Federal insurance that covers fertility treatment?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have CareFirst, it covered the vast majority of IUI costs including $0 for generic medications of any kind. I believe it covers some IVF costs as well but haven’t gotten that far yet myself.

None of the federal plans cover a cent of IVF costs.

Now granted I don't have federal coverage, but only the actual retrieval and lab was counted under my IVF coverage. All of the monitoring, labs, and some of the meds were billed under regular insurance, even during IVF cycles.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have CareFirst, it covered the vast majority of IUI costs including $0 for generic medications of any kind. I believe it covers some IVF costs as well but haven’t gotten that far yet myself.

None of the federal plans cover a cent of IVF costs.

Now granted I don't have federal coverage, but only the actual retrieval and lab was counted under my IVF coverage. All of the monitoring, labs, and some of the meds were billed under regular insurance, even during IVF cycles.

That’s nice. Federal plans specifically exclude that if it is for an IVF cycle, even if it would be covered for TI or anything else. If your clinic lies or makes a mistake, it might get covered, but yeah it’s not covered under any federal plan unfortunately.

[Anonymous]

GEHA covered about 60-70% of my IVF. Mostly monitoring appts and ancillary charges for retrieval and transfer (eg the anesthesiologist was covered but not the actual retrieval). GEHA was also in network at SGF because it’s United in this area. The big challenge was convincing SGF to submit the claims to insurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have CareFirst, it covered the vast majority of IUI costs including $0 for generic medications of any kind. I believe it covers some IVF costs as well but haven’t gotten that far yet myself.

None of the federal plans cover a cent of IVF costs.

Now granted I don't have federal coverage, but only the actual retrieval and lab was counted under my IVF coverage. All of the monitoring, labs, and some of the meds were billed under regular insurance, even during IVF cycles.

That’s nice. Federal plans specifically exclude that if it is for an IVF cycle, even if it would be covered for TI or anything else. If your clinic lies or makes a mistake, it might get covered, but yeah it’s not covered under any federal plan unfortunately.

That’s awful, I’m sorry.

[Anonymous]

Anonymous wrote:GEHA covered about 60-70% of my IVF. Mostly monitoring appts and ancillary charges for retrieval and transfer (eg the anesthesiologist was covered but not the actual retrieval). GEHA was also in network at SGF because it’s United in this area. The big challenge was convincing SGF to submit the claims to insurance.

When was this? Some of the plans used to offer some coverage but they no longer do. The GEHA plan documents all say no coverage for IVF, but diagnostics are covered. Either way (if thus was several years ago or somehow the services were coded in a way that didn’t indicate they were for treating infertility), you got lucky!

[Anonymous]

This is the GEHA poster. GEHA covered IUIs and IVF (multiple retrievals and transfers) in 2018 and 2019 and my baby was born in early 2020. Like I said before, some specific procedures were excluded but we got the so-called in-network price. But for example GEHA allowed something like $250 per monitoring appt and I paid $30 copay and $30 coinsurance.

[Anonymous]

Oh, GEHA poster again. The docs do NOT say no coverage. They say diagnosis and treatment covered except for these specific procedures, and they interpret the listed procedures super narrowly. So the excluded IVF means the actual retrieval and actual transfer are excluded. And genetic testing of the embryos was also excluded. SGF kept telling us nothing was covered and then when they submitted - surprise! - we had substantial coverage. Again, my biggest challenge was getting SGF to submit.

[Anonymous]

Anonymous wrote:Oh, GEHA poster again. The docs do NOT say no coverage. They say diagnosis and treatment covered except for these specific procedures, and they interpret the listed procedures super narrowly. So the excluded IVF means the actual retrieval and actual transfer are excluded. And genetic testing of the embryos was also excluded. SGF kept telling us nothing was covered and then when they submitted - surprise! - we had substantial coverage. Again, my biggest challenge was getting SGF to submit.

Yes! PP above here and this is what I was trying to explain. My financial coordinator at GW did the same. I think many people don’t even try and not everyone gets the best financial coordinator who is willing to fight for coverage. We had MANY rejections over 5 IVF cycles and the FC just kept fighting them.

[Anonymous]

PP again. And you need to get a copy of the actual insurance policy from your HR and get a lawyer friend to help you read it. DO NOT listen to the customer service rep who tells you what is covered. Read the document yourself and KNOW what’s covered.

[Anonymous]

Federal BCBS didn’t even cover IUIs or the cost of meds for IUI. This was last year but I don’t think it’s changed.

[Anonymous]

Federal Carefirst covers 50% of IUIs. I assumed it meant for the whole cycle ($1800 self-pay at SGF) but it was only for the IUI procedure itself, meaning my monitoring appointments have all been covered apart from a co-pay, with my portion of the IUI itself costing about $80 out of pocket. I also got my trigger shot outside of insurance coverage because it was cheaper to go through my non insurance pharmacy ($100 copay with insurance $50 at an alternative pharmacy without insurance).

[Anonymous]

Anonymous wrote:I have CareFirst, it covered the vast majority of IUI costs including $0 for generic medications of any kind. I believe it covers some IVF costs as well but haven’t gotten that far yet myself.

I had the same experience with CareFirst for IUI, but it covers nothing for IVF.