Aetna IVF

Anonymous
Hi ladies,

I am having a hard time getting an answer from Aetna for my IVF coverage for this year and next year (Aetna Open Access High). Per my policy, I get three attempts IVF per live birth up to $100,000. This year, I did one IVF cycle with 2 FET. If I were to continue with Aetna for next year, will I get only 1 more chance? or it start all over again (3 attempts)?

I am getting very frustrated with Aetna since they don't know the 100% answers. Each time I called they tell me different answer.

Thanks.
Anonymous
I would go with MD IPA - it's cheaper and it covers meds.

But I agree, I tried looking it up for you and it doesn't define whether a FET cycle counts as an IVF cycle...
Anonymous
Call your financial counselor at your clinic, they should be able to find the answer for you.
Anonymous
The reason why I want to continue with Aetna is that I might need to use surrogate but my own egg. And if Aetna let me have 3 new attempts in 2015, I can save about $2000 on the yearly benefit payment. I already did 1 cycle (2FET) this year and the meds are about $500. And I figure if I continue with Aetna, the $2000 saving can covers the additional meds costs.

If I only get 1 attempt then it is a different story. Sigh!!!!
Anonymous
And I also call my clinic financial advisor and she is not 100% sure either. So frustrating.
Anonymous
I have MD IPA. The three attempts are per live birth, not per calendar year. Aetna probably has something similar.
Anonymous
14:22 - so that means I can have more than 3 attempts as long as I don't have a live birth?
Anonymous
I think FET is counted as one cycle.

3 cycles per live birth means the insurance only covers 3 tempts for a baby born. If you failed 3 times, the insurance wont' cover ivf cycles any more.
Unless you have a live birth, it will reset to 0 and insurance company will cover another 3 ivf cycles for another baby.
Anonymous
Thanks 15:05. If I select basic open access (instead of current high open access) and Aetna only give me 1 attempt (bc two attempts occured in 2014) then I am screwed. So maybe it is safer to do MD-IPA and forget about saving the $2000 saving on the benefit payment.
Anonymous
MD IPA will count FET as one cycle. A lot of people self pay for FET since the fresh cycle benefit is more valuable with MD IPA.
Anonymous
I am considering switching to Aetna from MD IPA as we have had 2 failed cycles using MD IPA. Is the Aetna Open Access Basic or High option better for someone considering IVF? I am a federal employee. Thanks!
Anonymous
Anonymous wrote:MD IPA will count FET as one cycle. A lot of people self pay for FET since the fresh cycle benefit is more valuable with MD IPA.


Holy sh*t. I could kill my financial counselor for not telling us this. Did I really just blow #3 on a FET?
Anonymous
There is some language on the aetna infertility page that a fet will count in the same cycle as a fresh cycle if you do eSET in the cycle immediately following the fresh cycle.
Anonymous
Sorry that wasn't clear. You have to do eSET in a fresh cycle and a fet the next cycle immediately after the fresh cycle in order for it to count as 1 attempt.
Anonymous
Why does this have to be so confusing. I am about to start Aetna open access IVF later this month. Which pharmacy do you recommend? I just have have Open Access-not high.
I was given the estimate of 3-5k for meds from Dominion
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