Question about IVF coverage - how flexible are they?

[Anonymous]

I have an insurance with IVF coverage (CareFirst) but for same sex couples you can only get coverage after six IUIs.

I am finding these IUIs devastating and with my PCOS, the very low success rate for IUIs, and the high cost of donor sperm, I would really like to skip ahead to IVF because doing six of these things.

Has anyone tried to find some flexibility with IVF coverage and had any luck?

[Anonymous]

No flexibility at all, like at all. They don’t want to pay for IVF so they will do everything they can to block you. Dedicate the winter to plowing through. Convince your RE to let you do back to back.

[Anonymous]

Anonymous wrote:No flexibility at all, like at all. They don’t want to pay for IVF so they will do everything they can to block you. Dedicate the winter to plowing through. Convince your RE to let you do back to back.

Ugh that’s what I feared. Thanks for the answer. I’m so grateful that MD and some other states have mandated IVF coverage but I truly believe requiring 6 IUIs first is a disproportionate burden to place on same sex couples!

[Anonymous]

Lesbian here. I know multiple lesbian couples who got pregnant via IUI. Believe me, you don’t want to do IVF unless you have to. Give the IUIs a chance... good luck!

[Anonymous]

We got the 6 IUI requirement waived due to male factor infertility, which obviously wouldn't apply to you, but there was a section in the policy document that listed criteria for skipping right to IVF. Worth reading just in case, though unfortunately I agree they are very strict unless a defined exception applies.

I also agree that most lesbian couples I know got pregnant with IUI. Assuming your only issue is PCOS, your chances with IUIs should be better than regular timed intercourse since the IUI meds will help any irregular ovulation due to the PCOS. In fact I'd be careful doing IUIs with too many follicles since PCOS patients usually have good egg quality and you could easily end up with multiples.

[Anonymous]

Anonymous wrote:We got the 6 IUI requirement waived due to male factor infertility, which obviously wouldn't apply to you, but there was a section in the policy document that listed criteria for skipping right to IVF. Worth reading just in case, though unfortunately I agree they are very strict unless a defined exception applies.

I also agree that most lesbian couples I know got pregnant with IUI. Assuming your only issue is PCOS, your chances with IUIs should be better than regular timed intercourse since the IUI meds will help any irregular ovulation due to the PCOS. In fact I'd be careful doing IUIs with too many follicles since PCOS patients usually have good egg quality and you could easily end up with multiples.

Very interesting. You’d think lesbians would also be covered under the “male factor infertility” clause!

Thank you for sharing your insight.

[Anonymous]

The Maryland legislature just revised the mandated fertility coverage to only require 3 failed IUIs for lesbian couples before covering IVF. Looks like these revisions go into effect Jan. 1, 2021. See http://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0781?ys=2020RS

As a woman in a same-sex marriage who did the 6 failed IUIs before moving to IVF, I think there's a lot to be said for switching to IVF after 3 IUIs. Even if insurance covers a lot of the IUI costs, you're still paying $1000ish for sperm and dealing with all the stress of monitoring. And IUIs with frozen sperm have very low success rates whereas IVF has much higher success rates.

[Anonymous]

Anonymous wrote:The Maryland legislature just revised the mandated fertility coverage to only require 3 failed IUIs for lesbian couples before covering IVF. Looks like these revisions go into effect Jan. 1, 2021. See http://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0781?ys=2020RS

As a woman in a same-sex marriage who did the 6 failed IUIs before moving to IVF, I think there's a lot to be said for switching to IVF after 3 IUIs. Even if insurance covers a lot of the IUI costs, you're still paying $1000ish for sperm and dealing with all the stress of monitoring. And IUIs with frozen sperm have very low success rates whereas IVF has much higher success rates.

Wow this is amazing!! I never would have known if you didn’t post this. Since I failed 4 IUIs this year I think I’ll just wait until January and do IVF then!

[Anonymous]

Anonymous wrote:

Anonymous wrote:The Maryland legislature just revised the mandated fertility coverage to only require 3 failed IUIs for lesbian couples before covering IVF. Looks like these revisions go into effect Jan. 1, 2021. See http://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0781?ys=2020RS

As a woman in a same-sex marriage who did the 6 failed IUIs before moving to IVF, I think there's a lot to be said for switching to IVF after 3 IUIs. Even if insurance covers a lot of the IUI costs, you're still paying $1000ish for sperm and dealing with all the stress of monitoring. And IUIs with frozen sperm have very low success rates whereas IVF has much higher success rates.

Wow this is amazing!! I never would have known if you didn’t post this. Since I failed 4 IUIs this year I think I’ll just wait until January and do IVF then!

Good luck, OP! Definitely doublecheck your coverage in open enrollment to make sure it falls under this law, but I think it should apply to any plans that the existing MD infertility mandate applied to. I'm really glad I moved on to IVF, and I hope it goes well for you.