Infertility coverage required of MD health exchange plans?
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Anonymous
| Hi, I heard from a coworker that Maryland requires exchange plans to cover IVF treatment. Does anyone know if this is true? I have had recurrent miscarriages and would consider signing up for an exchange plan rather than going through my federal plan next year, but only if I knew I could get IVF treatments through it. Thanks! |
Anonymous
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Maryland is one of the states that mandates they cover fertility treatments so you will be able to find a plan that covers it. I am on my husbands insurance so I can't tell you directly which plans will have this coverage. Hopefully someone will have direct experience with them otherwise it will be a lot of work digging through them all. I am sorry for your losses and hope you are able to have success soon.
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Anonymous
I'm not sure all plans in the exchange have coverage. But at least some do. For example: Carefirst HealthyBlue Plus Gold $750 You can check the exchange https://secure.marylandhealthconnection.gov or buy directly from the insurance company. Read summary of benefits for each plan. |
Anonymous
| I have Care First Gold plan purchased from the exchange and IVF is covered at 100% but first you must have tried IUIs first and they allot 6 IUI tries prior to approving IVF. So depending on whether you have had doctor assisted IUIs in the past, will determine how many IUIs they will approve for you and that will ultimately get you closer to your IVF approval. |
Anonymous
| Bump - anyone else have experience with the MD health exchange plans? |
Anonymous
| I'll bump also. Maybe we are all tapped out with experience on the MD exchange, but I had a new question I thought someone could answer. I've looked at a few plans and it looks like they require that the service area be in MD or MD/VA/DC. My clinic is out of state. Has anyone been on a MD exchange plan and successfully used it at a clinic not in MD/VA/DC? |
Anonymous
| The exchange plans do cover IVF. All of CareFirst's plans will cover. I don't have any experience using the plans out of state, but I imagine it would be the same as using out of network providers. |
Anonymous
| FYI - my RE told me this morning that they would not cover for me because my problem is recurrent miscarriage and not infertility. They are only covered for people who can't get pregnant at all, not those who can't carry to term. Really glad I know this now because the BCBS plans aren't cheap. Good luck to everyone. |
Anonymous
| PP, this seems important to know beforehand so thanks. Who do they cover vs not? What about people with DOR? I have had miscarriages due to chromosomal abnormalities of the fetus and now inability to get pregnant due to age-related DOR. Would I be covered? For example, Aetna fed is not covering people whose infertility is due to age. Do the exchanges have similar restrictions? |
Anonymous
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PP here. I think the key is that you have to have been trying to get pregnant for 2 years with no luck (and my RE said they will get the medical records to confirm that this is the case). In my case, I have been trying, have gotten pregnant, but have never carried past the first trimester. He was clear that the exchange plans will not cover IVF for me.
Good luck! |