Best Fed Government Insurance for IVF?

[Anonymous]

I work for the Federal Government and currently have Blue Cross insurance, and I live in VA (if that makes a difference). Blue Cross paid for all the tests that determined that I cannot get pregnant without IVF (egg donation). However, Blue Cross will not pay for anything else. There are lots of insurance co's that work with the Fed Govt and I am starting to research which ones might be more generous. Can anyone offer any suggestions?

[Anonymous]

MDIPA is probably the best Federal insurance choice for IVF coverage. They pay 50% of up to 3 cycles per live birth and are what we used. I can't seem to find that information now but I do know that they have some inclusion criteria for paying for IVF. The couple must be married (no singles) for 2 years and must have a documented reason for infertilty (male factor, diminished ovarian reserve, etc) or be documented as trying to conceive for at least a year. Also, I'm not sure if they will 1) pay for your IVF portion of donor egg IVF but not the donor costs or 2) not pay for the cycle at all because it is a donor cycle. I know there they will not pay for a donor cycle in full (which stinks). I hope someone else can help you with this.

[Anonymous]

I agree. MDIPA, which is now United Healthcare, I believe, is the best for Fed. Gov't workers. Good Luck!

[Anonymous]

Do they pay for the meds as well?

[Anonymous]

They pay for meds as well. I think I paid about $250 in copays for over $3K in meds.

I looked at the MDIPA member book last night and it appears that they will not pay for IVF if donor eggs or sperm is used.

[Anonymous]

You might want to speak directly with MDIPA first. I called them two weeks ago and asked if they would accept the test results that we spent the past year doing, and their answer was NO--they will require us to redo everything (and pay 50% of all the costs for everything, from initial RE consultation through the HSG).

Their toll free number is 1-877-835-9861

[Anonymous]

Previous poster--I'm not sure that is correct. I think maybe you just got a rep. who didn't know what he/she was talking about?
I had Carefirst Blue Cross in 2005 and had all my infertility testing and consult with the RE done with them. Switched to MDIPA in 2006 and they immediately payed for an IVF cycle that I began on January 3rd.

[Anonymous]

Does it cover IUI'S? At this point I am not sure if we will need IVF, but I am afraid of not changing plans now and on feb or march my doctor tell me we will need IVF... I hate this all!

[Anonymous]

Original poster here: Thanks to all for helping. I just spoke with MDIPA and they specifically exclude IVF WITH A DONOR EGG. I just wanted to let others that need this info know. I cannot find one that covers donor egg IVF.
I am still on the search for a better insurance. If anyone else knows something, please pass along the info!
Thanks!

[Anonymous]

I had MDIPA in 2008 and found them fine to work with. I'm switching to Aetna Open Access in 2009. I found it helps to call the plan directly and ask a lot of questions, even before you are a member. When I called Aetna, the rep indicated that my portion of a donor cycle would be covered. That isn't in writing in the plan that's posted on opm.gov, but that is what I was told. I'd call and ask your own questions. Otherwise, my research found that the 2 plans are very similar for IVF and IUI coverage - both offer 6 IUI's with oral drugs, and 3 IVF's. Under Aetna, though, FSH day 3 cannot exceed 19. Both cover ICSI. I'm sure you know that open season was extended through January. Best of luck!

[Anonymous]

OP, I would call the plans as pp suggested. But if you still can not get coverage and since you are open to "egg donation", did you think about "embryo donation"? Genetically the child would not have any link with you or your husband, but you would still carry the pregnancy and it is much cheaper than a regular IVF.

[Anonymous]

I'm starting to research this for 2010 since open season has ended for 2009. I have BCBS Standard which has been great for covering diagnosis and for hopping around to different specialists without needing referrals. But, after 10 months of trying we have found out that DH has Male Factor Infertility (motility 10%). I think we may end up doing IVF, specifically Intracytoplasmic Sperm Injection (ICSI). One difference that I noticed between Aetna and MDIPA is that Aetna will cover IVF after 2 years of trying even if there is another documented reason, but the MDIPA criteria is 2 years OR documented reasons such as MFI. So for us it makes a difference in the wait time since we'll only have been trying a year and a half by the time I can change insurance. Thought I would share that fine print in case it helps anyone else. Also, Kaiser has similar coverage and is worth looking at, but does not cover ICSI.

[Anonymous]

You might want to double-check coverage for BCBS Federal. I have had all of the initial diagnostic testing covered, am paying approximately $150 for the meds and will have all monitoring covered (as long as the doctor submits as "diagnostic" I have been assured that it will be covered). I am paying out of pocket for IVF with ICSI, about $11,500.

[Anonymous]

I you have a crummy semen analysis (we did) then MDIPA will pay for IVF/ICSI before the 2 years are up.
We had it covered at a year of trying.

good luck!

[Anonymous]

I have an Aetna PPO through my employer and my IVF procedures were paid at 100%. My employer is in the state of Maryland and Maryland is a state that is required to provide IVF coverage. There were restrictions from what I can remember, I think it had to be wife's eggs and husband's sperm, the employer had to employ more than 50 people and you had to have been trying unsuccessful for a few years.

You might want to look into Aetna again. I am not sure if Govt. agencies work with Aetna.