Carefirst Value Gold 1000 vs Gold 1750

[Anonymous]

I am in the process of getting additional insurance thru the MD exchange for IVF treatment in 2021. I hoping someone could help me understand the difference between the two plans. Other than the obvious deductible $1,000 vs $1,750, I see the $1,000 value plan has no separate medication deductible. Not sure what that means exactly. is that worth the extra $4 a month??

thanks in advance!

[Anonymous]

Sorry I don’t have an answer but I have a question for you hope you don’t mind sharing some info - the exchange allows you to buy their insurance on top of one you already have? If so how are benefits coordinated with two insurance plans?

[Anonymous]

I am a fed employee, and my husband and daughter Are on my insurance so I don’t want to cancel it. Previously SGF submitted all claims to kaiser and once kaiser denied the claims then they submitted it to carefirst.

[Anonymous]

Are your fertility drugs on the formulary for the 1000 plan?

[Anonymous]

After applying for a private plan, how long does it usually take to hear back if you were accepted?

[Anonymous]

If you're with Shady Grove, I would go for the $1k plan because they use an ambulatory surgical center for their egg retrievals. If you use a clinic that just charges it as an office procedure, go with the $1750 plan. I have the $1750 plan and am at Shady Grove and I regret it because it made me lose about $900. Here's the scenario with the costs that would vary between the two plans:

1750 plan: Pay $300 (or $350, can't remember) in medicine costs. Pay $800 toward the deductible for the facility fee for your first retrieval. Pay another $800 for your next retrieval or for a transfer. Pay co-insurance for insemination of about $100 at each retrieval. Now you've met your deductible. The next facility fee if you need it for a retrieval or transfer will be $75. Let's say you only need 1 retrieval and 1 transfer. You've roughly spent $2000

1000 plan: Pay $1000 in medicine costs. Deductible met. Pay $75 facility fee for first retrieval and $0 for embryo insemination. Pay $75 for transfer facility fee. You've spent $1050.

See why I'm kicking myself?

[Anonymous]

Sorry, that's $1150 in the last line above.