Insurance coverage and birth control - Mirena IUD?

Question

I just found out that my insurance will not cover my IUD that I got a month ago. I plan on appealing it. I've researched alot on claiming that it's discrimination. Is there any other points that I should address to presuade the company to pay for it. I can't pay $700 right now. SO I am pulling out anything I can.

Answer 1

You need to explain to them why it was medically necessary.  They aren't required to pay for elective procedures or medical equipment.  I can almost assure you that if you are having this problem, they have dealt with it many more times before - and won.

It is always best to check with you insurer before having a procedure.  You may have more luck going after the doctor's office.

Answer 2

Ain't gonna happen.  Sorry.

Check your policy.  Most likely, it contains a specific benefit exclusion stating that IUDs will not be covered for any reason.

If there's a benefit exclusion written into your contract for something, then you don't have coverage for it...for any reason.  Doesn't matter what the reason is that you want/need it.  An insurance policy is a contract for the services spelled out in the contract, and unfortunately your contract doesn't include Mirena.

I'm a fan of Mirena - had it myself for awhile.  But don't get your hopes up about getting coverage.  Sorry.

My own experience w/getting coverage for Mirena is a little bizarre.  My insurance policy at the time covered getting Mirena.  However, I had different insurance when I had the Mirena removed, and that policy didn't cover IUDs.  So, I had to pay for the removal out of my own pocket...a little over $400.  (A policy that doesn't cover IUDs generally doesn't cover removal of them either, unless there is a medical emergency.)

Answer 3

i have healthnet, mine was covered

Answer 4

Why did you need it?

My insurance only covers my birth control because I have three week long periods without it.

If you are totally healthy, unless your insurance says otherwise, there is no reason insurance would cover it.