3 attempts per live birth?

[Anonymous]

I am trying to figure out insurance options before open enrollment (Fed). Some of the plans say "3 IVF attempts per live birth, 6 per lifetime." I don't understand what this means. So far I have had 0 attempts but am worried it might take more than 3 the first time. What happens if you hit 3 tries with no live birth?

Thanks!

[Anonymous]

You go OOP after 3 tries if you wish to continue trying for a baby.

[Anonymous]

Anonymous wrote:You go OOP after 3 tries if you wish to continue trying for a baby.

This.

[Anonymous]

What PP said. After three tries, you are paying for any more IVF attempts out of pocket. After you have a baby, and you want #2, you get 3 more tries at IVF covered by insurance. Again, if those three tries for #2 aren't successful, you are on the hook to pay yourself. If you want a #3 you are on the hook from the start, they will only cover 6 lifetime.

Now, if you get pregnant first shot at IVF twice in a row, you'd get 3 tries to have a #3 and that'd be covered.

Make sense?

[Anonymous]

There is a way around it. You can do 3 tries on one insurance then switch brands and do 3 more. I used 3 from my employer insurance. Jan 1 bought my own plan on the MD health exchange and got more tries.

Sneaky - but it works. We figured it was much cheaper to pay more a month for my insurance than pay OOP for 3 rounds of IVF

[Anonymous]

Anonymous wrote:There is a way around it. You can do 3 tries on one insurance then switch brands and do 3 more. I used 3 from my employer insurance. Jan 1 bought my own plan on the MD health exchange and got more tries.

Sneaky - but it works. We figured it was much cheaper to pay more a month for my insurance than pay OOP for 3 rounds of IVF

What was the coverage like with the MD exchange plan?

[Anonymous]

Pp here - BCBS Gold or Platnium plan- it's like $350 month. Procedure -and monitoring were company's. Medication coverage was spotty - some I got cheap others were totally OOP or really expensive. But better than no coverage.

You can buy from a broker during open enrollment which I think starts in OCt.

Note - you are then stuck with the insurance for a year.

If you and DH can be on different plans for a year it works - if you both need to be on the same plan it could be overly expensive.

[Anonymous]

Anonymous wrote:There is a way around it. You can do 3 tries on one insurance then switch brands and do 3 more. I used 3 from my employer insurance. Jan 1 bought my own plan on the MD health exchange and got more tries.

Sneaky - but it works. We figured it was much cheaper to pay more a month for my insurance than pay OOP for 3 rounds of IVF

This. I didn't really consider it sneaky, though. I switched from Fed MDIPA to Fed Aetna (MDIPA had better coverage). I actually called to clarify this point with Aetna before switching.

[Anonymous]

Anonymous wrote:

Anonymous wrote:There is a way around it. You can do 3 tries on one insurance then switch brands and do 3 more. I used 3 from my employer insurance. Jan 1 bought my own plan on the MD health exchange and got more tries.

Sneaky - but it works. We figured it was much cheaper to pay more a month for my insurance than pay OOP for 3 rounds of IVF

This. I didn't really consider it sneaky, though. I switched from Fed MDIPA to Fed Aetna (MDIPA had better coverage). I actually called to clarify this point with Aetna before switching.

Did you do this recently? And did you do 3 tries with MD IPA and then switch to Aetna? Our clinic told us this might not work since even though they are different plans it is the same employer, and they might hold us to one set of 3 attempts.