OPM to require FEHB plans to cover 3 rounds of ART starting in 2024

[Anonymous]

Wow, they are bringing down the hammer on the FEHB plans.

The FEHB Program currently covers the diagnosis and treatment of infertility, but does not provide coverage for “assisted reproductive technologies (ART)” or other fertility-related procedures.

The letter states that FEHB carriers are required to provide coverage of artificial insemination, drugs associated with artificial insemination procedures and the cost of in-vitro fertilization (IVF)-related drugs for three cycles each year.

https://www.nteu.org/blog/2023/03/23/fehb-to-expand-fertility-coverage-in-202

[Anonymous]

Why did they allow the plans to drop the coverage to begin with?

[Anonymous]

Anonymous wrote:Why did they allow the plans to drop the coverage to begin with?

When did that happen? Probably depends on the administration.

If a Republican is elected in 2024, they will probably try to take away the benefit. If you are going to do ART, you’ll want to do it in 2024.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why did they allow the plans to drop the coverage to begin with?

When did that happen? Probably depends on the administration.

If a Republican is elected in 2024, they will probably try to take away the benefit. If you are going to do ART, you’ll want to do it in 2024.

Not sure when it was removed, but wasn’t it in place pre-Obama?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why did they allow the plans to drop the coverage to begin with?

When did that happen? Probably depends on the administration.

If a Republican is elected in 2024, they will probably try to take away the benefit. If you are going to do ART, you’ll want to do it in 2024.

Not sure when it was removed, but wasn’t it in place pre-Obama?

Nope.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why did they allow the plans to drop the coverage to begin with?

When did that happen? Probably depends on the administration.

If a Republican is elected in 2024, they will probably try to take away the benefit. If you are going to do ART, you’ll want to do it in 2024.

Not sure when it was removed, but wasn’t it in place pre-Obama?

FEHB has covered diagnosis and testing, but never covered the ART procedures.

This new requirement is a big change.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why did they allow the plans to drop the coverage to begin with?

When did that happen? Probably depends on the administration.

If a Republican is elected in 2024, they will probably try to take away the benefit. If you are going to do ART, you’ll want to do it in 2024.

Not sure when it was removed, but wasn’t it in place pre-Obama?

FEHB has covered diagnosis and testing, but never covered the ART procedures.

This new requirement is a big change.

IVF was covered up until recently. Even once it was removed Shady Grove provided the same rates for Feds that had Aetna for the year or so following the removal.

[Anonymous]

Are they going to let us use it right away or do we still have to "try" for 12 months first??

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why did they allow the plans to drop the coverage to begin with?

When did that happen? Probably depends on the administration.

If a Republican is elected in 2024, they will probably try to take away the benefit. If you are going to do ART, you’ll want to do it in 2024.

Not sure when it was removed, but wasn’t it in place pre-Obama?

FEHB has covered diagnosis and testing, but never covered the ART procedures.

This new requirement is a big change.

IVF was covered up until recently. Even once it was removed Shady Grove provided the same rates for Feds that had Aetna for the year or so following the removal.

Here is an old thread talking about the plans that covered IVF (not all did). There are posters stating that they received coverage in 2006, which was during the Bush Admin.

https://www.dcurbanmom.com/jforum/posts/list/20189.page

[Anonymous]

Anonymous wrote:Are they going to let us use it right away or do we still have to "try" for 12 months first??

Who knows. But you might as well get documentation of “trying” now. Doesn’t hurt you and if you get pregnant naturally, all the better!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why did they allow the plans to drop the coverage to begin with?

When did that happen? Probably depends on the administration.

If a Republican is elected in 2024, they will probably try to take away the benefit. If you are going to do ART, you’ll want to do it in 2024.

Not sure when it was removed, but wasn’t it in place pre-Obama?

FEHB has covered diagnosis and testing, but never covered the ART procedures.

This new requirement is a big change.

IVF was covered up until recently. Even once it was removed Shady Grove provided the same rates for Feds that had Aetna for the year or so following the removal.

Here is an old thread talking about the plans that covered IVF (not all did). There are posters stating that they received coverage in 2006, which was during the Bush Admin.

https://www.dcurbanmom.com/jforum/posts/list/20189.page

Coverage amounts/benefits were discretionary. FEHB plans could decide to offer a benefit as a way to attract Feds. You’ll notice that in those posts some respondents were getting a benefit/major discount at SGF, while others got nothing under their respective FEHB plans. Given that there are dozens of potential plans, they offer differentiating services and benefits. It did not appear that any previous FEHB provided 100% coverage for ARTs. It was difficult to dicipher the exact coverage for a plan and how the plans stacked against each other in terms of fertility coverage and benefits.

It seems that OPM will now require all plans to offer ART services, at a max of 3 rounds per year. It’s not clear how much will be covered, what the cost sharing will look like, etc. But this clearly will increase transparency and comparability when evaluating plans. Just knowing that your FEHB plan has to meet a baseline benefit is helpful.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why did they allow the plans to drop the coverage to begin with?

When did that happen? Probably depends on the administration.

If a Republican is elected in 2024, they will probably try to take away the benefit. If you are going to do ART, you’ll want to do it in 2024.

It was removed under Obama you partisan twit.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why did they allow the plans to drop the coverage to begin with?

When did that happen? Probably depends on the administration.

If a Republican is elected in 2024, they will probably try to take away the benefit. If you are going to do ART, you’ll want to do it in 2024.

Not sure when it was removed, but wasn’t it in place pre-Obama?

FEHB has covered diagnosis and testing, but never covered the ART procedures.

This new requirement is a big change.

IVF was covered up until recently. Even once it was removed Shady Grove provided the same rates for Feds that had Aetna for the year or so following the removal.

Here is an old thread talking about the plans that covered IVF (not all did). There are posters stating that they received coverage in 2006, which was during the Bush Admin.

https://www.dcurbanmom.com/jforum/posts/list/20189.page

Coverage amounts/benefits were discretionary. FEHB plans could decide to offer a benefit as a way to attract Feds. You’ll notice that in those posts some respondents were getting a benefit/major discount at SGF, while others got nothing under their respective FEHB plans. Given that there are dozens of potential plans, they offer differentiating services and benefits. It did not appear that any previous FEHB provided 100% coverage for ARTs. It was difficult to dicipher the exact coverage for a plan and how the plans stacked against each other in terms of fertility coverage and benefits.

It seems that OPM will now require all plans to offer ART services, at a max of 3 rounds per year. It’s not clear how much will be covered, what the cost sharing will look like, etc. But this clearly will increase transparency and comparability when evaluating plans. Just knowing that your FEHB plan has to meet a baseline benefit is helpful.

Yup, you had to research which plans had coverage. The PP that said ART was never covered was incorrect.

[Anonymous]

IVF was covered under the Aetna plan in 2016-I used it to get pregnant with my first child. It was dropped in 2017.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why did they allow the plans to drop the coverage to begin with?

When did that happen? Probably depends on the administration.

If a Republican is elected in 2024, they will probably try to take away the benefit. If you are going to do ART, you’ll want to do it in 2024.

Not sure when it was removed, but wasn’t it in place pre-Obama?

FEHB has covered diagnosis and testing, but never covered the ART procedures.

This new requirement is a big change.

Wrong.
I did IVF at Shady Grove between 2014-2017 and 3 cycles of IVF was definitely covered by United-MD-IPA, Aetna and Kaiser. BCBS covered diagnostics but not actual IVF.