Reply to Federal Health Plans & IVF coverage

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[quote=Anonymous]It appears AETNA no longer covers IVF or drugs - this is from their plan brochure - am I reading it wrong?

Infertility services 
Infertility is defined as the inability to conceive after 12 months of 
unprotected intravaginal sexual relations (or 12 cycles of artificial 
insemination) for women under age 35, and 6 months of unprotected 
intravaginal sexual relations (or 6 cycles of artificial insemination) for 
women age 35 and over. 
• Artificial insemination and monitoring of ovulation: 
- Intravaginal insemination (IVI) 
- Intracervical insemination (ICI) 
- Intrauterine insemination (IUI) 
Note: Coverage is only for 3 cycles (per lifetime). In-network benefits 
requires members to 1) access care from Aetna's select network of Plan 
Infertility providers and 2) obtain preauthorization from the Plan prior to 
services. Otherwise, out-of-network benefits will apply. You must 
contact the Infertility Case Manager at 1-888/238-6240. 
• Testing for diagnosis and surgical treatment of the underlying cause of 
infertility. 
Note: We cover oral fertility drugs under the prescription drug benefit. 
In-network: 15% of our Plan allowance 
Out-of-network: 40% of our Plan allowance 
and any difference between our allowance and 
the billed amount. 
[u][b]Not covered: [/b][/u]
• Assisted reproductive technology (ART) procedures, such as:
[b]- In vitro fertilization[/b]
- Embryo transfer including, but not limited to, gamete GIFT and 
zygote ZIFT
- Services provided in the setting of ovulation induction such as 
ultrasounds, laboratory studies, and physician services.
- Services and supplies related to the above mentioned services, 
including sperm processing
• Reversal of voluntary, surgically-induced sterility.
• Treatment for infertility when the cause of the infertility was a 
previous sterilization with or without surgical reversal
[b]• Injectable fertility drugs[/b]
• Infertility treatment when the FSH level is 19 mIU/ml or greater on 
day 3 of menstrual cycle.
All charges
I[/quote]

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