Best federal employee insurance for IUI

[Anonymous]

We recently got married and have the option to change our insurance. My spouse works for the federal government and currently has Carefirst Basic. I’m considering joining their plan or another federal plan since mine doesn’t cover IUIs. Do any federal plans cover IUI? Curious what any of you on such a plan pays OOP for treatment. Thanks!

[Anonymous]

None of the federal plans cover fertility treatments. BUT some facilities can charge for portions of your treatment as a hospital rather than as a fertility clinic, which your federal insurance WILL cover. I have the same plan as your husband (great plan btw!) and was quoted $2500 per cycle for IUI from SGF. I went with GW and because they charged insurance as a hospital, all diagnostic testing, blood work, meds, and monitoring was covered. All I had to pay for was the actual IUI procedure, which was $400.

So insurance matters less than where you go.

[Anonymous]

Anonymous wrote:None of the federal plans cover fertility treatments. BUT some facilities can charge for portions of your treatment as a hospital rather than as a fertility clinic, which your federal insurance WILL cover. I have the same plan as your husband (great plan btw!) and was quoted $2500 per cycle for IUI from SGF. I went with GW and because they charged insurance as a hospital, all diagnostic testing, blood work, meds, and monitoring was covered. All I had to pay for was the actual IUI procedure, which was $400.

So insurance matters less than where you go.

Thank you for the info! I was paying $1650 out of pocket at CFA but $400 is way more doable!

[Anonymous]

Anonymous wrote:None of the federal plans cover fertility treatments. BUT some facilities can charge for portions of your treatment as a hospital rather than as a fertility clinic, which your federal insurance WILL cover. I have the same plan as your husband (great plan btw!) and was quoted $2500 per cycle for IUI from SGF. I went with GW and because they charged insurance as a hospital, all diagnostic testing, blood work, meds, and monitoring was covered. All I had to pay for was the actual IUI procedure, which was $400.

So insurance matters less than where you go.

This is not correct. I have Carefirst BlueChoice as a FED and it covered 50% of my IUIs (I did four). With co-pays for monitoring, it cost about $400 per IUI total. It also covered all diagnostics and monitoring appointments when I moved onto IVF.

[Anonymous]

Anonymous wrote:

Anonymous wrote:None of the federal plans cover fertility treatments. BUT some facilities can charge for portions of your treatment as a hospital rather than as a fertility clinic, which your federal insurance WILL cover. I have the same plan as your husband (great plan btw!) and was quoted $2500 per cycle for IUI from SGF. I went with GW and because they charged insurance as a hospital, all diagnostic testing, blood work, meds, and monitoring was covered. All I had to pay for was the actual IUI procedure, which was $400.

So insurance matters less than where you go.

This is not correct. I have Carefirst BlueChoice as a FED and it covered 50% of my IUIs (I did four). With co-pays for monitoring, it cost about $400 per IUI total. It also covered all diagnostics and monitoring appointments when I moved onto IVF.

This was at SGF, btw.

[Anonymous]

How long ago did your BCBS cover fertility treatment at SG?

[Anonymous]

Anonymous wrote:How long ago did your BCBS cover fertility treatment at SG?

2020 and 2021. I just checked the OPM website and the plan documents say infertility and IUI are covered.

[Anonymous]

Anonymous wrote:How long ago did your BCBS cover fertility treatment at SG?

It’s the carefirst plan though, not the most popular BCBS plans.

[Anonymous]

Oh ok. Thanks. I have a different BCBS plan.

[Anonymous]

To the poster with BCBS who got partial coverage for IVF diagnostics and monitoring, could you share roughly how much you were left paying out of pocket for IVF? I am going to be starting a new federal job soon and need to pick insurance, and am hoping to do a FET next year so trying to figure out the best plan with that in mind. Thank you!

[Anonymous]

Anonymous wrote:To the poster with BCBS who got partial coverage for IVF diagnostics and monitoring, could you share roughly how much you were left paying out of pocket for IVF? I am going to be starting a new federal job soon and need to pick insurance, and am hoping to do a FET next year so trying to figure out the best plan with that in mind. Thank you!

I am the poster with carefirst insurance that covered my IVF monitoring appointments. I was in a sort of unique situation with insurance through my federal job and my husband's non federal job. My husband's insurance covered IVF with a lifetime limit, so that covered most of my expenses. Honestly it was an accident (I meant to cancel my fed insurance but messed it up and missed the window) but it ended out working well in my situation because a lot got billed to my fed insurance first so it did not count against my lifetime limit on my husband's insurance. Apparently some people with a federal Aetna plan have been able to negotiate the in-network rate with SGF, and I think that is the best deal. If you can't do that, I recommend you just pay for one of the out of pocket packages that SGF offers because it will be cheaper.

[Anonymous]

Anonymous wrote:

Anonymous wrote:None of the federal plans cover fertility treatments. BUT some facilities can charge for portions of your treatment as a hospital rather than as a fertility clinic, which your federal insurance WILL cover. I have the same plan as your husband (great plan btw!) and was quoted $2500 per cycle for IUI from SGF. I went with GW and because they charged insurance as a hospital, all diagnostic testing, blood work, meds, and monitoring was covered. All I had to pay for was the actual IUI procedure, which was $400.

So insurance matters less than where you go.

This is not correct. I have Carefirst BlueChoice as a FED and it covered 50% of my IUIs (I did four). With co-pays for monitoring, it cost about $400 per IUI total. It also covered all diagnostics and monitoring appointments when I moved onto IVF.

+1, got 50% IUI coverage with CareFirst in 2020

[Anonymous]

Anonymous wrote:

Anonymous wrote:How long ago did your BCBS cover fertility treatment at SG?

It’s the carefirst plan though, not the most popular BCBS plans.

Same here, Carefirst BCBS covered my IUIs fully, including meds. No coverage for IVF though.

BCBS FEP did not provide the same IUI coverage.

This was a few years ago though.

[Anonymous]

Sign up for an FSA too so your OOP costs can be tax advantaged. Just be mindful of spending deadlines.