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Forum: Trying to Conceive with Medical Assistance

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  #1  
December 16th, 2011, 12:05 PM
nina9809's Avatar Mega Super Mommy
Join Date: Feb 2009
Location: British but living in California
Posts: 2,581
I am planning on changing my health insurance coverage to something that covers me better should I need to go the infertility route....

I am on a company plan so they can not reject me. I am currently with Kaiser.

The best Kaiser plan I see only covers 50% and it does NOT go towards your OOP Max and they do not cover IVF.

I swear I have heard people on JM who have great health coverage and have been covered for IVF before.... a certain number a year anyway....

What type of coverage do people have here? What is there out there with good coverage? Does anyone have IVF coverage???
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  #2  
December 16th, 2011, 12:32 PM
KMH KMH is offline
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Join Date: Sep 2008
Location: right of center
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I'm not one of the lucky ones that has IVF coverage...my insurance (military) covered testing but no IUI or IVF By the time we finish our January FET, we will have spent more than $25k out of pocket I hope you can find something to help you out!

Some states have mandated coverage. Here is some info on that: Insurance Coverage in Your State RESOLVE: The National Infertility Association

Conceive Magazine (love it!) had an article recently about the best companies to work for if you are infertile. The 50 Best Companies 2010 List - Conceive Online

Here is some general info. Health Insurance Coverage for IVF | In Vitro Fertilization

I'm sorry, Nina, it seems like all I do is give you links I hope that this info is helpful, and most of all I hope that you get a BFP before you even need it
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  #3  
December 16th, 2011, 01:40 PM
Platinum Supermommy
Join Date: Oct 2006
Location: NY
Posts: 6,083
I had pretty good coverage when we were ttc my daughter, but our plan has since changed and FORTUNATELY has gotten better (I was nervous for awhile, because it could have easily gone the other way).

I work for a school district, so get state benefits-which usually means good benefits. Now, we are starting meds again and all of our IUI's, office visits, blood works, labs, u/s and meds are covered. Well-for meds...we ordered a ton of injectables and only paid 55 dollars. If we have to go the IVF route, our insurance covers three. So yeah, it's a fantastic plan and I consider myself very lucky.

However, if you can't get onto a really good plan-there are always IVF packages (at most clinics) that will allow you to buy a few cycles for a much cheaper rate. Also, there is an IVF grant that many people end up getting.

Good luck...I hope you get onto an awesome plan!
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  #4  
December 16th, 2011, 02:12 PM
*JenJen*'s Avatar impatiently waiting
Join Date: Aug 2008
Location: west, but east. south, but not north.
Posts: 7,756
I have the same as Melissa, as I'm a military spouse as well.

Good luck getting insurane coverage!
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  #5  
December 16th, 2011, 02:30 PM
nina9809's Avatar Mega Super Mommy
Join Date: Feb 2009
Location: British but living in California
Posts: 2,581
Quote:
Originally Posted by scubagirl80 View Post
I had pretty good coverage when we were ttc my daughter, but our plan has since changed and FORTUNATELY has gotten better (I was nervous for awhile, because it could have easily gone the other way).

I work for a school district, so get state benefits-which usually means good benefits. Now, we are starting meds again and all of our IUI's, office visits, blood works, labs, u/s and meds are covered. Well-for meds...we ordered a ton of injectables and only paid 55 dollars. If we have to go the IVF route, our insurance covers three. So yeah, it's a fantastic plan and I consider myself very lucky.

However, if you can't get onto a really good plan-there are always IVF packages (at most clinics) that will allow you to buy a few cycles for a much cheaper rate. Also, there is an IVF grant that many people end up getting.

Good luck...I hope you get onto an awesome plan!
Who are you insured with and what state do you live in?
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  #6  
December 16th, 2011, 04:38 PM
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Join Date: Oct 2006
Location: NY
Posts: 6,083
Our company is Blue Cross Blue Shield and we live in NY

I should add, although I don't know if it makes a difference, that my district added a rider on to our policy for fertility treatments. I guess a lot of the riders are pretty good.
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  #7  
December 16th, 2011, 06:21 PM
*CAMM*'s Avatar Platinum Supermommy
Join Date: Jan 2007
Location: somewhere over the rainbow
Posts: 8,635
Its pretty hard to find private insurance that covers infertility. Conceive (the magazine) has a list of employers that provide infertility coverage and what they cover.

