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[quote=Anonymous][quote=Anonymous]Kaiser has been discussed in several other threads recently, but I have some additional questions:

1. What is the difference between Kaiser Standard/Basic vs High other than premium differences?  Are there any differences as it relates to infertility coverage?

2. Does Kaiser cover ICSI if it is not needed for male factor reasons?  What about assisted hatching?  If not, what does SG charge for ICSI?

3. Does it cover FETs?  I was on an Aetna plan this year through my husband that covered 3 IVF attempts, but FETs were not covered.

4. If you've already been going through infertility treatments and join Kaiser, how long does the process take to get referred to SG?[/quote]

I can answer some of these -- on my first year with Kaiser fed, and I've done two SG retrievals. Everything has been GREAT with KP, and I highly recommend them. In terms of standard/basic, I think the only difference is that one of them has a lower OOP max, which you will quickly hit with IF services. You'll end up saving money in the long run because after you hit your max everything is free, even the stuff they cover at 50% (after you hit max, it is 100% covered).

ICSI is not covered for non-male factor reasons. Neither is PGS. To do PGS at SG, you must also do ICSI. So that is annoying to pay OOP but still better than paying for everything OOP!

It covers 3 IVF attempts. I forget if FET means fresh or frozen. I don't know what the deal is for fresh. Retrievals and frozen transfers both count as an attempt. So you could do one retrieval and two frozen transfers, or three retrievals, or two retrievals one frozen transfer.

I had already done IUI with SG, and so as soon as my plan was active I made an ob/gyn appt and laid out my case, and she put in a referral to SG. We had already been trying for three years and did three IUIs at that point. Basically, I think if it's obvious you are having difficulty, they're going to refer you. They probably go by that 6mo for AMA or 1 yr for younger guideline. It also probably depends on the doctor you see a bit -- maybe some are weird about it? But mine was totally on board and supportive. It was very easy.[/quote]

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