Feds - benefits open season! Infertility coverage advice...
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Anonymous
| Thanks, PP, for your post. Usually no frozen embryos for me, unfortunately. I'm not sure I totally understood what you meant on your oop expenses for the procedure. What did you max out? So, your total oop expense for the procedure was $1500? Thanks again! |
Anonymous
With MDIPA, you have a maximum out of pocket limit, after which you don't pay any co-pays for things that are fully covered (you do continue to pay copays for partially covered treatments such as IVF). Monitoring appointments are considered fully covered, so after you hit your annual limit (which is $1800 for an individual plan, can't remember what it is for a family plan) you don't have to pay copays anymore. Between other medical bills, IUI, IVF, and a D&C, I hit my max right after my first cycle. My out of pocket was lower for my second IVF cycle since I didn't have copays associated with monitoring appointments. Including meds, I think my total expense was something like $1800-1900 (excluding cryopreservation). |
jindc
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21:12 - that's intereasting, I'm changing to MD IPA and I thought that your "max out of pocket" did not include fertility - maybe that's a change for 2013?
I got a sheet from GW about the expected cost on each insurance plan, and they quoted me about $4500 before meds with MD IPA (the difference without meds between MD IPA and Aetna was insignificant). Is that not how it works - maybe that's their negotiated rate with the companies and I pay 1/2 that? If IVF counts towards your max out of pocket, does that mean you then pay nada for maternity care out of pocket? Or is that something different? One more MD IPA question for you veterans: if I'm on self only, and then need to do more than 3 IVFs, can my husband sign up for self+ family next year and then my cycles be covered, or is that it? sorry for these ?s - I've never really needed insurance until now. Glad MD IPA is an option, I guess! |
Anonymous
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My out of pocket costs for prescriptions only for the last cycle with MDIPA (I'm on a high dosage) was $374.
PP: I don't think so. I think your 3 cycles on MDIPA would be liftetime, regardless of who is the policyholder. |
Anonymous
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My OOP costs for prescriptions for the last cycle with MDIPA was $374.
PP: No, your 3 cycles (per live birth) with MDIPA are lifetime, regardless of who the policyholder is. |
jindc
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Dang, oh well. Here's hoping we won't need three cycles...sigh (but it's hard not to worry).
But I still am confused about the OOP for the cycle if it's 50%, but I guess I'll find out. And it doesn't count towards your annual OOP max - IVF is not included in that, unfortunately, according to the brocure anyway |
Anonymous
| Wow, MDIPA seems to be SO much better than Aetna. Does anyone know if it is better to be on MDIPA as a family (ie, both myself and spouse) or just for me (re. fertility treatments)? MDIPA is kinda expensive for a family plan (we don't already have kids) so my husband could get his own insurance through work and then MDIPA would cover all our fertility stuff though my plan. Does anyone know if this works? Or, does his sperm collection etc. need to be put on MDIPA under his name? Thanks for your help! |
Anonymous
Yes, that works fine. I'd wait to add your child and your husband until you give birth. (And then you can switch plans if you like.) |
jindc
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| Question...if my husband is on his own plan, when he has to give his sample and all, does his plan cover it, or would it all be me because I am the ivf patient? He has to pick a plan too, so just wondering... |
Anonymous
| My understanding it is that it is all your plan but that is exactly the question I am wondering. Anyone else know for sure??? |