So, we had our insurance meeting at work today and here’s the sitch:
The new insurance (Health Advantage) will cover 50% of infertility diagnostics and testing, but no treatment. They do not have any RE’s in network, but if my doctor says I need to see one they will make an exception and most likely cover the one that he refers me to. I’ll have to work with a case manager on this, but she said since Infertility is covered that it shouldn’t be an issue covering the doctor who treats it (seems like a no brainer to me….). Tricare Humana, however, covers 85% of IF diagnostics, testing, and treatment up to ART, which they don’t cover (big surprise). BUT, this means I could start taking metformin or injectables if need be and have that covered. I pay 15% up to the $1000 catastrophic cap (which I think is their fancy military term for deductible).
I stayed after the meeting and talked to the HA lady, and she said that what would happen is they are my primary insurance by default, so the doctor would bill to them first. Then whatever got rejected and sent back would be billed to Tricare Humana. Then whatever got rejected after that would be sent to me. Basically, this means that I won’t have to pay very much at all for the basic care that I need. Once we get to IUI/IVF (God willing, we won’t) then it’s all out of pocket again, but this is really good news peeps. Really, really good.
The bad news is for Chief that his insurance costs go from $53.00 a month just for him to $195.00 a month to cover me and any future family. It’s nothing to complain about really, but I feel bad being so high maintenance.
I am no well-oiled machine, that is for sure.