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Well, fluck me.

**O-Face****O-Face** member
10000 Comments Sixth Anniversary 25 Love Its
in Wedding Woes
YAY for IUDs in IA.

Your IUD is subject to co-pay AND deductible under my insurance plan.  Oh such lovely useless benefits. 

Guess who will be calling her dr.'s office to see how they want to work with me?

THIS girl.  :(
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Re: Well, fluck me.

  • **O-Face****O-Face** member
    10000 Comments Sixth Anniversary 25 Love Its
    edited December 2011
    The worst part?  I only have msyelf to be upset with. 
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  • Mrs.ThistletwatMrs.Thistletwat
    2500 Comments
    edited December 2011
    Sorry, O-Face. That sucks. Hopefully the doc's office will be able to work out a payment plan.

    Does ins in IA cover BCP or other forms of prescription BC? Seems ridiculous if they cover those that they wouldn't cover IUD - which is way cheaper in the long run.
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  • 6fsn6fsn member
    Knottie Warrior 10000 Comments 500 Love Its Name Dropper
    edited December 2011
    Gaah, that sucks.  They should work with you.
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  • **O-Face****O-Face** member
    10000 Comments Sixth Anniversary 25 Love Its
    edited December 2011
    Oh they cover BC, but if it's done in an outpatient service (um, maybe I should've used an ALLEY service?) it's not covered and will be applied against your deductible. 
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  • HeffalumpHeffalump member
    Knottie Warrior 5000 Comments 500 Love Its First Answer
    edited December 2011
    That is totally sucky.  I'll bet your doctor will work with you. 
    �
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  • MinMMinM
    10000 Comments
    edited December 2011
    I called the hospital on Friday and they were so nice about setting up a payment plan. I'm hoping it goes that way for you too.
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  • nicoleg1982nicoleg1982 member
    5000 Comments
    edited December 2011
    Oface, can you ask them to code it as an office visit?  Esp. if you didn't attend an outpatient surgery/hospital center to have it inserted?
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  • **O-Face****O-Face** member
    10000 Comments Sixth Anniversary 25 Love Its
    edited December 2011
    I just don't understand how an IUD would be covered at all under their pharmacy coverage, unless I actually got it filled at a pharmacy, brought it back and had it inserted?  What?

    I'm definitely going to call my Dr.'s office. 

    And remember this in a few years when it's time for a new one.
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  • nicoleg1982nicoleg1982 member
    5000 Comments
    edited December 2011
    This is the way my insurance billed it:

    From-To-Date of ServiceDescription of ServiceAmount BilledAmount AllowedAmount PaidDeductible AmountCopayment AmountCoinsurance AmountRemarks*04/21/2010INSERT INTRAUTERINE DEVICE$290.00$92.17$32.17$0.00$60.00$0.0004/21/2010LEVONORGESTREL IU CONTRACEPT$950.00$779.50$623.60$0.00$0.00$0.0004/21/2010US EXAM, PELVIC, LIMITED$150.00$122.07$122.07$0.00$0.00$0.0004/21/2010URINE PREGNANCY TEST$20.00$7.69$7.69$0.00$0.00$0.00Totals:$1,410.00$1,001.43$785.53$0.00$60.00$0.00
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  • **O-Face****O-Face** member
    10000 Comments Sixth Anniversary 25 Love Its
    edited December 2011
    Their wording is very "liberal" and inclue "Physician's Office" as well. I am just kind of stumped.

    "As deemed by us" is what gets me.  Okaaayyy. 
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  • loveshine1loveshine1 member
    Ninth Anniversary 5000 Comments 25 Love Its
    edited December 2011
    Ugh. That sucks. Can you file an appeal with the insurance company?

    And the doctor should be willing to work with you. They should be able to reduce the cost to a non-insurance amount, and then set up a payment plan.
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  • *Barbie**Barbie* member
    Knottie Warrior 5000 Comments 500 Love Its Name Dropper
    edited December 2011
    i'll likely be paying out of pocket when I get my Mirena post-Wolverine because my insurance covers BC, but not IUDs. Considering the huge upswing in cost, I'm hoping the Dr.'s office will work with me - I'd just get the pill, but they give me migraines. 
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  • **O-Face****O-Face** member
    10000 Comments Sixth Anniversary 25 Love Its
    edited December 2011
    Okay.  My freak out is on hold.  I am sending the verbage to my dr.'s office, who called it "bullshit".  I love her.  We shall see. 
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  • **O-Face****O-Face** member
    10000 Comments Sixth Anniversary 25 Love Its
    edited December 2011
    ::sigh::

    I guess I will be making payments.  Add it to the roster, right?  Silly me..thinking my insurance would pay for it.  Psh.
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  • Wrkn925Wrkn925 member
    2500 Comments 5 Love Its
    edited December 2011
    I went today to get consult for an IUD

    With Anthem and Mirena:

    --If I purchased the Mirena at a pharmacy,  they would not pay any, because I would be buying medical supply on prescription plan.
    --If inserted in office, it's billed as medical supply and Anthem pays 100% and insertion.

    Didn't they make you fill out a coverage form first?  I just had to do this, like an hour ago, and Mirena is finding out my coverage for me.
    When I thought I was going to have to go with the first option, Mirena offered me a payment plan that spread it out over almost a year.  If your DR hasn't paid Mirena yet, they will let you do that.
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  • Wrkn925Wrkn925 member
    2500 Comments 5 Love Its
    edited December 2011
    uck, I guess that's not Mirena, so that information is useless to you.  Sorry.

    1.) Try to get them to refile it as medical supply. 
    2.) If insurance is through work, talk to your HR person about arguing it.
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