Fed Insurance IVF Converage - Maryland IVF Mandate?

[Anonymous]

This is OP, thank you for all your input and so happy to see this helped many families.

[Anonymous]

Anonymous wrote:I’m a MD resident and have CareFirst HealthyBlue HMO Gold. I have a monthly premium of $437.45 with a $1750 annual deductible (my health savings offset a lot of the deductible). It covers 6 IUIs and 3 IVF attempts with a lifetime max of 100k. For IVF meds, I was only responsible for paying $550, everything else was covered.

Are the attempt count including previous attempts with different insurance?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m a MD resident and have CareFirst HealthyBlue HMO Gold. I have a monthly premium of $437.45 with a $1750 annual deductible (my health savings offset a lot of the deductible). It covers 6 IUIs and 3 IVF attempts with a lifetime max of 100k. For IVF meds, I was only responsible for paying $550, everything else was covered.

Are the attempt count including previous attempts with different insurance?

I'm not 100% sure as I haven't done it myself, but when I was doing research on this last year, I believe they will pay for those attempts as long as you're with another company. Hopefully someone who has done this can chime in.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m a MD resident and have CareFirst HealthyBlue HMO Gold. I have a monthly premium of $437.45 with a $1750 annual deductible (my health savings offset a lot of the deductible). It covers 6 IUIs and 3 IVF attempts with a lifetime max of 100k. For IVF meds, I was only responsible for paying $550, everything else was covered.

Are the attempt count including previous attempts with different insurance?

I'm not 100% sure as I haven't done it myself, but when I was doing research on this last year, I believe they will pay for those attempts as long as you're with another company. Hopefully someone who has done this can chime in.

Never done it either but I thought I read the same thing too.

[Anonymous]

We joined the health exchange and it was a bear to pay each month but we decided we could do it for a year, and thankfully it worked. It ended up being much less than paying out of pocket. I would 100% recommend splurging for the extra out-of-pocket costs for PGS testing. I did 2 retrievals-- the 1st batch looked "perfect" by the old standards but they were ALL abnormal. I had a healthy birth and spare frozen embryo from the second batch. Good luck! (FWIW, I was in my late 30s at the time; gave birth just after my 39th birthday.)

[Anonymous]

Anonymous wrote:We joined the health exchange and it was a bear to pay each month but we decided we could do it for a year, and thankfully it worked. It ended up being much less than paying out of pocket. I would 100% recommend splurging for the extra out-of-pocket costs for PGS testing. I did 2 retrievals-- the 1st batch looked "perfect" by the old standards but they were ALL abnormal. I had a healthy birth and spare frozen embryo from the second batch. Good luck! (FWIW, I was in my late 30s at the time; gave birth just after my 39th birthday.)

Also, we qualified for shared risk at SGF but we decided to trust that if we qualified for that, we would be successful paying less. We were lucky. It is ridiculous how hidden the coverage can be and I remember it feeling like a major research project at the time. Good luck!

[Anonymous]

Are you covered under the IVF mandate if you live in DC but work in Maryland? I work in Maryland and company is HQ there but live in DC so can’t figure out which law applies to me. Of course I tried to call the hotline and they were useless

[Anonymous]

Anonymous wrote:Are you covered under the IVF mandate if you live in DC but work in Maryland? I work in Maryland and company is HQ there but live in DC so can’t figure out which law applies to me. Of course I tried to call the hotline and they were useless

You couldn't purchase MD individual insurance because you live in DC. Your company's insurance may be under the MD mandate, but there are a lot of loopholes, so it's very possible they might not have infertility coverage.