I think Kaiser will still cover IUI, diagnostics. The language is in the other thread.

Such a bummer, this is the only thing that has been covered for me with fertility and even that small savings has made me so happy/relieved.

Anonymous wrote:I've heard, but haven't confirmed, that BCBS will not cover monitoring in 2017.

When it rains it pours.

Anonymous wrote:I've heard, but haven't confirmed, that BCBS will not cover monitoring in 2017.

The billing coordinator at my doctor confirmed this last week.

I've heard, but haven't confirmed, that BCBS will not cover monitoring in 2017.

Anonymous wrote:BCBS will cover monitoring and some diagnostic related costs and so that might be helpful. But places like Shady Grove won't even bill to BCBS for IVF since it isn't a covered service. Nor will they for IUI if I recall correctly but may be wrong. GW used to bill BCBS for all monitoring related costs associated with IUI and all you had to pay was the actual $400 IUI fee. I don't know if that is still the case or not.

sortof. On BCBS Standard for IUI they will bill you upfront for 5 in-cycle monitoring visits, plus the $400 for IUI+spermwash, so about $557 at the start of the cycle. BCBS Standard in 2016 (haven't seen the new brochure) covers all monitoring (less co pays) and meds for a timed intercourse cycle, and all diagnostic testing (less co pays) for infertility. A monitoring visit (sono+bloodwork) usually costs me around $35.

from what I have heard SG just refuses to do itemized billing, which means that they won't submit to BC for covered monitoring, and it makes it difficult to use your FSA as well.

I'm with CFA and they submit everything to BCBS and see what sticks. All the diagnostic and monitoring was covered. The meds associated with my clotting and immune issues were covered too even though they were prescribed for infertility. But they're not technically infertility drugs so they were covered. The actual IUI and trigger shot were not covered but just about everything else has been. And once you are pregnant everything is covered, even at the RE -- I'm 13 weeks and have to go back every few weeks for special blood tests and they've all been covered.

IVF would be a different story. And I would not use CFA for IVF unless you have clotting or immune factors -- they're the only place around that treats for those so you'd have no choice. That's why I am there. But if you do have a choice, I'd go elsewhere. I love my doctor, under whose regimen I have finally made it out of the first trimester where I never did with another clinic. But I have not at all been impressed with the nurses.

Anonymous wrote:I have federal BCBS Standard as secondary insurance and went through a FET with GW earlier this year. I have infertility coverage through my primary policy, an Aetna PPO through my employer that covers 50%. BCBS covered my contribution of the 50% for all of my monitoring appointments, but nothing for the actual FET procedure.

And if PP 14:19 is talking about Brian as being the "awesome finance guy", he is back at GW (at least this spring)!

Yes I was definitely talking about Brian. So glad to hear he is back.

definitely do the fsa to at least get the tax benefit. my dh is a fed as well so we can use both of them for $5000 total. we have geha ppo and what was covered for me was the early diagnostic stuff-hcg, hormone testing, etc. we have the PPO because of the option to see specialists, but it is very expensive.

FWIW we chose to do shared risk with SG. we wanted the refund option. this was around $30K but included icsi and pgd. the pgd was the important part to us, definitely worth the extra money.

I have federal BCBS Standard as secondary insurance and went through a FET with GW earlier this year. I have infertility coverage through my primary policy, an Aetna PPO through my employer that covers 50%. BCBS covered my contribution of the 50% for all of my monitoring appointments, but nothing for the actual FET procedure.

And if PP 14:19 is talking about Brian as being the "awesome finance guy", he is back at GW (at least this spring)!

Anonymous wrote:BCBS only covered diagnostics: bloodwork, ultrasound, HSG etc at SG. They explicitly said there would be no coverage of IVF so I'm not sure you can get any monitoring covered, even ultrasounds and bloodwork. I do believe there is some coverage for IUI, check the plan brochure.
Is shared risk an option?

Ye, SG I very very strict about this. They won't even submit to BCBS for monitoring costs related to an Assisted Cycle. Other clinics in the area are not! Check around and try and speak to their financial folks. GWU used to have an awesome finance guy there but I heard he has since left a number of years ago. The CFA finance people were pretty disastrous when I was first going through fertility treatment back in 2013 and 2014. I refused to even cycle there because of the finance people I spoke with.

I had BCBS and they covered all the diagnostic testing but nothing else.

The BCBS HMO plan in 2016 covered IUIs and the associated medications.

As for Aetna, I am curious whether SG will still offer the negotiated rate. Based on the explanation the financial folks provided me, I doubt it: Aetna requires non-covered services to be offered at the negotiated rate. But if there are not any covered services, there is not a negotiated rate presumably.
I feel lucky to have had limited coverage this year and it truly saddens me that the women in public service in the DC area won't get any coverage. Infertility is a disease. It is wrongheaded that it is being treated differently than many other health conditions.

BCBS only covered diagnostics: bloodwork, ultrasound, HSG etc at SG. They explicitly said there would be no coverage of IVF so I'm not sure you can get any monitoring covered, even ultrasounds and bloodwork. I do believe there is some coverage for IUI, check the plan brochure.
Is shared risk an option?

BCBS will cover monitoring and some diagnostic related costs and so that might be helpful. But places like Shady Grove won't even bill to BCBS for IVF since it isn't a covered service. Nor will they for IUI if I recall correctly but may be wrong. GW used to bill BCBS for all monitoring related costs associated with IUI and all you had to pay was the actual $400 IUI fee. I don't know if that is still the case or not.

Now that it looks like Kaiser and AETNA will cease IVF coverage, do any other Federal Employees out there have thoughts on what would be the best insurance to cover some of the costs associated with IVF?

I seem to recall BCBS will cover some of the associated blood work and monitoring costs. Not much, but it's something. Is there a better plan out there if we are otherwise healthy, but looking to do IVF?