Forum Index
»
Infertility Support and Discussion
Insurance IVF Coverage
![[Post New]](/jforum/templates/default/images/icon_minipost_new.gif){kind=icon}
Anonymous
| MD IPA is open to all Feds in the metro DC region (MD, VA or DC). It covers 50% of IVF costs for up to 3 cycles per live birth (both fresh and frozen cycles count towards the 3 per live birth cap). With ICSI, I pay about $4100 per cycle and $150 for all the meds per cycle. |
Anonymous
| To 12:59. Are you sure MDIPA is not offered to feds who live in VA. They have a preferred provider listing for Virgina, DC, Delaware and WV. |
Anonymous
| I think that the state of MD requires the IVF coverage. In order to operate in MD, the insurance plans have to have it. Not so in VA, so the VA plans, even if Federal, don't have to have it. I think the catch is that if these plans want to offer for fed employees, they have to offer in all states, but may tailor their plans according to state requirements. Fed requirements would be a baseline here. |
Anonymous
| I went on the OPM website under the health plans. Clicked on VA and MDIPA does not show up as an option, even as a national plan. Maybe I'm missing something but I think when I researched last December Unitedhealth was the only one that covered a few things related to IVF. |
Anonymous
It is there - I am in VA and on the plan |
Anonymous
Yes it is. Go to plans by state - VA and look under State Specific HMO, HDHP and CDHP Plans. It is right after Kaiser. M.D. IPA - N.VA/Cntrl VA/Richmond/Tidewater/Roanoke JP |
Anonymous
It has been awhile but if I remember correctly they did ask if I had ever been pregnant and how long we had been trying. |
Anonymous
| thanks, I'll check it out. The website isn't that intuitive. |
Anonymous
|
Is that 2-yrs of TTC requirement for ALL United Healthcare Plans??
I am going to the RE tomorrow for the first time and I thought I had IVF coverage. We have not been trying for 2 yrs (it's only been 6 months) but I'm almost 40. Do I just tell the RE we've been trying for 2 years?? I don't want to lie about my medical history or say something that will affect treatment options, etc., but I also don't want to wind up paying out of pocket for IVF or, worse, being forced to waiting until another 18 months - that would be unbearable & my odds of success with my own eggs would be dropping by the month while I wait for some stupid insurance time limit! I logged into UHC.com but my plan documents are not available online so I can't review the fine print. Help! |
Anonymous
| OP here. I would tell the doctor that you've been trying 2 years. For me the issue is the fact that I've been pregnant but it wasn't viable. It all depends on how they or your doctor defines infertility. If you have no pregnancies then who knows how long you've been trying. You've been having sex for two years, yes probably with birth control but . . . The plan documents also require you to do a less invasive method before you go for IVF. If you are going to Columbia you may be able to get pregnant with injectibles and TI. |
Anonymous
|
Thanks. 12:33 here again.
If I tell the doctor we haven't been using birth control for 2 yrs, would that work for insurance purposes? (We were using bc, but only condoms, nothing hormonal, so I don't think omitting that info would affect the dr's assessment of my situation. I'd be a little concerned if I were fudging it about when I went off the pill or something, but this seems ok, doesn't it??) We have been really "trying" in earnest (temperature charting, OPKs, well-timed intercourse, etc.) for 6 months, but I would think unprotected sex counts for the insurance time limit purposes right? Or does it depend on the doctor? I am going to Shady Grove. |
Anonymous
We live in VA, have MDIPA and they paid 50% of our IVF costs in 2008. Back in 2003, we were on Kaiser and they paid 50% of our IVF costs as well. |
Anonymous
|
OP here. My guess is that doctors aren't that specific, especially in cases like yours. Yes, you know that you were using codoms, but since no one has been in your bedroom. You can say that you've been trying for two years, but you've been charting etc. for 6 months. Another poster mentioned that there is no definition of infertility in the brochures. For me, I had a non-viable pregnancy that had to be terminated. We started "trying" in Dec '07 when I had my IUD removed. I was just asking on how they interpreted 2 years or if it seems to be one of those "wink, wink, nudge, nudge" things that doctors are willing to "fudge" for their patients. I am not advocating insurance fraud here, but I think there is room for argument. I don't want to lie either but there are "infertile" couples out there who have multiple miscarriages. The conceive but don't stay pregnant.
The doctors are going to give you a complete battery of tests anyway. You may have to go through a couple of IUI's before they move on to IVF. (another insurance requirement) You may get pregnant that way and the IVF coverage will become a non-issue. |
Anonymous
| PP is correct - most require that you have tried at least one less evasive means before moving to IVF. In the case of Aetna it was one IUI then IVF. Most say 2 years of trying to conceive OR list some other conditions (most related to male problems). Also, they never asked my RE how long I had been trying to conceive they just asked me in the phone interview. |
Anonymous
| 12:33---be aware that the UHC two year requirement is regardless of the woman's age---which I think really sucks. |