Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)

MY FORM OF BIRTH CONTROL IS BEING DENIED!

Don't let the government fool you!  Not all birth control methods are considered equal.  This year since there is a "war on woman" the policy needs to change.  My health insurance will not pay for my Natural Family Planning.  They tell me because it is coded educational.  When you take birth control, have an IUD or the patch, doesn't the doctor educate you on the product?  Doing Natural Family Planning has the same result of birth control pills and it should be covered.  My religious liberty comes into to play.  I am being discriminated against!  All forms of birth control should be covered or none at all!  How many Natural Family Planning families are out there that have this same problem?  Would love to hear from you. 

Re-editing do to some comments.  Natural Family Planning - the Creighton method this is how it works.  It doesn't tell you when your period ends (how silly).  It tells you when the best days are to conceived if you want a baby and the days not to have sex if you don't want a baby.  You sit down with a nurse and they give you instructions on the method.  By using this method, I found out that I had fertility problems.  Which this methods help to diagnose. I have been diagnosed with ovarian dysfunction.

I simplified the method too much.  This is complicated and can't be done on an app!  The nurse teaches you how to identify your sensation after you wipe.  the charting has about 10 different ways you can chart.  They use soft - s for sensation, o- obersvation - ft - for finger test.  You can have peak type mucus or non-peak type mucus.  If you have mucus you are fertile.  The charting is harder for people with abnormal cycles and for menapausal women.  Sometimes you can't read your observations correctly. It is not as easy as some of you are trying to make it out to be.

People keep posting they haven't ever had to pay.  You do, you just don't know about it.  You have to have your employer buy a more expensive plan.  I am quoting my insurance company. As far as insurance goes, yes depending on your insurance sometimes it is covered.  Mine used to be. The basic first tier insurance that your company chooses to save money only covers pills, IUD, patches. If you want this kind of coverage, your company has to pay a higher premium and go to the next tier.  This is what I am saying that is unfair.  All forms of birth control should be on the basic first tier and covered.

I am speaking to politicans about this and tyring to see how many women are having this problem.  In the St. Louis area there are 30% of women.  The other 70% that are covered should not have to pay a higher premium for this either. I am doing this as research.  The NFP office is trying to change the laws on this. The government assigns the Revenue billing code.  That code is what is preventing my coverage.  I have no control on that code and neither do the doctors.

This site I thought, was for other moms to help one another.  Not bash them.  I don't get the belittling.  Just because I think something you wrote is dumb and you are misinformed I would never come out and say that.

by on Oct. 13, 2012 at 10:13 PM
Replies (61-70):
rfurlongg
by on Oct. 14, 2012 at 3:14 PM
It should be billed as a perimenopausal visit. Most women in perimenopause see their care provider frenquently. Talk to your care office billing dept and tell them to code the billing as peri management. If you have traditional ins that should be no problem.

Quoting blessingsofmany:



Quoting rfurlongg:




Quoting blessingsofmany:


I would like to see NFP covered.  Just like birth control pills. I should not have to pay a higher premium to have the coverage.  I don't know how to get more specific than that.


If you carry insurance that covers a dr's vist, your insurance cover the education needed to successfully use NFP. That is easily covered in one drs office visit and can be done easily and quickly during a well visit.


Obviously, you get it.  But, my nurse likes to meet every couple of months.  I think about 4 times a year.  We can't afford that much out of pocket expenses.  I only see my doctor once a year.  I am peri and worried about having a child at my age.  I don't want to be pregnant at 50.  It is harder to chart (for me) while maybe going through that year of menopause.  This method used to be very easy for me till I started having limited mucus. 


The women that are in the 70% should be mad about having to pay extra for the coverage to received this treatment, while birth control is free.

Posted on CafeMom Mobile
blessingsofmany
by Member on Oct. 14, 2012 at 3:14 PM


Quoting ShadowLark:

You're not listening. You don't take the pill, you get the education about nfp during the visit where the "option" of the pill is presented. Doesn't matter that you'll NEVER use that option. Just that it was mentioned.


Quoting blessingsofmany:

 


Quoting ShadowLark:

That would work!



Quoting rfurlongg:




Quoting blessingsofmany:


Ok.  Gottcha ya.  The service is not covered because it is coded as education.  I would be happy to pay a co-pay.  They will not even cover anything to do a medical coding issue.  They will not pay for me to meet with my nurse for instruction.  They are telling me the only education they will cover is for a diabetic.  Again, the frustration lies that you have to pay a higher premium to get coverage.  This method should be covered just like the pill.


