September 16, 2009

What questions to ask your Insurance Company

Most RE offices will ask that YOU, the Patient, contact your insurance company. Before calling your insurance company, have this information on hand:

Note: I know these should be "common sense" but I like to be thorough!

• Name of the insured individual
• Employee/Patient ID Number or Social Security Number
• Name of employer
• Name of plan
• Group code/ number
• Patient’s name and date of birth

Be sure to get the name (or agent #) of the person to whom you are speaking with and his or her telephone and extension number.

Answers to the following question will help you understand which procedures will be covered and reimbursed during the course of your therapy for infertility. Remember if you are unsatisfied with the answers you receive; ask to speak to a supervisor or another representative who is more familiar with the infertility benefits.

Important Questions For YOU to ask Your Insurance Company

• What are my infertility benefits?

• What is excluded?
• What do the benefits cover?
• Do they cover diagnostic procedures done in an office
• Do they cover treatment procedures done in an office
• Do they cover drug therapy?
• What types of treatment are covered? Intrauterine
insemination? In vitro Fertilization? ICSI intracytoplasmic
sperm injection)?
• Do I need a referral for diagnostic procedures or
• Do I need pre certification?
• What are the maximum allowed attempts for non-IVF
procedures, such as artificial insemination?
• What are the maximum allowed attempts for In vitro
• Are donor sperm and egg options covered?
• Is the egg donor covered by my plan if she has
• Do I need to use specific pharmacies or mail – order
• Do I have a pre existing clause?
• If I have a Dollar benefit, how much of this has been used?
How much of this benefit is left?

Since this post may not be that easy to print, I have created a handy PDF file that I’d be more than willing to email to readers.

If interested, please send me an email (not a comment) to and I’ll promptly email it to you!

Until next time!

Sunshine Bud


C said...

That's great information, thanks for posting it, I'll definitely be copying it down if/when I need to call my insurance company.

Flora Bud said...

This is such great information and it will help out some lost soul out there. Thank you!


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