MDIPA Federal and Annual Deductible

[Anonymous]

I'm a little confused on the 2014 MDIPA Federal plan and what counts towards the annual deductible. I know MDIPA increased the deductible from $1800 to $3000 for self from 2013 to 2014. But for those of you who have been using MDIPA this year for infertility treatments, do IUI and IVF monitoring appointments still count towards that deductible? I previously read on here for MDIPA in 2013, people saying that their 1st IVF was a certain cost but then their 2nd IVF was significantly less because they met the deductible and MDIPA started covering more. I'm just wondering if that's still the case for 2014 just with the higher amount. And for what it's worth, I find their whole online claim system totally confusing because it lists what "may be" my responsibility but that doesn't take into account everything I already paid at SG after the monitoring appointments. I'm not sure if somehow once that's reconciled what I've contributed to the annual deductible will increase.

We just finished 3 rounds of IUIs and they weren't successful. We are trying to determine if we should take a bit of a break to decompress from it all or if we should proceed with our first IVF immediately because of the potential financial savings in this calendar year.

Thanks so much!

[Anonymous]

I've been using MDIPA for two IUIs and two fresh cycle IVFs this year, and although many claims are still making their way through the system, it looks like very little ($972) has been applied to my out-of-pocket maximum. Almost $600 of that was from a mock transfer. I think the plan brochure includes some detail on payment for infertility treatments not being applied to the deductible.

You probably already know that five monitoring appointments (+ the baseline bloodwork and u/s) are included in the deposit you pay, so only additional monitoring appointments are extra. I had two or three for each of my IVF cycles that weren't covered.

[Anonymous]

Is the annual deductible the same as the maximum catastrophic out-of-pocket? The 2014 MDIPA brochure says that copayments/coinsurance for infertility treatment doesn't count toward that maximum:

Page 22: http://www.opm.gov/healthcare-insurance/healthcare/plan-information/plan-codes/2014/brochures/73-100.pdf

After your copayments and coinsurance total $3,000 per person or $8,000 per family
enrollment in any calendar year, you do not have to pay any more for covered services.
However, copayments and coinsurance for the following services do not count toward
your catastrophic protection out-of-pocket maximum, and you must continue to pay
copayments and coinsurance for these services:
• Dental Discount benefits
• Eyeglasses or contact lenses
• Copayments or coinsurance for infertility treatment
• Copayments or coinsurance for chiropractic services
• Expenses for services and supplies that exceed the stated maximum dollar or day limit
Be sure to keep accurate records of your copayments since you are responsible for
informing us when you reach the maximum.