IVF and IUI ..What insurance do you have and what does it cover?

[aidianliam]

Hey-im looking into changing my insurance policy so i can find insurers who cover more fertility treatment. I am approaching ivf. I know several women who have said they get 50k lifetime fertility or their insurance pays for half of ivf..yadda..yadda. SO i thought we could post what carrier we have and what is covered ...so i can find a better plan:D

I have blue cross blue sheild-They cover bloodwork, appointments, ultrasounds, ovideril, progestrine, clomid..but no injections and no procedures.

Thanks so much!

[fish142]

Hi. I'm one of those lucky ones with fabulous insurance. It's the Empire Plan in NYS and as far as I know it's mostly available to employees of the state government and govt agencies and affiliates. It has a $50k lifetime maximum per person for IVF (but since my dh has no problems, all the charges count towards me) and if you go to certain NYS clinics ("Infertility Centers of Excellence"), which fortunately I am able to do, they pay for everything except for copays for drugs and blood labwork. Hope you can find such great insurance coverage in VA. Good luck! :)

[Sunny]

I have United Health and we are covered for everything. I pay the copay for office visits, that's it. I can't even begin to imagine how the stress of having to pay out of pocket would add to the already frustrating state of the waiting game. Good luck everyone!!

[Hope2BMommy]

WE have Aetna PPO. All visits are covered (must pick a fertility place that is covered though), however I pay my co pay of $25 each visit. We are covered at 50% of 6 tries for IUI, and we are covered at 50% for 3 tries of IVF. My meds are dirt cheap, so they are covered somewhat too! Good luck! You know, some states are required to pay for all of infertility!

Aidianliam, I sent you a private message!

[Erin C]

Wow!!! I need to move. I live in NE and ins. companies aren't required to pay anything for infertility - so they don't. I had BCBS while we were going through testing and IUI and they paid absolutely nothing. Of course, after I was already pg, they started paying for diagnostic stuff. That would have at least helped. I now have United Health and they also pay nothing. Feel lucky if you have anything paid :)

[Jenifer]

I have a friend that has Health Partners but it only covers 6 IUI's per confirmed pregnancy. And it covers all of her meds adn tests.

[pblennox]

I live in NJ. They passed a law years ago that employers with 50 or more employees must follow the Family Building Act of NJ. No limit to IUIs, meds are covered and you get 4 egg retrievals per lifetime, this can be with your own eggs or a donors eggs, if you use a donor, the donors medical expenses are covered but not legal and compensation costs. You must be trying 2 years under 35 and 1 year over 35 though, but i think that there are some exceptions if say your tubes are blocked.

Patty

[eagles212]

I live in nj as well, and what Patty said about nj, my insurance--amerihealth ppo--covers. My copay is $5 for office visits and all labwork and surgical procedures are completely covered w/ no copay. My meds are $15 for brand and $10 for generic.

[charlotte98]

I have BCBSNC and they cover pretty much nothing. We are paying out of pocket for IVF $14,000. However, they do cover a lifetime fertility med amount of $5,000, so I'm hoping that they'll pick up the tab for our IVF meds since we've never used this benefit before. I didn't even know that we had it! When we were TTC#1 we had United Healthcare and only payed $250 per IUI plus meds. It seemed like a lot then, but I sure wish I had that coverage now!

Char

[copwife]

I tried to find a better insurance plan too!
But from what i found the only infertility benefits come from group plans, not indivual plans. Does anybody hane an indivual plan that covers anything, such as bloodwork, and ultrasounds? and if so what kind is it?
Our plan used to cover blood and u/s, but as of 2006, nothing!!!!!
So everything is out of pocket!!
Jodi

[copwife]

Question for sunny and hope2,
Do you live in a state that is mandated? And is it an indivual policy?
I was looking on e-insurance, at aetna pos plan, but it says nothing about infertility coverage?

Jodi

[sphynx]

Texas is obviously one of those "not mandated to cover crap" states...

I have Aetna HMO and get coverage for diagnosis but nothing for IVF, IUI, etc., and definitely nothing for meds. In fact, they don't even cover my prenatal vitamins, and didn't cover my birth control pills (ironic they put you on these when trying to calm your ovaries...) So, essentially, since we already went through all the tests, we're now on our own. Yippee!!

I think I need to move....:D

[Hope2BMommy]

Copwife,

I don't know what you mean by individual plan? We do have Aetna, it is a PPO, and I believe is also a POS (I don't know what that is, but it is on the card).......We had Aetna HMO, but I knew we were doing fertility stuff, so when I started digging around I found the HMO covered nothing for infertility, so for the beginning of the year we switched to the PPO.....We get 6 IUI's covered at 50% per life, and for IVF we get 3 tries per life covered at 50%....I believe MA, and MD are two of the states that have pretty good laws about infertility.

[copwife]

Hi girls,
Thanks for the input. The group plan is what you get from an employer, indivual is what you take out on your own. D/h 's plan is an hmo, covers everything under sun but fertility, so i looked at aetna ppo, my re's practice is on there, so maybe it offers some kind of coverage. I think i am going to talk to an insurance agent, they might be able to tell me more about any exclusions.
Thanks girls

Jodi