Fed Employees: IVF Insurance Questions

[Anonymous]

I’m a federal employee, live in Virginia and did three ivfs with SGF. I agree with all of the above. My husbands insurance covered IVF so even though the premiums were more, it made sense to us switch to his insurance. Just another thought.

[Anonymous]

Anonymous wrote:GEHA is covering monitoring and add’l charges like the anesthesia but not the actual egg retrieval itself or PGS. So that’s like thousands of dollars that we don’t have to pay. We just pay the coinsuramce and the actual procedure. .

I just looked this up and can't seem to find anything on it. Can you provide more details and information on what you've seen about this?

[Anonymous]

Anonymous wrote:

Anonymous wrote:GEHA is covering monitoring and add’l charges like the anesthesia but not the actual egg retrieval itself or PGS. So that’s like thousands of dollars that we don’t have to pay. We just pay the coinsuramce and the actual procedure. .

I just looked this up and can't seem to find anything on it. Can you provide more details and information on what you've seen about this?

I am interested in hearing more about this as well. If the egg retrieval is billed separately, how much was it?

[Anonymous]

Anonymous wrote:Right, no more IVF under federal insurance. Kaiser may still cover IUI, and there was a BCBS HMO that covered IUI but not sure of the current status.

For cost savings, I feel like the best bet is BCBS Basic. Even in an IVF cycle, the copay for monitoring is $40. This is huge savings when those visits can be hundreds per time and you have 5+ visits per cycle. They also do cover fertility medications, including injectables, if you are doing a timed intercourse cycle. So there's some potential to do a couple of TI cycles and maybe get your nurse to order extra meds. If you save what's left from those, you may not have enough for a whole cycle, but that can still be serious savings.

So they don't cover IVF, but do cover sex changes and gender identity hormone therapy?

[Anonymous]

Anonymous wrote:Yes, if you have Aetna FEHBP then Shady Grove gives you their Aetna negotiated rate - it’s about half the sticker price for IVF, FET etc. meds not covered of course. But I saved a boatload of money by switching to Aetna and going to Shady Grove.

Which of the Aetna FEHB plans? HMO Open Access, Basic or Family? Do you remember drug costs?

[Anonymous]

I think it’s all of the Aetna FEHBP plans but I had the HMO open access. Call SGF to ask if it matters. Drugs not covered so I think I spent $5k or so?

[Anonymous]

It’s any Aetna plan. SG doesn’t actually charge the company it just honors the negotiated rate and you pay less.

We added me to my husband’s aetna policy for this benefi but once we got all the numbers we didn’t end up using the benefit. It’s less $ for one cycle but the 2 cycle discounted plan was way cheaper than two Aetna cycles. And the shared risk, if you qualify, is a great savings from multiple Aetna single rounds if you need many rounds. We wanted another shot if the first round didn’t work and I’m so glad we did.

[Anonymous]

Anonymous wrote:It’s any Aetna plan. SG doesn’t actually charge the company it just honors the negotiated rate and you pay less.

We added me to my husband’s aetna policy for this benefi but once we got all the numbers we didn’t end up using the benefit. It’s less $ for one cycle but the 2 cycle discounted plan was way cheaper than two Aetna cycles. And the shared risk, if you qualify, is a great savings from multiple Aetna single rounds if you need many rounds. We wanted another shot if the first round didn’t work and I’m so glad we did.

We have Kaiser, which we love, but are looking at the difference of an FET with Aetna negotiated rate (1800) or regular (4600) with Kaiser. That’s a crazy difference. That said, FET meds with Kaiser have been about $40 and I don’t know what they would be with Aetna. Kaiser also seems to have better overall pricing especially since we have two kids and all their appointments are free with Kaiser. If I knew we would only have to do one more FET, I don’t think I would switch. But when you do two or more...

Thoughts anyone??

[Anonymous]

I just bought FET drugs out of pocket from Freedom Fertility and it was $235 for progesterone injectables and estrogen pills. WAY cheaper than retrieval meds.

[Anonymous]

Also if you do the Two Cycle (they call it Multicycle) or the Shared Risk, FETs are included for all blasts. So you don't have to worry about the price difference of FETs.

[Anonymous]

If you end up OOP, max out your FSAs and/or do the math on whether you could itemize and take a medical expense deduction if you pay for Shared Risk and file your taxes separately from your spouse.

[Anonymous]

Any updates to the guidance above?

[Anonymous]

Anonymous wrote:Any updates to the guidance above?

No. A woman can choose to become a man paid for by insurance but still can’t get help having a baby.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Any updates to the guidance above?

No. A woman can choose to become a man paid for by insurance but still can’t get help having a baby.

Terrible!