To get the px for the pill you must visit (ethically)your dr once every 12mo for a refillabel px label. This is true of any medication requiring a px.Generally the px for the pill, and most other regular medication, is filled at a well visit. Schedule a well visit and while there ask about NFP. It will be billed as a 'well visit.' 


  



I will not take the pill because of side effects and religion


Natural Family Planning does not offer the pill.  Hence the word Natural

krysstizzle
by DeepThought on Oct. 14, 2012 at 3:18 PM

You're not understanding. 

Nobody is suggesting that a pill is part of NFP. They're saying you can get education on various kinds of bc (including both the pill and nfp) during a routine dr's visit. 

Quoting blessingsofmany:


Quoting ShadowLark:

You're not listening. You don't take the pill, you get the education about nfp during the visit where the "option" of the pill is presented. Doesn't matter that you'll NEVER use that option. Just that it was mentioned.


Quoting blessingsofmany:



Quoting ShadowLark:

That would work!



Quoting rfurlongg:




Quoting blessingsofmany:


Ok.  Gottcha ya.  The service is not covered because it is coded as education.  I would be happy to pay a co-pay.  They will not even cover anything to do a medical coding issue.  They will not pay for me to meet with my nurse for instruction.  They are telling me the only education they will cover is for a diabetic.  Again, the frustration lies that you have to pay a higher premium to get coverage.  This method should be covered just like the pill.


To get the px for the pill you must visit (ethically)your dr once every 12mo for a refillabel px label. This is true of any medication requiring a px.Generally the px for the pill, and most other regular medication, is filled at a well visit. Schedule a well visit and while there ask about NFP. It will be billed as a 'well visit.' 


  



I will not take the pill because of side effects and religion


Natural Family Planning does not offer the pill.  Hence the word Natural


blessingsofmany
by Member on Oct. 14, 2012 at 3:22 PM


Quoting rfurlongg:

It should be billed as a perimenopausal visit. Most women in perimenopause see their care provider frenquently. Talk to your care office billing dept and tell them to code the billing as peri management. If you have traditional ins that should be no problem.

Quoting blessingsofmany:

 


Quoting rfurlongg:




Quoting blessingsofmany:


I would like to see NFP covered.  Just like birth control pills. I should not have to pay a higher premium to have the coverage.  I don't know how to get more specific than that.


If you carry insurance that covers a dr's vist, your insurance cover the education needed to successfully use NFP. That is easily covered in one drs office visit and can be done easily and quickly during a well visit.


Obviously, you get it.  But, my nurse likes to meet every couple of months.  I think about 4 times a year.  We can't afford that much out of pocket expenses.  I only see my doctor once a year.  I am peri and worried about having a child at my age.  I don't want to be pregnant at 50.  It is harder to chart (for me) while maybe going through that year of menopause.  This method used to be very easy for me till I started having limited mucus. 


The women that are in the 70% should be mad about having to pay extra for the coverage to received this treatment, while birth control is free.

The hang up is the government assigns the revenue billing code.  The word educational is in it.  It is automatically denied.  There are 3 codes for billing.  One is a CPT, one is Revenue, and one is the diagnosis code.  The cpt and diagnostic code is not the problem.  The insurance company told me that
they don't have the problem with that.  It is the government assigned code for revenue that is the problem.  The NFP office in St. Louis can only legally use two codes.  They are working on trying to change that law too.  That is why I am trying to find out how many women have the same issue I do, so we can tell the government officials and lobbyists.  We are trying to get the word out.

blessingsofmany
by Member on Oct. 14, 2012 at 3:33 PM


Quoting mhaney03:

I think my brain just melted.

I used NFP for a long time without going to a doctor.  You don't need a doc to tell you how to track your cycle.

Curious what model do you use, there are several out there?  I use Creighton.  Doing charting is not as simple as people think.  Especially when you have abnormal cycles.  I have friends who are on yellow stickers.

rfurlongg
by on Oct. 14, 2012 at 3:36 PM
Here is the thing: you are trying to get a non-px choice of birth control covered just as it requires a px. That is unrealistic. Condoms or lessons on how to use them are not covered, nor should they be. They do not require a dx or a px. If you choose to use nfp, more power to you. However it requires one visit, one time, that can easily be covered during a well visit. If you are dealing with perimenopausal issues, then that is your visit. Call and make an appt because you are perimenopausal. Period. If you insist on see your care provider for continued education on nfp (although you have made it clear you are really seeing her for peri symptoms) and insist on education coding, that is on you. Traditional nfp does not require more than one visit. You are choosing to make this hard and expensive on yourself.

