Author Topic: Insurance Coverage for IVF  (Read 1198 times)

snair1271

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Insurance Coverage for IVF
« on: February 03, 2010, 11:13:10 AM »
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. 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

Michele

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Re: Insurance Coverage for IVF
« Reply #1 on: February 04, 2010, 05:59:56 AM »
Have you called your insurance company yourself to ask what happened?  If they say that the limit was $15000, do you have any written booklet, etc, showing $25000?  I would start with the insurance company and make sure that this is accurate.  It may just be some confusion.

Michele
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snair1271

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Re: Insurance Coverage for IVF
« Reply #2 on: February 04, 2010, 11:22:42 AM »
Thanks Michele. I am in the process of getting the documentation. Hopefully that will support my case. I will keep you posted on what happens

Soook