I worked for an insurance company that was bought by Cigna..once we were switched over I finally had coverage for my 3rd IVF cycle.
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  #8  
December 16th, 2011, 07:30 PM
Mega Super Mommy
Join Date: Dec 2011
Posts: 1,154
I have BCBS through my employer and would have had coverage for everything up through IUI, but IVF was our only option from a medical standpoint and neither my health insurance nor my husband's covers it. We decided though to participate in my fertility center's "Shared Risk" program, which allows us up to 6 fresh IVF cycles (and as many intermediate frozen embryo cycles as warranted) for one fixed fee ($20,000), and refunds the money if we do not end up with a live birth or if we withdraw from the program. That fee, though, doesn't include the cost of the medications, which can be substantial. Anyway, it was a great option for us given our lack of coverage for IVF, as we can proceed for a while without worry that we won't be able to afford another try. My understanding is that there are many clinic which offer similar multi-cycle discounts.

I hope, though, that you don't have to go the route of fertility treatments at all! Good luck!
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  #9  
December 18th, 2011, 02:47 PM
♥Ashley♥'s Avatar Platinum Supermommy
Join Date: Apr 2008
Location: St. Louis, MO
Posts: 14,102
Quote:
Originally Posted by *CAMM* View Post
Its pretty hard to find private insurance that covers infertility. Conceive (the magazine) has a list of employers that provide infertility coverage and what they cover.
I have ZERO coverage, and I have Anthem BCBS in Missouri.
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Cycle #10-11 - Met with first RE, diagnosed with heterzygeous MTHFR mutation & slightly low SA on all counts. -BFN, Cycle #12 - First IUI+Trigger - BFN, Cycle #13 - BFN
Cycle #14-15 - Met with new RE, diagnosed with a blocked right tube that previous RE completely overlooked or didnt care to mention. Soy (120mg) - BFN
Cycle #16 - Clomid (100mg) - BFN, Cycle #17 - Clomid (100mg)+Trigger+IUI - BFN
Cycle #18 - Acupuncture+Clomid (100mg) - BFN
Cycle #19-27 - 2 Soy (160mg) cycles, the rest all natural also 30lbs lost!! - BFN's
Cycle #28 - New RE is GREAT! Put on bcp 7/6/11, Lap surgery 8/1/11- Tubal cyst (5cm) found and removed, Uterine Septum removed, and Stage II-III endo removed. Cycle #29 - All Natural - BFN, Cycle #30 - All Natural - BFN, Cycle#31 - All Natural - BFN, DONE TTC FOR NOW




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  #10  
December 18th, 2011, 04:00 PM
Platinum Supermommy
Join Date: Oct 2006
Location: NY
Posts: 6,083
Quote:
Originally Posted by ♥Ashley♥ View Post
I have ZERO coverage, and I have Anthem BCBS in Missouri.
That sucks

I know it really all depends on the specific plan your employer gets, rather than the company they get it with.
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Secondary Infertility Blog*~*http://onemunchkin.blogspot.com/ *~*

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  #11  
December 19th, 2011, 07:08 AM
MandyEllen's Avatar Mega Super Mommy
Join Date: Aug 2010
Location: New Jersey
Posts: 1,452
My company is self-insured by Qual Care. I am covered for all IUIs (testing, meds, bloodwork, IUI itself). Because I'm only 32, I had to do 3 IUIs to move onto IVF. IVF is then covered for 4 egg retrievals in my lifetime, but as many IVFs that we can get out of those retrievals.

I believe in NJ, it is mandatory that insurance companies cover women over the age of 35 for infertility. Good luck with finding the right plan for you!
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  #12  
December 19th, 2011, 07:15 AM
kelbert's Avatar a.k.a. Kelli
Join Date: Sep 2010
Location: Texas
Posts: 2,659
I am on my DH's insurance and he has really good coverage. He works for an oil company and we have United Health Care. Its a 90/10 plan but for IVF there is a 5000 max.

I am not sure what all we have paid, but all I know is that we are blessed to have this coverage and I am very thankful. If we didn't have it, IVF would not have been an option for us.
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  #13  
December 19th, 2011, 07:43 AM
nina9809's Avatar Mega Super Mommy
Join Date: Feb 2009
Location: British but living in California
Posts: 2,581
Thanks for all these answers ladies!
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  #14  
December 20th, 2011, 11:22 AM
Super Mommy
Join Date: Jan 2007
Location: Texas
Posts: 975
My health insurance only covers "diagnosis". I had to pay for IUIs and IVFs out of pocket (and it doesn't count toward my deductible). I was very fortunate that about 90% of medicine costs were covered with my insurance.

Look into "Heath Care Discount Programs". This is not an insurance plan, but an additional plan (outside of your insurance) that has negotiated rates with certain doctors for certain services. Your doctor has to participate. I was fortunate to find one that my RE participated in and we did save quite a bit. Luckily my dentist participated too, as I needed a crown too!
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