Quoting blessingsofmany:



Quoting rfurlongg:

It should be billed as a perimenopausal visit. Most women in perimenopause see their care provider frenquently. Talk to your care office billing dept and tell them to code the billing as peri management. If you have traditional ins that should be no problem.


Quoting blessingsofmany:


 



Quoting rfurlongg:






Quoting blessingsofmany:



I would like to see NFP covered.  Just like birth control pills. I should not have to pay a higher premium to have the coverage.  I don't know how to get more specific than that.



If you carry insurance that covers a dr's vist, your insurance cover the education needed to successfully use NFP. That is easily covered in one drs office visit and can be done easily and quickly during a well visit.



Obviously, you get it.  But, my nurse likes to meet every couple of months.  I think about 4 times a year.  We can't afford that much out of pocket expenses.  I only see my doctor once a year.  I am peri and worried about having a child at my age.  I don't want to be pregnant at 50.  It is harder to chart (for me) while maybe going through that year of menopause.  This method used to be very easy for me till I started having limited mucus. 



The women that are in the 70% should be mad about having to pay extra for the coverage to received this treatment, while birth control is free.


The hang up is the government assigns the revenue billing code.  The word educational is in it.  It is automatically denied.  There are 3 codes for billing.  One is a CPT, one is Revenue, and one is the diagnosis code.  The cpt and diagnostic code is not the problem.  The insurance company told me that
they don't have the problem with that.  It is the government assigned code for revenue that is the problem.  The NFP office in St. Louis can only legally use two codes.  They are working on trying to change that law too.  That is why I am trying to find out how many women have the same issue I do, so we can tell the government officials and lobbyists.  We are trying to get the word out.

Posted on CafeMom Mobile
louzannalady
by Bronze Member on Oct. 14, 2012 at 3:36 PM
There are SOOOO many reputable resources in the topics of NFP. I see your point, but I have learned how to NFP for conception and prevention purposes easily on my own. There is even a great app for tracking your info called Ovuview.
Posted on CafeMom Mobile
louzannalady
by Bronze Member on Oct. 14, 2012 at 3:39 PM
Why can't you just ask about how to use NFP during a normal visit? Easy peasy.
Posted on CafeMom Mobile
needabreak8
by Member on Oct. 14, 2012 at 4:11 PM


Quoting blessingsofmany:

I would like to see NFP covered.  Just like birth control pills. I should not have to pay a higher premium to have the coverage.  I don't know how to get more specific than that.

I agree with others here.. we are not ridiculing you.. please don't be offended..  we don't undertand what you are saying.. Those of us that have used NFP did it on own own for free.. I don't get why this needs insurance coverage.. unless you are talking education classes?? Please explain what you mean.

needabreak8
by Member on Oct. 14, 2012 at 4:23 PM
1 mom liked this

 

Quoting blessingsofmany:

 

Quoting rfurlongg:


Quoting blessingsofmany:

I would like to see NFP covered.  Just like birth control pills. I should not have to pay a higher premium to have the coverage.  I don't know how to get more specific than that.

If you carry insurance that covers a dr's vist, your insurance cover the education needed to successfully use NFP. That is easily covered in one drs office visit and can be done easily and quickly during a well visit.

Obviously, you get it.  But, my nurse likes to meet every couple of months.  I think about 4 times a year.  We can't afford that much out of pocket expenses.  I only see my doctor once a year.  I am peri and worried about having a child at my age.  I don't want to be pregnant at 50.  It is harder to chart (for me) while maybe going through that year of menopause.  This method used to be very easy for me till I started having limited mucus. 

The women that are in the 70% should be mad about having to pay extra for the coverage to received this treatment, while birth control is free.

OHHHHHH ok I am with you now .you are dealing with mid-life hormonal issues..that may need blood work or kits to help  you track your fertility since the signs are harder to see in your body right now.. .. Now this I understand.. I am 40 and my hormones are all over the place..I  can no longer tell if I am fertile or not because the obvious signs that I had before are no longer present.. however it is not an issue for me since my husband had a vasectomy 3 years ago..if he had not we would be using ovulation kits and condoms

Add your quick reply below:
You must be a member to reply to this post.
Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)



Featured