Optimum Chouce United Healtcare Infertility Coverage

[Anonymous]

Does anyone have this insurance that can give me an idea of their coverage? There website is confusing.

[Anonymous]

I have United Healthcare PPO and it includes a program called ParentSteps, which is provided by OptumHealth and provides access to discounted fertility treatment through certain providers. Is that what you mean, or is Optimum Choice something else?

[Anonymous]

OP---call United Health Care and have them send a copy of your policy to you. I have UHC PPO which contains an endorsement re infertility coverage---not sure whether what I have is standard or not. It's a MD policy. MD is one of the few states that mandates health insurers to provide some type of infertility coverage. For example, our endorsement provides the following: Infertility services at 50% (e.g., IUI are covered at 50%). IVF is covered 100% with a lifetime cap of 3 cycles or $100K. Infertility tests and studies (e.g., an HSG)---are 100% subject to standard co-pay. Coverage kicks in only after 2 years of trying unsuccessfully to get pregnant, and also only covers the union of my eggs and DH's sperm (e.g., no donor egg IVF covered).

Get your policy and read it closely. Appeal any denial of benefits---it's always worth appealing. Keep every piece of paper they send you in a chronological file. Be vigilant about tracking expenses and co-pay requirements between your RE and UHC, as one or both will frequently get the billing wrong and tell you that you are obligated to pay more than you should.

Best of luck.

[Anonymous]

I'm poster 13:00. I'm in VA and my coverage under UHC PPO is different b/c we don't have the mandate as in MD. I have no coverage for IUI (PP has 50%) and IVF is covered only up to $10K in a calendar year (which is a problem since it's only January!).

One thing I (thankfully) learned from this board is that you have to be TTC for 2 yrs before coverage kicks in. It is important to tell your doctor that you've been TTC for 2 yrs when you go for a consultation. I don't know how insurance companies get away with this when the standard of care is to see an RE after 6 months if you are over 35 or after 1 yr if you are younger, but somehow they do.

[Anonymous]

this is going to vary widely based upon your employer (if your coverage is employer-based). I have this same insurance and $50k of infertility benefits, with no requirement of two years TTC. Definitely get your hands on a copy of your policy book, which your HR Dir should have on hand (or, if you're not employer-based, should be easily gotten from UHC).