Another Aetna Open Access question

[Anonymous]

I am a Fed looking at Aetna Open Access for IVF. DC#1 was born thanks to IVF in 2009. We have been trying since then, including IVF (I currently have M.D. IPA and have run through the infertility benefits), for DC #2. I have severe endometriosis, diagnosed in 2008 after one year of infertility.

I noticed the brochure states trying for two years AND endometriosis AND no success with lesser treatments. For severe endo, standard practice is IVF. So, my question for women who have experience with this plan -what am I in for in terms of a wait to qualify for IVF coverage?

In reading other threads, users seem to be pretty happy with Aetna (excepting the drug coverage), but I just want to make sure that I am not signing myself up for a whole lot of IUIs (which never worked for me before DC#1) before I can even start IVF. I know other plans consider severe endometriosis a green light to IVF (without an extended wait period). Anyone have experience with severe endo/IVF/Aetno coverage? Any input would be greatly appreciated. Thanks!

[Anonymous]

I would talk with your RE. I did the opposite switch to MDIPA from Aetna and was worried, but my RE billing office took care of everything and i didnt have to repeat any tests and they accepted all of my earlier diagnoses. The good thing about Aetna is that they have a dedicated fertility telephone line. You could also call them to get some specifics.

[Anonymous]

I only had to do i IUI with Aetna and they approved the IVF with no problems/hassles. My understanding is if you already have a documented hx of infertility it shouldn't be a problem. If you have already gone through MDIPA I would think this would be your best bet.

[Anonymous]

I was really nervous that Aetna would make me do IUIs before authorizing IVF--however, they authorized IVF right away. There's no guarantee in advance, of course, so you don't know until you switch and try. They're not in the business of wanting to pay for unsuccessful IUIs just to go on to pay for IVF, so if you have a trusted RE and the standard is IVF, I think your chances are good.