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Discussion Starter · #1 ·
Hi all,

I have a question, i will be having Immune treatment soon with Dr Gorgy for recurrent miscarriage, i have private Bupa health care through my work. I know i cant claim for any fertility treatment and i have a history on my medical records for RM years before the policy was started. I have read somewhere that some ladies have managed to claim by saying its immune related and not fertility, just wandering if there is a way round it? would any one like to shed any light? as i am trying to explore all options!

Kindest Regards
Zoe
 

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I'm pretty sure you can't do anything through Dr Gorgy as he isn't registered with Bupa, but Dr Eskander is.  So you can have any exploratory procedures done through him and Bupa covers hem.  Dr Gorgy is happy for patients to do this. You just have to be careful to say it's diagnostic (sorry can't spell!) and not treatment.

I had a saline something through him and will be having a hsterography (sp!) also.  (both are covered)

Hope that helps

Spring
xxx
 

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Discussion Starter · #3 ·
Hi Springflower,

Thanks for your reply
i have checked my insurance certificate and it says For any treatment that is for or is related to miscarriages and their complications is not covered for me as it is a pr-existing condition. Does Dr Eskander work at/for Dr Gorgy then at FGA? would he follow the same protocol? i have already had all the bloods but am thinking maybe blood re-tests etc after LIT and Intralipids etc? Just wandering how i would go about it all.

Thanks in advance
Zoe
 

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Hi Zoe

I wonder if you could get round it by say it's for fertility investigations? Dr E is a Gynaecologist he has his own clinic but so works from FGA on Thursday and Friday in the afternoons.  TBH I'm not sure whether we would be able to get the blood tests done through him (and Bupa), but you could ask?

When I told Dr G I wanted to do whatever we could, but if there were areas where we could save money then I'd like to persue them.  He was very good, and he told me which blood tests the gp would probably do and also that Dr E could help out with things covered under Bupa. 

It's very frustrating you have the pre- exisitng condtion on you cover, so annoying!

Someone else might be able to advise on the blood tests etc.

Goodluck with everything.


Spring
xxx
 

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Springflower said:
Hi Zoe

I wonder if you could get round it by say it's for fertility investigations? Dr E is a Gynaecologist he has his own clinic but so works from FGA on Thursday and Friday in the afternoons. TBH I'm not sure whether we would be able to get the blood tests done through him (and Bupa), but you could ask?

When I told Dr G I wanted to do whatever we could, but if there were areas where we could save money then I'd like to persue them. He was very good, and he told me which blood tests the gp would probably do and also that Dr E could help out with things covered under Bupa.

It's very frustrating you have the pre- exisitng condtion on you cover, so annoying!

Someone else might be able to advise on the blood tests etc.

Goodluck with everything.

Spring
xxx
NOOOOOOO!!!! As far as I know, BUPA will never cover for fertility investigations. If they even hear the word 'fertility' they'll completely shut up shop.

The only thing I can think of, is to go to an endocrinologist. Maybe speak to one first and see whether or not they'll do a full immune panel. There are reproductive endocrinologists out there (apparently Dr Conway is very highly regarded round these parts) maybe see whether or not they'd be willing to do the tests.

I know it's not ideal but my autoimmune disease (Hashimoto's) is related to the thyroid so it may be a tenuous link but it might be worth checking it out?
 

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Interesting, as Bupa were happy to cover me as long as it's classed as a fertility investigation.  Hmm guess it depends on the type of Bupa cover you have.

Spring
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I've been wondering exactly the same thing, the BUPA cover I have definitely covers us for investigation,subject to being a member for so many months before hand, so am now looking as to whether I should be my immunes done with Mr Gorgy or at ARGC, as we've decided to cycle there next.  Just not sure what I can and can't get covered, as it does seem you have to have the investigations done with a consultant that is registered with them.  Am going to do some more investigating  with BUPA and will let you know if I manage to get any more information.

Helen x
 

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Discussion Starter · #8 ·
Thank you Helenlouisey i am not sure i will be covered as i think anything pre-existing they wont cover you for, however my certificate does say treatment for miscarriage is not covered but not investigations? But if Mr Gorgy is not registered with Bupa then i cant use it any way! looks like im going to have 2 approach the bank................ Gulp! Please let me know how you get on


Zoe
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Hi Zoe - Mandy's right - if you can establish an immunes 'link' (maybe via your Factor V Leiden??) as a reason for having the NK Assay and cytokine tests then B u p a should be happy to give you a pre-authorisation number.

Re; Dr Conway - I managed to get most of my Level 1 immune tests done via him, but he wouldn't entertain doing any of the Level 2 (NK assay, etc) because he doesn't agree that levels in the blood are an accurate reflection of what is going on in the uterus.

Re; investigations - I had an HSG covered by B u p a a couple of years ago due to my amenorrhea, and they stressed it was because it was diagnostic / investigative - but they don't cover 'treatment'. They have a list of conditions that are covered for investigations.

Dr E is on the list of B u p a consultants - but it doesn't look like his work at FGA is covered? Best to check with FGA.

http://consultant-guide.bupa.co.uk/Mr-Adel-Aziz-Eskander-2675035.aspx?srcPostcode=&returnUrl=http%3a%2f%2fconsultant-guide.bupa.co.uk%2fsearch.aspx%3fp%3d1%26s%3d275a2537_d236_4166_99eb_6adcf4c63635

Helen - best to check with ARGC first as from what I've read they sometimes ask ladies to re-do their immune tests even if they have been done recently by Dr G.

/links
 
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