(Closed) Can anyone answer an insurance question?

posted 8 years ago in Babies
Post # 3
Member
273 posts
Helper bee
  • Wedding: August 2009

Hi Heathaah,

Sorry, I can’t help – I live in Canada, and so have no idea! I just wanted to send you best wishes and lots of baby dust!   I have no idea where I am in my cycle right now, (agg! – should have had AF already!) so am going to get a copy of TCOYF and hopefully will be able to make heads or tails of it soon…  I just found out my insurance doesn’t cover fertility drugs… eek.  But at least our health system will hopefully cover all the doctors appointments, etc.   

Hope you get a good answer!

Post # 4
Member
1184 posts
Bumble bee
  • Wedding: August 2011

I *think* you are covered as a resident of MA. I would definitely ask to speak to a manager at the insurance company. Some of the reps don’t have a clue and just want to get off the phone with you. In the past when I’ve gotten an answer I didn’t like (or expect) from our insurance company, I’ve called back and gotten a completely different answer from a different person.

Post # 5
Member
1940 posts
Buzzing bee
  • Wedding: July 2010

I don’t live in MA but here is some information I found online:

Do you have insurance through your employer?  If so, I would contact HR.

Massachusetts Infertility Insurance – Who Is Covered

The Massachusetts infertility law covers employers of all sizes – unlike in other states.  The key consideration is whether your insurance plan provides pregnancy benefits.  Confirm coverage with your employer before beginning infertility treatments.

Consider using supplemental infertility insurance coverage to fund your maternity leave, and protect your income in case of complications, and/or premature birth.

Who is Not Covered

The Massachusetts infertility insurance rules have many exceptions once you take a closer look. 

The law can only be enforced when the Massachusetts has jurisdiction to regulate.  If your employer is headquartered in another state, your health plan may not be subject to this mandate.

The law regulates health insurance companies, not employers.  If you work for a large employer that self insures, you may not be covered.  Check with your HR department before undergoing infertility treatments.

Some Massachusetts insurance companies deny infertility coverage if the female partner smokes, not providing coverage unless the woman undergoes a smoking cessation program, followed by a urine test to detect nicotine in the body. 

Post # 6
Member
71 posts
Worker bee
  • Wedding: May 2010

I live in MA also and have heard that many of these companies have some sort of supplemental insurance or policies to cover fertility treatments. Have you looked at the boston.com TTC message boards? They are very active with women dealing with this sort of thing and I’ve seen at least one thread devoted to this topic. Good luck!

Post # 7
Member
2090 posts
Buzzing bee
  • Wedding: August 2010

I don’t have the answer either – but you might want to call around to a state regulatory agency or department of the state that regulates/handles insurance as they might know, or be willing to tell you more, than a rep at an insurance company would be.

Post # 8
Member
1184 posts
Bumble bee
  • Wedding: August 2011

i just looked more online and found the same info eva posted. i’d call your HR department and see what you can find out from them.

Post # 9
Member
682 posts
Busy bee
  • Wedding: August 2009

I can’t answer your insurance questions but I really hope you are covered, at least partially! I was just complaining in another post how expensive treatments are and we have 50% coverage! Now I feel bad for complaining when other people have insurance that don’t cover anything. I’m sending good vibes your way and I hope you get good news about your coverage!

Post # 10
Member
5670 posts
Bee Keeper
  • Wedding: August 2010

I don’t believe you are covered initially through your insurance company. But you might be able to petition the insurance company since you are a MA resident and it is a state regulation.

Post # 12
Member
1645 posts
Bumble bee
  • Wedding: May 2010

It should be based on where you reside, not where the insurance company resides. For instance, my step mom works for an insurance company who covers all of Verizon employees, nationwide. The insurance company is based out of NY, but the benefits and regulations vary from state to state. As long as you don’t fall into the exceptions listed above, you should be covered since you reside in MA. Try going higher in the insurance company. It might not be something that they deal with often, so you might have to get a manager to get acurate info.

Post # 14
Member
3041 posts
Sugar bee
  • Wedding: May 2010

It depends on the law. If the law says EMPLOYERS are required to provide that insurance, than you have it (I’d still double check thou). If the law says the INSURANCE COMPANIES are required to provide it, than it depends on your policy.

I would talk to your work’s HR department 1st. Not sure if you can get a hold of them easily (like can you just walk into their office, cause if you can, do that!). Ask them for an outline of your insurance coverage. If they refer you back to the insurance group, ask them for the policy handbook. At my old workplace, if you ask if you’re covered for something, they could explain it to you & they’d find out for you. Not sure if your work is like that.

I’d get something faxed or mailed in writing JUST IN CASE you talk to some person who says you’re covered & then you end up not. I mean, its not that you don’t trust them, but someone can look something up & read it wrong if they have no idea what they’re doing (like you think your insurance rep sounds like).

I would ask for a copy of the insurance coverage reguarding infertility at your workplace.

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