Why Day 3 bloodwork for insurance?

I have Aetna insurance and I know I am really lucky. They cover most of my IVF costs. But my doctor's office called and said my insurance wanted to get day 3 bloodwork. Now I am concerned. Has anyone else had to do this? What are they looking for?

11 replies   

Its normal procedure for your RE to do 3 day testing to check for hormonal levels.

Day 3 bloodwork/sono results give your RE information about your "reproductive potential" via the presence of specific hormones. I would guess that your insurance has a range they're looking for in order to cover what are still, unfortunately, considered to be elective medical procedures. I bet you can call and get more info from Aetna or your RE. If they accept Aetna, their office should be familiar with their policies.

Good luck!

This is probably the normal day 3 testing. Day 3 is when they would test for FSH and estradiol. Pretty much it tells them how "old" your eggs are and what the potential there is for having good eggs each month, or how many there will be if stimulating for IVF.

I have Aetna too and this just happened to me. They require me to have current (meaning within the last 6 months of treatment) day 3 blood work in order to cover the current cycle.

I received a call from my clinic ON DAY 3, and they said I had to get in that day to have the test or insurance would reject payment on the cycle. Luckily I was able to make it happen.

It's a good reminder to keep in touch with your clinic's billing office prior to procedures. Just to make sure all the t's are crossed etc.

Best of Luck on your cycle!

My insurance is the same way. They require day 3 lab results less than than 12 months old. I know they will deny coverage if the results are too high for women over 40, but not under 40. I would read through your handbook and medical criteria for IVF. If you're FSH and E2 are in the normal ranges, you should be fine.

Thanks for the replies. I am 35 years old. I say that because one of you mentioned insurance companies being more concerned with the numbers if you're 40+, so in that case I will be alright! I actually missed my first opportunity to do my day 3 blood because I knew certain things needed to happen when my period started and when I called the office, the lady said I just needed to pick up BC pills. Then when it was too late, the financial lady called and asked about if I had done my 3 day bloodwork and it was day 10.

Day 3 blood work is pretty standard. I've had to have it with all of my IVF cycles. They just need to get a baseline for your hormone levels and check your fsh levels. It's really no big deal.

http://www.aetna.com/cpb/medical/data/300_399/0327.html

has some general info re what Aetna looks for . . . may or may not be included in your specific policy

I have Aetna as well. I have to say they covered everything for my 1st cycle. Day 3 testing is normal for all INS companies. Best of luck to you. I'm starting another cycle 8/8. Currently waiting for Aetna to approve this one. We are blessed to have INS. So many of the ladies on here don't have any.

I'm doing by first IUI this month, but if God forbid we have to move to IVF, did Aetna cover that too. I will be so thrilled if they do!

Yes, Aetna is like many other insurance companies for requiring Day 3 levels. They're looking at the basics, just to make sure you're "worth the expense." Insurance requires FSH to be below a certain level, for instance.

Different states mandate different coverage, so Aetna may not cover the same stuff with different employers in different states. It's hard to tell. If your state mandates IVF coverage, then yes, Aetna would probably cover it. :)

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