[rsb528]

HI! I am new to this forum and though that I would ask my first question! My DH had his sperm analysis in June 2008 in which we paid for out of pocket. It was never submitted through insurance. In August 2008, I began a new job and have had BCBS since then. We are in open enrollment right now and I am changing my insurance plan to one that includes infertility coverage. We will still be with BCBS, just a different plan. My question is...will the sperm analysis that occured prior to us having BCBS be considered a pre-existing condition? I have talked to my doctor's office and they have told me that once we begin the IVF/ICSI procedure, all records are sent to BCBS upon their request; which includes the sperm analysis we paid for on our own. Does anyone have any idea what may happen? I just don't want to change to an insurance plan if we aren't going to need it. Right now, the plan we are on is free and the plan we would be changing to is $250+/month. Any help would be appreciated. Thanks!

[HananMG]

Originally Posted by rsb528

HI! I am new to this forum and though that I would ask my first question! My DH had his sperm analysis in June 2008 in which we paid for out of pocket. It was never submitted through insurance. In August 2008, I began a new job and have had BCBS since then. We are in open enrollment right now and I am changing my insurance plan to one that includes infertility coverage. We will still be with BCBS, just a different plan. My question is...will the sperm analysis that occured prior to us having BCBS be considered a pre-existing condition? I have talked to my doctor's office and they have told me that once we begin the IVF/ICSI procedure, all records are sent to BCBS upon their request; which includes the sperm analysis we paid for on our own. Does anyone have any idea what may happen? I just don't want to change to an insurance plan if we aren't going to need it. Right now, the plan we are on is free and the plan we would be changing to is $250+/month. Any help would be appreciated. Thanks!

RSB, hi! I think any fertility benefits is awesome. I would not worry too much and contact bcbs directly even in your open enrollment. But are you just covering you or both? If you are covering both of you then I would say, go for it and contact bcbs to find out. Similar had happened to us and we seem to be ok so far. That would give your DH his own fertility benefits up to the lifetime maxium as it does for you. I know I probable did not answer your questions but I would say even if DH analysis are not covered due to pre-existing, it is still so worth it since IVF is so $$$$ and you never know what your family will need. You can always appeal the insurance and claim on taxes in afterwards.

Let me know and Blessings always to you and your DH!!!

Hanan

[ImHis]

A lot of this will also depend on what the company has decided to put into their coverage. You can call and ask them.... but if you can get any of it covered at all...your stuff..you are doing great. There are so many companies that choose to not put any infertility benefits into their coverage. Also sometimes insurance companies won't have pre existing clauses as long as you haven't been with out insurance for a certain period of time, or, they will not consider it pre existing if it has been so long...so you just need to ask your HR department or call them.

[StillWaiting410]

I paid for my first IVF out of pocket. Then I also had the opportunity to switch from bcbs PPO (no IF coverage) to bcbs HMO (full IF coverage). I did ask about pre existing conditions before I switched, thinking the same as you... if it's not covered, it's definitely not worth it. I did not ask bcbs directly, I asked the person in charge of benefits at my company. Her answer was, as long as I entered at open enrollment, then I was fully covered for all they had to offer. That the insurance could not turn me down. **I don't know if this is true everywhere** but we've had no problems with them covering everything we've needed so far.
Greatest luck to you! I hope the insurance can ease some of the stress.

[rsb528]

Thank you so much for all your input. It makes me feel better to hear this from others that have gone through it. I try to be optimistic, but insurance stuff scares me. You never know what to expect. The insurance plan we want to change to covers $25k per couple for services and supplies for infertility per lifetime. They also cover quite a bit of the meds that we will have to take. Not all...but most. This is our first time doing this and I feel completely clueless. Everyone has been so helpful, but I still fel as if I have absolutely no clue what it going to happen. I'm excited though...can't wait to start!

[sarahelaine57]

My Dh has great IF insurance through his work, and we have switched twice already and to different insurance companies and both did not consider it a preexisting condition, so hopefully this is the case for you, I would think that it would be ok.