Reply to Kaiser - Infertility Services DO count toward OOP Max

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[quote=Anonymous][quote=Anonymous]So we got our meds today, and it did show up  as counting against the OOP maximum. Our OOP now shows as $0. Shady Grove said after the retrieval, they will verify with Kaiser the OOP. Also, if doing Frozen. ICSI is only covered if you have two abnormal sperm samples. So for us it wasn't covered. It basically broke down like this for us.

$2300-Meds Kaiser Pharmacy (counted online towards OOP)
$2750 IVF (covered, Will be reduced to $0, since the meds counted towards the OOP of $2250 in Mid Atlantic)
$2000 ICSI (Not covered for us)
$1500 PGD Biopsy (Not covered by Kaiser)
$2000 (PGD Testing  Lab fee, not paid to SG, not covered under insurance)
$1800 Cryopreservation and first year storage (Not covered by insurance)

So real out of pocket. $2250+2000+1500+2000+1800= $5300+4250= $9550

We have two FSA's so we are waiting for those to reimburse us the $5100. Which means we still owe $4450 outside the FSA.

Then we are waiting until next year to do the actual FET. Which will be $2500+ Meds. Which will be reduced down to the OOP for 2017

Do you have to do frozen? No, but when we looked at it, the success rates were higher, than Fresh. Do you have to do PGD? No, but this ensures you don't implant embroyo's that don't have a good chance of making it.

Hope this helps, it was like going through a maze to find our final costs.
[/quote]

Can you explain why you added the 4250 after the 5300?

Also, I thought that the IVF through Kaiser is covered at 50%? Or is that until you meet your OOP?[/quote]

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