Monday, March 1, 2010

insurance refusal for treatment

Question
Ok..long question.  I suffer from menorrhagia (heavy periods) and irregular cycles.  Recommendation from my PCP, since I am pretty sure I want no more children, is the Mirena IUD.  Now this is also recommended in medical literature.  My insurance company denied an approval for this.  (catholic health care system, does not pay for any birth control)  However, in this case, it is the medically recommended treatment for a medical condition NOT simply for use as birthcontrol.

How do I approach this???  I met my deductable and would like to get it done ASAP!


Answer
Hi Brenna!



You need to prove that the IUD is not for birth control but for heavy periods.  Get a letter from your DR stating this and do an appeal with your insurance company.  Make certain you tell your Dr that he/she can not mention anything related to birth control.



Good Luck!

Tricia