Coverage for IVF when fertility isn't the problem

[Anonymous]

My husband and I have been looking into using IVF with donor eggs. Fertility isn't the issue...all systems are a go. The problem is genetics. I have a physical condition that is genetic. The condition would not impede on my ability to raise children, so the condition itself is irrelevant. But will insurance (MDIPA, for example) cover IVF if there is not a fertility issue? Or is a referral or request from Shady Grove or another fertility clinic enough? Does insurance get into the reasoning behind going the IVF route? Does the reasoning matter?

[Anonymous]

it totally depends on your insurance, it's different for everybody. If you have it with your employer it will depend on the plan they settled with.

My insurance covers it 100% (did IVF) but my OB had to verify that we TTC for 2 years before seeking alternatives.

Good luck!

[Anonymous]

Anonymous wrote:it totally depends on your insurance, it's different for everybody. If you have it with your employer it will depend on the plan they settled with.

My insurance covers it 100% (did IVF) but my OB had to verify that we TTC for 2 years before seeking alternatives.

Good luck!

Your insurance covered it 100% with donor eggs?

[Anonymous]

I can tell you that in Maryland, the infertility mandate requires that a wife's eggs be fertilized with her husband's sperm, which cuts out single mothers and fathers, same-sex couples, and those using donor gametes.

You may be lucky in that your own insurance company may be less restrictive. However, it's definitely something that you'll have to clarify with them.

[Anonymous]

Are you talking about using PGD (genetic testing) to ensure the embryos don't carry the condition or are you talking about using donor eggs. The majority of insurances will not cover donor eggs. At all. If you have insurance that does cover IVF, you have to have been trying to get pregnant for over 2 years, unsuccessfully for the insurance to cover it. The PGD testing is also usually not covered.

[Anonymous]

MDIPA does not cover donor egg IVF, even outside of Maryland.

[Anonymous]

Donor eggs will not be covered regardless of circumstances.
IVF is covered if you are trying for 2 years. PGD is never covered.

[Anonymous]

It is rare, but sometimes Donor Egg is covered, as is PGD. It depends on the individual plan.

[Anonymous]

Anonymous wrote:Donor eggs will not be covered regardless of circumstances.
IVF is covered if you are trying for 2 years. PGD is never covered.

The two-year rule does not apply if you have a special condition, such as endometriosis.

[Anonymous]

We just did IVF with Donor Eggs and 0% was covered. Sometimes insurance will cover part (such as the transfer since you are the patient) but rarely will it cover the retrieval or the stims for the donor (since the insured person is not the patient in that case.) The fees to a clinic for matching and the donor's compensation are really never covered.

[Anonymous]

If you have a known genetic issue that can be tested for with PGD, I believe Aetna Federal will pay for the IVF and PGD. I can not speak for donor eggs or other plans.