FET at SG, negotiated rates and OOP rate for 2017
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Anonymous
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I've seen several threads that mention this topic, but the details seem to conflict. Since that was all early on in the debacle of Feds dropping IVF coverage, I'm wondering if there is a consistent story on these matters now:
- What is the OOP rate for FET in 2017? Is it $7,100 or $4,600 or something else? If the higher rate, is it for new patients or all patients? - Are they really giving Aetna patients the negotiated rate even though Aetna Fed has dropped IVF? If so, what is that rate and is it for only patients who were Aetna in 2016 and are carrying it through to 2017, or for new Aetna Fed enrollees also? - If there is a deal with Aetna, has it been determined whether a similar deal will apply to Kaiser? I've emailed my financial counselor with these questions but have not yet gotten a response. |
Anonymous
Is your counselor Cleveland? If so, good luck with that. I can't answer your question specifically, but back when I was cycling, I had Aetna but no fertility coverage, and there was a specific rate for Aetna patients. |
Anonymous
| I was just quoted the OOP rate (I do not have Aetna), and it was $4600 |
Anonymous
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I do have Aetna and paid the negotiated rate earlier this year. It's $5,800 for a freeze all cycle plus $1800 to freeze. If you do the fresh transfer cycle its about $7000 plus $1800 to freeze anything extra. There are annual storage fees.
Having Aetna is a big savings if you do a frozen transfer - those are $1850 if you have Aetna. Without Aetna I think OOP a cycle is $9,500-11,000 plus the $1800 for freezing and the frozen transfers are $4,600 per cycle. Obviously meds are on top of all that. |
Anonymous
| I just had a FET--it was $4600. |
Anonymous
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Just to update, I got confirmation today from my SG financial counselor that the 2017 OOP rate for FET is $4600.
The Aetna negotiated rate applies to all Aetna plans regardless of whether they cover IVF or not and is $1850. Aetna is the only carrier with whom they have this special contract to provide a negotiated rate regardless of IVF coverage, so it does not apply to Kaiser. |
Anonymous
| Just wondering if the contract applies to fresh cycle rates in addition to FET. Even though FEHB has dropped IVF with Aetna, is there a negotiated rate on the fresh cycle at SG that is lower than the OOP rate? |
Anonymous
yes, see the previous poster - looks like a savings of a few thousand dollars (7k vs 10-11k) |
Anonymous
| Does this include any medications? |
Anonymous
No. |
Anonymous
| Medications are an additional 4-5k |
Anonymous
NP here. But to clarify, not for a FET. If you're just thawing and transferring, meds could be much cheaper (200…300?) and are OTC drugs that might be covered under your pharma benefit, and not excluded infertility drugs, like progesterone in oil or estradiol. |
Anonymous
Good point. My FET meds were cheap and covered. The 1,800 Aetna rate sounds like a good deal. |
Anonymous
| Bump for 2018 - Does SGF still have a negotiated FET rate for Aetna, and does anyone know what it is? |
Anonymous
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I was told in April, excluding meds:
$1,850 for Aetna negotiated rate $4,600 OOP Included/unlimited in Multi-Cycle (2 cycles soup to nuts $24,000) |