmed that we were covered.

I definitely do not want to pay these bills as this seems completely unfair and I am thinking of getting legal assistance but just worried about the cost. Any advice is greatly appreciated.

Thanks
Soook

[PMRNC]

Since they verified these benefits in 07, hopefully it was done in the following few years. Lots of policies that did cover IVF were downgraded to lower rates, wouldn't be unusual for your plan to have changed in 3 years. If it did, you could go to the clinic and maybe try to work things out. If they had checked the benefits yearly or bi-annually maybe this confusion could have been avoided, however first you should find out when the max was decreased.
Not much you can do if it was.

[snair1271]

Thanks for your response. I am in the process of checking that and will keep you posted on what happens

Soook