https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Sun, 12 Apr 2026 00:24:04 +0000 https://boards.hellobee.com/topic/did-anyone-with-limited-if-coverage-use-it-all-up#post-2130962 Thu, 02 Apr 2015 14:59:24 +0000 PurplePumps 2130962@https://boards.hellobee.com/ <p>@Mrs.Pinecone316: @GreenThumb: She said they'd never make someone pay more than the insurance rate, but she keeps insisting that the insurance rate was 9k, not 6k even though that's what insurance adjusted it to. And she said if they bill insurance, they bill 2k, where as the cash price would include that. If they don't get any additional payment and 6k is the price, I'll definitely fight for that.</p> <p>@ShootingStar: She told me that if I hit my lifetime max, insurance will actually notify them and tell them not to bill them since I have no coverage. Which I thought sounded fishy too... I think I need to call the insurance company and get their side of this too. Oh, yea, IF coverage doesn't go toward my deductible or over all medical lifetime max, apparently it's a beast of it's own. Good news is that I didn't have to pay my deductible before the coverage kicked in I guess. </p> https://boards.hellobee.com/topic/did-anyone-with-limited-if-coverage-use-it-all-up#post-2130856 Thu, 02 Apr 2015 14:03:36 +0000 ShootingStar 2130856@https://boards.hellobee.com/ <p>@PurplePumps: That honestly sounds kind of scammy to me. The finance person at your RE does not work at your health insurance and is not privy to all aspects of your plan. It is her responsibility to bill them first (and therefore you get the negotiated rate) and have the insurance deny the claim. You could also make the case that the amount for those procedures should be going against your lifetime maximum. </p> https://boards.hellobee.com/topic/did-anyone-with-limited-if-coverage-use-it-all-up#post-2130849 Thu, 02 Apr 2015 14:00:15 +0000 GreenThumb 2130849@https://boards.hellobee.com/ <p>I haven't dealt with insurance for our IF other than for diagnostic testing and meds, so I can't offer any advice. But, how frustrating especially when you know what the negotiated rate is!! I agree with @Mrs.Pinecone316: to ask again about the price/negotiate if possible, but hopefully :goodluck: you won't have to have to do another round after this one! </p> https://boards.hellobee.com/topic/did-anyone-with-limited-if-coverage-use-it-all-up#post-2130814 Thu, 02 Apr 2015 13:43:45 +0000 Mrs.Pinecone316 2130814@https://boards.hellobee.com/ <p>Hmmm.. I know with insurance that is how it works. Hospital bills something then the insurance agrees on a lower amount. But from the infertility stand point I have always seen out of pocket cash payments being lower as its more convenient for them to not deal with insurance and they are trying to help you out for not getting it covered. That would annoy me too. I paid 100% out of pocket for IVF so I really don't have much advice but to keep asking if they can negotiate the price at all? </p> https://boards.hellobee.com/topic/did-anyone-with-limited-if-coverage-use-it-all-up#post-2130638 Thu, 02 Apr 2015 12:22:12 +0000 PurplePumps 2130638@https://boards.hellobee.com/ <p>I'm not sure I trust what the finance lady is telling me since it doesn't seem to agree with what insurance is doing so I wanted to see if anyone has actually went through this.</p> <p>I have IF coverage, but only up to 7500. My last round of IVF went through insurance and got discounted to about 6k. So my next round, I expect to - go through insurance, get discounted to 6k, they pay the remainder of my lifetime max of 1500, I'll pay 4500. </p> <p>So in the crappy case I need yet another round, they said that since I used up my insurance benefits, they cannot bill insurance anymore and I'll have to pay the cash price up front of about 8k. BUT why can't they bill insurance, have them adjust it to 6k, and then say they wont cover it and then hand it to me to pay 6k?? Shouldn't I still get the insurance negotiated rate?</p> <p>And to complicate this, the doctor keeps telling me the contracted rate is 9k, and they were underpaid, so I have no idea what is going on or what will happen with billing the next round. </p>