Reply to Feds - what's the best insurance for IVF?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]^^ Thanks for following up, the OPM message sounds fishy to me. When a carrier is paying out more than they are taking in on claims, they increase pricing. It seems very odd that all Federal carriers have decided to remove IVF, on their on volition, but are not doing that with private sectors plans. The carrier would have just told OPM, plans,are now going up $200 per month for your elected coverages (which IVF is an election an employer makes outside of state mandates). The employer then negotiates with the carrier and makes cost changes such as higher co-pays, deductibles, or removes optional coverage. Maybe OPM said we will pay X more per month and if non-mandated programs have to be removed so be it.

I hope you are able to determine the truth and find a resolution.[/quote]

NP here.  Not many plans offered the IVF coverage to begin with.  It was only something like three plans in the FEHB market.  So it's not unrealistic that those three plans decided to stop offering the coverage because increasing their rates made their plans less attractive to the general FEHB population and only seemed to attract people looking to sign on for 1 year to get the IVF coverage and then drop and switch to another plan.

I highly doubt OPM told them not to offer the coverage.

The thing about FEHB is that there are a lot of plans offered.  The plans that have the best coverage and rates combined are the ones that get the most subscribers, and the more people they have who sign on, the stronger they are.  The plans that have been offering the IVF coverage had significantly higher rates than other plans, which made them less popular with the general population.  They were only popular with the population of people who wanted the IVF coverage (and thus cost them more money), and even then, a lot of those people (as seen here in DCUM threads) would switch to more affordable/better plans the next year once they were done with the IVF.

[b]Some of the private plans not on the FEHB market HAVE to offer IVF because the state they operate in mandates it (like Maryland).  My guess is they would drop that coverage if they could.  FEHB plans aren't subject to state mandates, so that doesn't apply.[/b]

I think all of the conspiracy theory nonsense about OPM playing a role in the dropping of IVF coverage in FEHB plans is just that -- a conspiracy theory that has no basis in reality.

Of course, OPM could mandate that ALL plans cover IVF, but then we will definitely see ALL plans  increase their rates because, so all of the people who would choose MDIPA one year for IVF and then switch to BCBS for the better rates/easier coverage (not an HMO) the next year won't be able to play that game.  All the rates will be comparable to the once high MDIPA rates.

It's worth noting that MDIPA actually lowered their rates the year they dropped the IVF coverage.[/quote]

Just to clarify, the carriers participating in the FEBH market (e.g. Aetna, BCBS, Kasier, etc) offer infertility to private sector clients regardless of state mandates. Mandates don't drive all the coverage offered by a carrier. The organization is free to pick and chose the coverage it wants. And it will pay accordingly.[/quote]

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