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Infertility

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would private healthcare cover a laproscopy

30 replies

Hyland · 23/01/2016 11:11

I know I cant use work heath care for pre existing fertlity issues.

I'm sure my consultant said i would be able to get a laproscopy through the NHS due to really painful periods etc.

So with this thinking does it mean my healthcare would cover it to?

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OrangeSquashTallGlass · 23/01/2016 11:43

It completely depends on your case and you'd need to ask your consultant.

I know two people who tried to go private for a lap; one was approved and the other not.

The reason one wasn't was because they thought there was a possibility the lap might show other complications which would mean more work/a lengthier stay and ultimately more costs.

Hyland · 23/01/2016 11:45

I'll wait for my consultant to respond to my email.

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FlatWhiteToGo · 23/01/2016 12:48

What does your policy say? I would call your insurer and say it's for painful periods and give them any other symptoms or comments that the consultant has said (e.g. if they suspect endometriosis or something similar). I wouldn't tell them it's primarily for fertility reasons as (on the whole) they'll run a mile! They should cover you if it's currently causing you physical pain.

AnotherTimeMaybe · 23/01/2016 12:51

If it's pre existing or for fertility issues they won't cover it
If it's cause of sever period pains etc 99% they ll cover it.

Hyland · 23/01/2016 13:29

Thankyou for your replies

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Hyland · 23/01/2016 13:54

I wonder if they are doing it for the purposes to relief pain. Would there be certain things they wouldnt do that is fertility related during the lap?

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Whatdoidohelp · 23/01/2016 14:01

Yes it will but for period pain only. If they have any inkling it's for fertility issue sit will be a big fat no.

sunshineonarainyday1 · 24/01/2016 10:17

My insurance covers fertility investigations but not treatment. I had first lap in 2012 as part of normal investigations and they found endometriosis. Consultant removed this (altho removal part wasn't actually covered). Also discovered I had bicornuate uterus. Following year when we wanted to start private IVF and fertility consultant wanted to know more about my two wombs, a different private gynae doctor did another lap but this time cited painful periods as the reason (periods were worse after initial surgery).

I found that both gynae consultants were very accommodating at putting the right codes on my insurance request to ensure everything was covered.

I would check whether your insurance covers infertility investigations (even if you already know some of the reasons) plus also see what the consultant suggests. They quite often have a good idea of what is and isn't covered but obviously depends on your individual policy.

sunshineonarainyday1 · 24/01/2016 10:57

Ps my first lap was done for fertility investigations but with hindsight I should have just said I had painful periods as there was big panic of "what if they find endo".... Consultant said he would remove it and basically not say this to insurance company so no one issues with them refusing to pay.

On my second go there was no issues of whether they'd pay for endo to be removed as it was for painful periods (they did remove more endo and paid for it).....even tho I had the first claim where they assumed endo hadn't been removed!

Hyland · 24/01/2016 12:50

Thank you sunshine

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Fuzzyduck21 · 25/01/2016 03:02

Yes I think so providing it's for painful periods and not for fertility. I had an ultrasound which was mainly to see what my ovaries were doing as I had some pain and it was fertility related but I went under the guise of pain and it was covered. It led me to realise I had fertility issues as suspected and then started on nhs to get it sorted!

PerspicaciaTick · 25/01/2016 03:06

My healthcare wouldn't cover anything which even hinted at fertility issues, but did pay for the lap to treat my endo...during which the consultant happened to check the condition of my one remaining tube.

Hyland · 27/01/2016 19:01

How quickly was you able to get the laproscopy after you had the referral to go through insurance?

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Chrisinthemorning · 27/01/2016 19:11

I had a lap and dye through Bupa for "menstrual disorders"- endo found and lasered as well. Just don't mention ttc (to Bupa- obviously mention to your consultant!). My consultant was a fertility specialist but still Bupa recognised.

Chrisinthemorning · 27/01/2016 19:13

It all happens pretty quickly privately- usually a couple of weeks for consultation and then book surgery again a couple of weeks.

Hyland · 27/01/2016 19:35

Thanks

It's all a bit confusing what to talk about and what bit to say!

Before you had the lap did any of the usual scans/HSG pick up any issues.

After lap how has it effected your periods and you ttc.

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loopylou1984 · 27/01/2016 20:30

Hyland - I work for an insurance company (obviously can't say which) and generally anything related to fertility is not covered. It is worth checking though because some companies (assuming it's a company scheme) can negotiate extra benefits. It should say in your handbook.

Re covering the lap. If it's put through as a gynaecologist claim due to something like painful periods then it will probably be covered, but if they suspect fertility then they will likely ask your consultant for a full medical report.

Worth a try though I'd say! X

Chrisinthemorning · 27/01/2016 21:52

Before the lap I hadn't had an hsg, but did have painful periods and premenstrual spotting which is an endo sign.
Afterwards I conceived after about 6 months but it wasn't to be. We had a son through ivf who is now 3.5. I have a mirena now to keep the endo at bay.
Good luck

Hyland · 03/02/2016 13:44

Because i have had painful periods before obviously! The insurance company is saying to me that it is a pre exisisting condition. Are they just trying to get off on a technicality? I went on the mini pill when i was 13 to control the cycle due to how bad they use to be when my body was trying to settle down with all those hornones lol. I'm now 37 so how can they consider it an exisiting condition when it is just a natural problem to have with periods. My issue now is the excessive clots and uncontollable pain where i take 2 ibuprophen and 2 paracetamol every 4 hours. Otherwise i would not be able to get through a working day.

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Blondeshavemorefun · 03/02/2016 21:01

i dont know if PHC will pay for your op

but i do know its much cheaper abroad if you have to pay/go private

i needed a Hysteroscopy, nhs would have been 6/9mths as non urgent

looked at private hospital near me and was quoted £3k maybe 2800 if i was lucky ......

i went abroad (madrid again hyland) and op was think £550 plus flights for df and i so another £200ish, basically whole op /flights/hotel was less then £800 !!!!!

Hyland · 03/02/2016 21:27

That is actually really helpful if I don't have any joy with work healthcare.

Thanks

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Blondeshavemorefun · 03/02/2016 21:44

i know its scary to go for an op abroad but i cant praise madrid enough

plus as having ivf there it was handy having op there as same doc who knew excalty what needed doing up there Wink plus all medical notes at hand

Hyland · 03/02/2016 22:01

It just seems like people recommend the lap.

To discover issues not known about or to possibly unblock a tube. Even if it's only partially blocked. Plus supposedly the fluid build up can go stagnant/toxic and spill out into the womb.

I just seem to be one of the unexplained cases. So feel like their must be more we don't know.

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Blondeshavemorefun · 03/02/2016 22:05

surprised gp wont refer you, tho even if he did it would be a wait like mine was

i saw madrid end of aug, found out needed op and was back there literally 6 weeks later beg oct, had to wait for my period and then book op think 8 days later so in the right place of cycle

Hyland · 03/02/2016 22:07

gp gave me referral letter no problem but this was on the assumption that work ins. will let me put in the claim.

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