insurance company that covers IVF?

[Anonymous]

Any tips on what insurance company has the best coverage for IVF?

[Anonymous]

Insurance companies don't typically cover IVF unless they are required to, which means purchasing insurance in a state where IVF coverage is mandated (Maryland is 1 of 15 states where infertility treatment is a mandated benefit).

The mandate is only applicable to fully-insured plans delivered in the State, which can be purchased in the individual market (like going to Carefirst's website and buying a policy from them without going through an employer), or bought through a Maryland employer that is NEITHER a small employer or a self-insured employer.

The mandate does NOT apply to self-insured plans (employers with a large number of employees tend to self-insure, which means the employer takes the risk in insuring the group) or to small-group plans (the mandate does not apply to the small-group market).

The mandate applies the same way to all insureds of a fully-insured plan so there really isn't really one with the "best" coverage for IVF. What I think you are really looking for is a fully-insured health plan in a state where infertility treatment is a mandated benefit.

* A note about buying in the individual market - you usually have to go through medical underwriting to get a quote for an insurance policy in the individual market. I don't know what they ask but they may ask for medical records before they issue coverage. And if you lie on the application, they can exclude coverage for treatment of whatever medical condition you lied about. For group coverage, there is no medical underwriting.

Good luck!

[Anonymous]

Just wanted to share that I have Aetna through Booz-Allen, and the insurance is unreal. (In a good way.) I am AMA and they completely cover 4 IVF cycles and multiple IUI cycles. It is kind of too good to be true.After my RE's finance person called them to verify things she actually said to me it was the best insurance plan she has heard of in a while. It is not something that comes up in a job interview exactly, but just wanted to note that in case anyone is thinking about switching jobs to get better insurance. Keep Booz in mind!!

[Anonymous]

PP: If you are AMA did you use a donor? Thanks

[Anonymous]

I think it depends on the employer, like PP said. I worked for a large nonprofit where we had IVF coverage. A colleague had 2 babies with that coverage. It was also Aetna.

[Anonymous]

If you're a fed, I think MD IPA is the usual choice.

[Anonymous]

Just FYI not all Aetna plans cover IVF. I'm actually curious which ones do... I have an AETNA PPO and it does cover a couple rounds of IVF and several IUIs but DOES NOT cover ANY drugs associated with these procedures, which really are a big chunk of the money.

[Anonymous]

p.p.:Are you familiar with MD IPA's federal coverage? I have Aetna Federal. They cover 50% of up to 6 I.U.I's, 50% of 3-IVf- but no coverage at all on the injectable medications (which can really add up). And they do not cover F.E.T. cycles.

[Anonymous]

Anonymous wrote:Just FYI not all Aetna plans cover IVF. I'm actually curious which ones do... I have an AETNA PPO and it does cover a couple rounds of IVF and several IUIs but DOES NOT cover ANY drugs associated with these procedures, which really are a big chunk of the money.

PP, what plan do you have with Aetna? We have federal insurance and it appears to me that IVF is only covered 50%, and only for HMOs.

[Anonymous]

my husband is a fed govt employee and we have Kaiser, which covers 3 IVF cycles per live birth. When I was looking into it, AETNA also covered it.

[Anonymous]

It depends on what plan your employer creates. My employer provides an Aetna plan with IVF coverage if you fit certain criteria.

[Anonymous]

ACtually, I believe that Kaiser is actually 50% OF three cycles per live birth, for both medicines and the IVF itself. Aetna covers the same thing (although how they count cycles is different)

If someone knows who covers 100% of cycles for federal plans, please let me know! But so far as I can tell, the only coverage is through
1) Aetna HMO
2) Kaiser HMO
3) MDIPA (HMO)

[Anonymous]

Above poster- the above applies to fed govt empoloyees.

[Anonymous]

Companies determine IVF benefits as part of the their insurance plan offerings (or not). Those benefits are then applied to the insurance policies that the company offers through the various insurance providers. Sometimes coverage is consistent from policy to policy within the same company and other times it varies. Your benefits department has the most accurate information on what infertility coverage, if any, your company offers.

[Anonymous]

I'm under my husbands insurance (united healthcare) and get 25k in benefits. Under the same united health care but at my company, which is pretty small, I was getting 5k coverage. I know of some teachers who have 100k in coverage!