MDIPA or BCBS..which is more cost efficient for IVF?

[Anonymous]

Can anyone give me a rough estimate of how much they paid per IVF cycle for meds and treatment with mdipa govt insurance? I am switching insurance companies and am covered under United on my work plan, but am trying to decide between MDIPA or BCBS as a secondary through DH. I believe BCBS covers meds...but not treatment.. but what does MDIPA cost? Thanks for the help! Open season is around the corner

[Anonymous]

i am assuming your United coverage does not include IVF benefits . . .

my bcbs covered my meds with a $100 copay

My Coventry Healthcare of Delaware insurance (Maryland residents only) covered my procedure at 50 percent coinsurance. The total for a cycle was 5,500.

Just wanted to put it out there for all the FED folks that Coventry covers MD residents for IVF too. Did you try Aetna or Geha-- I know one of them covers it.

[Anonymous]

MDIPA covers 50%. Meds usually end up only costing a few hundred. Cycles ran anywhere from 3500 - 4000 depending on what was done (ICSI), etc.

Aetna will charge as much for meds as the 50% cost of the cycle (I paid 3 - 4k through Aetna for meds and that was supposedly half price).

[Anonymous]

Thank you! My current United covers 50% of IUI and IVF, up to 30,000 but no meds. I was thinking of BCBS for secondary, if they cover meds..which would be wonderful. I live in Virginia and am wondering through Shady Grove, if 100% guarantee is the way to go, if meds are covered... So many decisions!!

[Anonymous]

OP--it really depends on meds that you are taking. It might be a greater benefit to take the MDIPA with the lower IVF price and a few hundred in meds than doing the United 50 percent coverage and having your meds covered by BCBS.

Also, remember that the 50 coverage is not 50 percent of the self-pay rate at most clinics, it is 50 percent of the negotiated insurance plan price. These are two different numbers and can result in a $1,000 to $2,000 difference.

My clinic, GW, charges one price for self-pay but I did not pay half of the self-pay rate, I paid half of the insurance rate which is higher.

[Anonymous]

I'm at SG and with United-Mamsi its 3132.79 estimated cycle cost...but paying in full for meds..

Do you know what meds or % of meds are covered under MDIPA?

[Anonymous]

Do you know what meds or % of meds are covered under MDIPA?

50% of IVF at SG is covered at SG as well and the per cycle cost with ICSI comes to around $4200. All these companies have negotiated rates which are cheaper than the cash rate, hence the 50% is less than 50% of what SG quotes on their IVF brochure.
Meds are covered under MDIPA with co-pays of $25 and $50. Cost per typical cycle is around $100-$175 (for instance, gonal f copay is $50, menopur was $25---so there will be some variance depending on what drugs your doctor decides to use). In my cycle I used upwards of $8K of stims and paid $150 for them (gonal f plus a refill and menopur plus a refill). It's an AMAZING benefit.

[Anonymous]

My clinic, GW, charges one price for self-pay but I did not pay half of the self-pay rate, I paid half of the insurance rate which is higher.

Interesting. We found SG to be the exact opposite. Self-pay IVF is over $9K/cycle without ISCI. Price with MDIPA's 50% copay was $3800/cycle (plus around $600 for ICSI). This makes more sense and is typical---self pay patients ALWAYS pay more for medical services unless they aggressively negotiate which is not always even a remote possibility with some hospitals/providers. Insurance companies (esp. HMOs like MIDPA) negotiate heavily for their rates because they bring such a large pool of potential patients to a practice.

[Anonymous]

WOW! That is an amazing benefit.. have you noticed any downfalls with the MDIPA?

[Anonymous]

To the 15:12 poster: Yes, I was floored when I found out but my cycle with ICSI costs $5100 and that was only with 5 ultrasounds. Coventry is a much smaller insurance group than MDIPA but I chose it because of their lack of restrictions on the procedure itself. With some insurances, you cannot use donor specimens and must be married.

[Anonymous]

my insurance covers meds but not IVF. How much of a savings is that? how expensive are the meds?

[Anonymous]

Anonymous wrote:my insurance covers meds but not IVF. How much of a savings is that? how expensive are the meds?

what insurance do you have? meds for my iui cycle were more expensive than the cycle itself, because insurance didnt cover meds..

[Anonymous]

Anonymous wrote:

Anonymous wrote:my insurance covers meds but not IVF. How much of a savings is that? how expensive are the meds?

what insurance do you have? meds for my iui cycle were more expensive than the cycle itself, because insurance didnt cover meds..

NALC (First Health) but I am with the Fed Govt so can switch if it makes sense.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:my insurance covers meds but not IVF. How much of a savings is that? how expensive are the meds?

what insurance do you have? meds for my iui cycle were more expensive than the cycle itself, because insurance didnt cover meds..

NALC (First Health) but I am with the Fed Govt so can switch if it makes sense.

Oops, meant Mail Handlers (again, think this is part of First Health)

[Anonymous]

my insurance covers meds but not IVF. How much of a savings is that? how expensive are the meds?

It completely depends on what kind of responder to the meds you are and therefore how much you need. I'd say the average meds for an IVF cycle cost around 3K. Women with poly cycstric ovarian syndrome or others who stim really easlier could get by on $1800 (or less, or more, there's really no knowing). Women who are poor responders and need large does of the stims will pay more. I'm 34 and earlier did an IVF at SG during which I had a really crappy response and ended up needing $7K in meds. (thankfully, I still got pregnant!)

If you want to get a best guesstimate of cost, ask your nurse or physician to estimate your beginning daily doses of gonal f and menopur (the 2 drugs that cost the most) and multiply this by 10 days of stims (the average length of stimming). You can then price them out at freedomdrugs.com which generally gives the lowest prices around for self-pay patients.