PCO and Insurance Companies
Question:
Hi, I am 32 yr. old female with atypical PCO (no outward sympotoms) but only one natural period in 2.5 years. I have been seeing an RE for two years tried two cycles clomid (no response) and one Metrodin (ovulated but no pg). After the Metrodin cycle my insurance, which has paid everything up till now refused to pay for Met. related ultrasounds arguing that this was "elective treatment." When I asked the RE if he could write a letter of medical necessity for me he basically refused saying that technically there is no "treatment" for PCO and that Meterodin was an elective treatment. Has anyone had any luck with appealing insurance denials. It is quite frustrating when the insurance companies treat pg as an illness but not PCO.
Response:
Hi, I think insurance company’s are in the business of annoying us! I am also surprised with your doctor’s attitude. After my second Metrodin cycle, my insurance company started a medical necessity investigation. My doctor, luckily, was quite helpful in having them pay me. She wrote a letter saying that the US were absolutely necessary because PCO women need to be monitored very closely to avoid hyperstimulation. Each metrodin cycle I had after that they hesitated to pay for a while until my doctor wrote another letter. But they did refuse to pay anything towards my Metrodin/IVF cycle. Good luck. Gigi
Response:
Filed under: PCO
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