Looking for health insurance broker for IVF coverage in MD

[Anonymous]

Hi,
We have a health plan from BCBS. But it doesn't cover IVF procedure. Do you guys know of any one who is well versed in different plans being offered in MD for IVF coverage?

[Anonymous]

Has Obamacare changed the coverage somehow? Maryland is one of just a few states that had mandatory infertility coverage, including coverage for IVF. It was required coverage. I think small businesses were exempt. If you work for a small business, can you get an individual policy? You might have to wait for open enrollment for that. A Blue Cross Blue Shield rep would help you with that if you wanted to stay on BCBS.

[Anonymous]

Anonymous wrote:Has Obamacare changed the coverage somehow? Maryland is one of just a few states that had mandatory infertility coverage, including coverage for IVF. It was required coverage. I think small businesses were exempt. If you work for a small business, can you get an individual policy? You might have to wait for open enrollment for that. A Blue Cross Blue Shield rep would help you with that if you wanted to stay on BCBS.

Hubby works for Fed and the policy we have doesn't cover any of that. We are waiting for next enrollment period. But I doubt there will be any change in Fed insurance plans. We were told Aetna does cover 50%.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Has Obamacare changed the coverage somehow? Maryland is one of just a few states that had mandatory infertility coverage, including coverage for IVF. It was required coverage. I think small businesses were exempt. If you work for a small business, can you get an individual policy? You might have to wait for open enrollment for that. A Blue Cross Blue Shield rep would help you with that if you wanted to stay on BCBS.

Hubby works for Fed and the policy we have doesn't cover any of that. We are waiting for next enrollment period. But I doubt there will be any change in Fed insurance plans. We were told Aetna does cover 50%.

Did you look at MD IPA HMO on the federal plan? It's a local Maryland product, although it's been purchased by UnitedHealthCare. It used to cover IVF. Maybe it does, still.

[Anonymous]

MD IPA didn't cover IVF this year on the federal plan

[Anonymous]

Anonymous wrote:

Anonymous wrote:Has Obamacare changed the coverage somehow? Maryland is one of just a few states that had mandatory infertility coverage, including coverage for IVF. It was required coverage. I think small businesses were exempt. If you work for a small business, can you get an individual policy? You might have to wait for open enrollment for that. A Blue Cross Blue Shield rep would help you with that if you wanted to stay on BCBS.

Hubby works for Fed and the policy we have doesn't cover any of that. We are waiting for next enrollment period. But I doubt there will be any change in Fed insurance plans. We were told Aetna does cover 50%.

Kaiser offers decent Fed coverage for 3 attempts but you can only go to Shady Grove. Do a search, there are a lot of recent and very detailed Fed Kaiser IVF threads.

[Anonymous]

I work for the FED and I have Aetna now and they are dropping all infertility coverage for next year. Can my wife sign up for her own insurance plan since we live in Maryland to take advantage of the Maryland IVF coverage mandate?

So, she could have her own private insurance plan through CareFirst, for example and also remain on my FED Aetna plan?

[Anonymous]

@ 15:18, yes your wife can go on her own plan and still benefit from your Federal AETNA plan. However if she's going to Shady Grove, she has to pick one method. If she goes with AETNA (which doesn't cover IVF anymore under the Fed plans), she can get the pre-negotiated rate of $7000 per cycle, excluding meds. If she goes with the CareFirst plan as a resident of MD, her cycle cost will increase to about approx. $10,500/cycle excluding medication.

[Anonymous]

Anonymous wrote:@ 15:18, yes your wife can go on her own plan and still benefit from your Federal AETNA plan. However if she's going to Shady Grove, she has to pick one method. If she goes with AETNA (which doesn't cover IVF anymore under the Fed plans), she can get the pre-negotiated rate of $7000 per cycle, excluding meds. If she goes with the CareFirst plan as a resident of MD, her cycle cost will increase to about approx. $10,500/cycle excluding medication.

Why do you say it would be $10,500 on CareFirst? There are several of these on the MD exchange and at least one of them says IVF has zero copay/coinsurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:@ 15:18, yes your wife can go on her own plan and still benefit from your Federal AETNA plan. However if she's going to Shady Grove, she has to pick one method. If she goes with AETNA (which doesn't cover IVF anymore under the Fed plans), she can get the pre-negotiated rate of $7000 per cycle, excluding meds. If she goes with the CareFirst plan as a resident of MD, her cycle cost will increase to about approx. $10,500/cycle excluding medication.

Why do you say it would be $10,500 on CareFirst? There are several of these on the MD exchange and at least one of them says IVF has zero copay/coinsurance.

Thanks for responses from both of you. My line of thinking would be that she could pick a private Carefirst (Blue Choice HMO 3500) plan, directly from them instead of the MD health exchange since it seems to be cheaper per month, then utilize the IVF coverage through that plan. The plan lists the pricing for IVF as "no cost, no deductible" and they are required to pay for at least three IVF cycles per live birth in Maryland.

[Anonymous]

Where are you finding info on this Carefirst Blue Choice HMO 3500 plan? If premiums are cheaper, why doesn't everyone buying on the exchange do this? I am about to pull the trigger on one of the HealthyBlue exchange plans, but I would of course like to save money and if this is cheaper, what is the drawback?

[Anonymous]

Anonymous wrote:Where are you finding info on this Carefirst Blue Choice HMO 3500 plan? If premiums are cheaper, why doesn't everyone buying on the exchange do this? I am about to pull the trigger on one of the HealthyBlue exchange plans, but I would of course like to save money and if this is cheaper, what is the drawback?

I was mistaken about buying directly from Carefirst versus the MD Health Exchange. They are the exact same plans and the prices are the same no matter if you apply thru carefirst's website or thru the health exchange. The Blue Choice HMO 3500 is a little cheaper than the Healthy Blue plans, but they both say "no charge, no deductible" under the AI/IVF column.

https://carefirst.inshealth.com/ehealthinsurance/benefits/ifp/CareFirst/CDS1183_MD_ACA_10.26.16.pdf

[Anonymous]

Thanks for that info. Consider that the 3500 has $2500 more deductible than the 1000 and if you have a pregnancy, the patient hospital stay, as well as many other charges, are after deductible. It doesn't seem like the savings is that much for the 3500 ($770 for the year?).

[Anonymous]

Anonymous wrote:Thanks for that info. Consider that the 3500 has $2500 more deductible than the 1000 and if you have a pregnancy, the patient hospital stay, as well as many other charges, are after deductible. It doesn't seem like the savings is that much for the 3500 ($770 for the year?).

Well I am a Federal employee, so I already have Aetna and my wife is on that plan with me. We would only be purchasing the Blue Choice 3500 as supplemental insurance just for her so that she can proceed with IVF treatments now that they have been dropped from Aetna. We would not get rid of my current health plan, so if she became pregnant, then we would just start using the Aetna plan for her regular OBGYN visits and hospital stays and so-forth. We would likely drop the Blue Choice 3500 plan once the IVF treatments and pregnancy have been completed.

[Anonymous]

how did the secondary insurance through CareFirst work out? I'm in the same position and am looking to do the same thing. However they are telling me I can't keep my primary insurance through work at the same time. Any advice would be greatly appreciated.