Fertility and Insurance Eligibility?

Question

Hi All,

So what are the loop holes yo see here? Can I get anything covered?

"Services or supplies that are designed to medically enhance a Member’s level of fertility in the absence of a disease state.

Procedures, drugs or biologicals for, or in connection with, artificial insemination, in vitro fertilization, or any other service, supply,

or drug intended to create a pregnancy. However, a service or supply may be covered if it is provided to treat an illness or

underlying medical condition resulting in infertility. Services which may be covered under this provision include treatment to

correct a previous tubal pregnancy and treatment by ovulatory drugs (such as clomid) or hormonal treatment used primarily to

treat irregular menstrual periods."

What would an "illness or underlying medical condition resulting in infertility" be? Examples?

Thanks you!

Answer 1

It would be best to talk to your insurance company . . .

Not an expert, but they mention tubal pregnancy so I would assume that any damage to the tubes would lead to coverage.

Other possibilities might be pcos, endometriosis, etc.

Good luck!