considering switching to MDIPA but have questions

[Anonymous]

For insurance companies that cover IUI and IVF - is it standard to require that a couple has been TTC for 2 years? I was considering switching from BC/BS to MDIPA this open season (I'm fed gvt) because I had read they had the best IUI/IVF coverage (plus meds) but we haven't been trying two years yet. (We're trying for #2, if that matters,and didn't need ART with #1, but that was 5 years ago). If we do wait another year to switch plans, does anyone know if MDIPA will cover IUI/IVF treatment immediately, or do you need to be on their plan for a while first? I have read conflicting accounts of whether we would have to redo testing if we move to MDIPA as well - anyone have a recent experience with that? Lastly, does anyone have experience with trying to add MDIPA as a secondary insurance - i.e, could we try and stay on BC/BS on my husband's plan (which we are happy with for all medical issues except ART) if I switch to MDIPA on mine? Or will the insurance companies just battle each other endlessly over who covers what? (Although ART should be simple - BC/BS covers nothing!)

God I hate trying to figure out insurance. Any help would be greatly appreciated.

[Anonymous]

We've had MDIPA for 4 years and used them for 3 cycles of IVF (which resulted in 2 pregnancies).
I don't have experience with using them as a secondary insurer.

By no means did they require us to repeat testing. I had all my testing done and paid for by bc/bs.
If you have an infertility diagnosis (in our case male factor) they do not require the 2 year wait. I'm not sure what the case is if you are unexplained. However, in the time between our IVF cycle 1 (successful pregnancy) and our IVF tries for pregnancy #2 our male factor infertility had resolved (sperm analyses spontaneously became 100% normal). However, we were still not getting pregnant. MDIPA paid for 2 more cycles of IVF at that point without questions although we were now technically without a diagnosis and had not been trying for 2 years (for number 2).
I think the whole "trying for 2 years" thing is to screen out women who turn to IUI/IVF after 6 months of trying (which actually might be appropriate if you are 40+ but still not somthing MDIPA wants to pay for right off the bat). I don't think MDIPA is scrutinizing your chart to see that exactly 2 years have passed since the moment you stopped the pill or other contraception. Ultimately, it is your word to your RE when you started to TTC. Honestly, for insurance purpases, simply having 5 years between pregnancies should be enough for them. I have never found them to be reticent to pay for infertilty things (i.e. didn't see them trying to get out of paying for IVF, etc). The approvals went very easily every time.

[Anonymous]

I agree with the PP - if your diagnosis warrants moving to IVF (MF or blocked tubes, for example), MD IPA will approve it based on the RE's recommendation. If you have had testing done recently, MD IPA shouldn't make you repeat it, but you do need to have current HSG results, day 3 bloodwork results, semen analysis results and a marriage certificate to get the IVF pre-approval.

I switched to MDIPA because of the IF benefit, but have been mostly very happy with them for all health care.

[Anonymous]

I have MDIPA and have not used it yet for IVF, but, when I called to get more information, they said they have a cost-estimate process. Basically, when you make an appt with your RE, he/she should write up all the diagnosis codes used in your IVF plan. You can send this to MDIPA and they will provide a cost estimate to you in about 3 three weeks.

I know that doesn't exactly answer your question but it may help if you do decide to switch.

[Anonymous]

just something to keep in mind, if you get pregnant naturally and miscarry, MD IPA may deny you for another year. be sure to read their fine print about the definition of infertility. also, they count a cycle once you start meds, instead of at egg retrieval (like aetna).