Insurance: IVF Cycle

[Anonymous]

Hey everyone!
I am at SGF and the billing/financial person wants to count an FET as a whole IVF cycle!
I get 2 ivf cycles covered by BCBS, I used up one (egg retrieval and fresh transfer) but had frozen embryo from that cycle, which we transferred and ended in miscarriage unfortunately.
Now SGF telling me my fertility benefits are up!!!! Wouldn’t the FET be part of the first IVF cycle that yielded the embryo?
Would love to hear from anyone who had a similar experience. Thank you

[Anonymous]

A FET wouldn’t be part of the first cycle, nor its own new IVF cycle (which would involve a retrieval), it would be its own standalone thing. Is it possible that the IVF cycle + first transfer + frozen transfer (ie all three procedures you had) just ate up your coverage limit? Personally that’s how it works for me with BCBS - X number of dollars for whatever procedures and then it’s gone. It doesn’t make sense that they would have charged either transfer as a second full IVF cycle though, so maybe an error there in their files. Their billing is certainly not the best.

[Anonymous]

Do you have progyny under BCBS?

[Anonymous]

Can you pay FET out of pocket and save the covered IVF cycle for egg retrieval? You may have to fight for it

[Anonymous]

Anonymous wrote:Do you have progyny under BCBS?

No I am on the PPO plan

[Anonymous]

Anonymous wrote:Can you pay FET out of pocket and save the covered IVF cycle for egg retrieval? You may have to fight for it

I will try, thanks … I wish it was a simpler process

[Anonymous]

every insurance has a different definition of ivf attempt. for me, it's 3 transfers per live birth. some count retrevials but not transfers. some (maybe yours) count both as an attempt. some have dollar limits on treatment but no limit on attempts. if you can, get your hands on the actual "plan document" and read it for yourself.

in our situation, we are letting insurance pay for 2 transfers, but for 3rd and beyond transfers we will pay OOP. that way, insurance will cotinue paying for retreivals. because if we let insurance pay for the third transfer insurance will pay for nothing after that.