Tuesday, July 12, 2011

Health Insurance

I contacted my health insurance company and requested that they direct me to their medical policy on infertility. By far, this was the best explanation of all of the facets of infertility and all of the procedures that come along with them and why/when they are offered. The IVF and ICSI section reads as follows:

ICSI and IVF for:
ICSI is covered for severe male factor when at least 2 unprocessed semen analyses show < 10 million total motile sperm or ≤ 2% strict Krueger normal forms or post processing semen analyses show ≤ 3 million total motile sperm. IVF is covered for moderate male factor when at least 2 unprocessed semen analyses show < 4% strict normal forms or post processing semen analyses show >3 and ≤10 million total motile sperm. 22 (hysterosalpingogram is not a prerequisite test in couples who present with male factor who require IVF and/or ICSI.)

Note: 2 semen analysis requirement for the diagnosis of male factor (Effective 4/2008)

ICSI is covered on the day of IVF if the post processing semen analysis of that day meets the ICSI coverage criteria noted immediately above. Retrospective authorizations will be allowed.

As it stands, we qualify for both of those procedures based on my husband’s first SA. Now we just need to wait and see what the second SA will show. So here’s my question: if there is one irregular SA and one regular SA, what conclusion can be drawn from that? Or is there typically a third SA at that point?

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