Reply to Kaiser - Infertility Services DO count toward OOP Max

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[quote=Anonymous][quote=Anonymous]Seems like Kaiser could be the cheapest way for feds to get IVF coverage, if all you pay is the $2500 OOP max.  So what if your meds don't quite add up to $2500--does any part of the monitoring or retrieval make up the difference toward meeting the max so that the remaining costs would be free?  Also, are there any coverage restrictions on Kaiser?  For example, Aetna has rules about FSH being below 19 and no coverage for infertility that is age-related.  Does Kaiser have any similar rules/situations that could mean a person's cycle wouldn't be covered after all?[/quote]

I doubt your meds will not add up to $2500.  I just did my first cycle, and just the first bit of meds (had to get more later) got me over the $2500 hump.  You have to buy the meds through Kaiser's pharmacy, which is not cheap.  However, if you don't reach $2500 through meds, then yes, they'd count some of your monitoring costs toward the $2500 until you reach the max.

Just a tip -- the pharmacy at Kaiser seems to forget to check if you've reached your out-of-pocket maximum.  Just remember when picking up additional rounds of meds that you've reached the max.  They'll adjust it and then make sure not to bill you.

In addition, once you reach the out-of-pocket max, make sure you inform SG so their financial office can verify this with Kaiser.

Good luck everyone.[/quote]

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