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[quote=Anonymous]We live in D.C., my husband is a federal employee, and we are going through open season to switch plans from CareFirst BlueChoice to another plan.  CFBC covers 100% IUI but no IVF; we've already done 4 IUI cycles, unsuccessfully, so I'm ready to move on to IVF sometime next year.  But, our infertility is definitely because of me, not him, and it's due to unknown factors - I'm just not producing the right hormones & I don't ovulate on my own.

I've been looking at Aetna, Kaiser, and MD-IPA, but my impression is that both Aetna and MDIPA cover IVF only under a pretty limited set of circumstances - endometriosis, exposure to DES, trouble w/ fallopian tubes, or male factor infertility.

I just talked to someone at MDIPA, who said that the doctor could submit a request for coverage if there's some other underlying reason, but she couldn't give me any explanation of how or why the insurance co. would agree to cover it for a ground that's not listed.  (Aetna's brochure has exactly the same language; they're just not open on the weekend, so I haven't talked to someone there today.)

Kaiser potentially seems to have better coverage - depending on how they define "a history of infertility of at least 2 years duration" - but I'm just wary of switching to Kaiser.

So... does anyone in the District have experience with a federal health plan covering (or not covering) IVF for infertility due to unknown causes?

Many thanks in advance! [/quote]

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