Financing IVF- Does BCBS cover anything?

[Anonymous]

Hi,

I the have BCBS Federal Government plan "BASIC" (not standard). I understand they cover a good chunk of injections for IVF. The clinic Shady Grove told me they do not cover anything for the actual IVF so it would be out of pocket $9,500. But I wonder has anyone had success getting BCBS to cover the monitoring?? It seems like if you could subtract the cost of ultrasounds and blood tests the costs would be much lower.

Thank you.

[Anonymous]

I had BCBS Standard and they covered monitoring too, just not the actual IVF procedures. I have no clue about the basic option.

[Anonymous]

Thank you! Do you remember what the cost thus turned out to be? I know the injections will be about 1,500 on my plan (luperon phase protocol).

[Anonymous]

The meds that were covered were actually only around 150-175 for my long lupron protocol. The monitoring was just billed to the insurance company with me. I paid 8400 for my IV cycle at CFA.

[Anonymous]

The coverage for the basic plan is on pages 38-39 of the plan brochure. You can look it up online at: http://www.opm.gov/insure/health/planinfo/2010/brochures/71-005.pdf. They don't cover anything for the actual IVF or IUI. I think for the drug coverage, you need to call the main BCBS number and ask to be connected with the ext for questions about coverage for medications. Some of the Federal plans give some coverage for infertility services. The nurse at my RE told me to shop around before Open Season and see what plans give the best coverage. If you are willing to wait until Open Season for your IVF, it may be worth shopping the plans a bit. Hope that helps.

[Anonymous]

We also have this plan. It covers part of the cost of meds but that is all. The monitoring is not covered once you start IUI or IVF b/c then it is considered part of your "treatment." (My monitoring and BW were covered prior to starting our 1st IUI cycle b/c we were still considered "diagnostic"). The gobal fees for IUI andIVF at SG cover monitoring and the procedure.

[Anonymous]

Caremark-CVS handles the pharmacy benefits and lupron, gonods, are covered. We are about to start an IVF cycle.

We thought that the montoring would be covered and have checked numerous other websites. It seems that they may cover it.

Anyone else know what else is covered by BCBS - other than the IVF procedure itself - egg retrieval and embryo transfer - which are not covered.

[Anonymous]

Shady Grove told me that BCBS does NOT cover monitoring during cycle since they code this as "treatment" vs. "diagnostic."

[Anonymous]

We have basic, Federal BCBS PPO - they wrote to me telling me that they cover infertility drug regimes. .

The plan specifically states diagnostiic and treatment of infertlity.

I would thnk that they would have said monitoring - drugs - excluded.

[Anonymous]

I checked with bcbs by phone the other day (I have the fed standard plan), and they confirmed what SG told me -- drugs and diagnostics are covered, but nothing for monitoring in connection with "procedures" or the procedures themselves.