Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thanks PP. From my discussion with SG, sounded like it would be all the costs you described, plus and addition $1750. Maybe I am just not understanding how tihs all works. I'll reach back out to them.

PP here. I was also under the same impression when I paid the $1750 last year. But at the end of the year, somehow I was only $1400 into my deductible. Looking at my insurance claims, the embryo transfer was ~$500 and the egg retrieval was ~$830. The rest was copays ($65 for monitoring visits with an US, $15 for labwork only visits, $30 for my consult, $300 surgical copay for my HSG).

Looking at your insurance claims, is it saying that the amount CareFirst paid the clinic was $500 and $830? Or was that the amount that they said you owed? That would answer whether the payments were going toward the deductible or if they were all just copays.

I personally owed the $500 and $830. So that amount came from the $1750 balance that I had already prepaid. There were maybe a couple of specialist co-pays in those amounts, those are just the total for the two dates of the procedures. Other than those two dates, the other $650ish I paid to SGF was all copays. What's very strange to me is that there was a $300 copay for my HSG, but not for the IVF procedures. This must be where the 100% IVF coverage comes into play.

PP, thanks for this information! I know this is an older thread already ,but do you happen to know how they broke down the $500 and the $830? I think there would be some doctor copays in there (like the anesthesiologist), but what other fees were those charges for since IVF is supposed to be 100% covered?

Anonymous wrote:OP here.Thanks to everyone for your feedback. It was really helpful. Will check back with what I find out from SG, but I based on the comments it sounds like most everything will be coved within the deductable.

Yes, please do! My financial person seems to be ignoring my queries, which is so aggravating!

Deductible

OP here.Thanks to everyone for your feedback. It was really helpful. Will check back with what I find out from SG, but I based on the comments it sounds like most everything will be coved within the deductable.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thanks PP. From my discussion with SG, sounded like it would be all the costs you described, plus and addition $1750. Maybe I am just not understanding how tihs all works. I'll reach back out to them.

PP here. I was also under the same impression when I paid the $1750 last year. But at the end of the year, somehow I was only $1400 into my deductible. Looking at my insurance claims, the embryo transfer was ~$500 and the egg retrieval was ~$830. The rest was copays ($65 for monitoring visits with an US, $15 for labwork only visits, $30 for my consult, $300 surgical copay for my HSG).

Looking at your insurance claims, is it saying that the amount CareFirst paid the clinic was $500 and $830? Or was that the amount that they said you owed? That would answer whether the payments were going toward the deductible or if they were all just copays.

I personally owed the $500 and $830. So that amount came from the $1750 balance that I had already prepaid. There were maybe a couple of specialist co-pays in those amounts, those are just the total for the two dates of the procedures. Other than those two dates, the other $650ish I paid to SGF was all copays. What's very strange to me is that there was a $300 copay for my HSG, but not for the IVF procedures. This must be where the 100% IVF coverage comes into play.

Anonymous wrote:

Anonymous wrote:Thanks PP. From my discussion with SG, sounded like it would be all the costs you described, plus and addition $1750. Maybe I am just not understanding how tihs all works. I'll reach back out to them.

PP here. I was also under the same impression when I paid the $1750 last year. But at the end of the year, somehow I was only $1400 into my deductible. Looking at my insurance claims, the embryo transfer was ~$500 and the egg retrieval was ~$830. The rest was copays ($65 for monitoring visits with an US, $15 for labwork only visits, $30 for my consult, $300 surgical copay for my HSG).

Looking at your insurance claims, is it saying that the amount CareFirst paid the clinic was $500 and $830? Or was that the amount that they said you owed? That would answer whether the payments were going toward the deductible or if they were all just copays.

I'm about to go through the exact same thing, and it drove me nuts that I couldn't get a straight answer on how things would be charged so I could decide between the Gold 1,000 and Gold 1,750 plan. Here's my educated guess as to what happens: The monitoring stuff (ultrasound, bloodwork) is straight copays, which don't apply to your deductible. Things like egg retrieval and transfer are done at a location that considers itself to be an ambulatory surgical center (at least, I think this is the case for Shady Grove Fertility but I couldn't get a straight answer from them). As long as it's not considered a hospital facility, there's a $300 copay for the facility, plus copays for things like anesthesia and the doctor/surgeon (which again none of these apply to the deductible). So it may be that the total costs end up being around the total deductible amount, but the payments weren't actually being applied to your deductible. If that is the case, then it's a better deal to have the 1750 plan since you have a smaller deductible for meds ($150 instead of $1k).

On a side note, I think it's lazy of them to just say to pay them the deductible. Why don't they bill you as you go along for exact amounts, or goodness know they have a lot of people getting IVF done through the Maryland CareFirst plan, so why don't they just add up the amounts based on experience and give you a more accurate estimate?! Anyway, I hope that helps and hopefully the getting a refund part won't be too difficult!

Anonymous wrote:Thanks PP. From my discussion with SG, sounded like it would be all the costs you described, plus and addition $1750. Maybe I am just not understanding how tihs all works. I'll reach back out to them.

PP here. I was also under the same impression when I paid the $1750 last year. But at the end of the year, somehow I was only $1400 into my deductible. Looking at my insurance claims, the embryo transfer was ~$500 and the egg retrieval was ~$830. The rest was copays ($65 for monitoring visits with an US, $15 for labwork only visits, $30 for my consult, $300 surgical copay for my HSG).

I went through this at another clinic. Paid the $1750 up front. Financial coordinator also came back with a co-insurance requirement, which I questioned and provided a printout of the insurance contract. She went back to insurance and got a different coverage statement without the
30% co-insurance. The $1750 was never applied to my insurance account and I'm awaiting a refund for that and other overcharges. I was also told I would pay $75 per visit, but ultimately paid $40. My last fertility visit was mid-October (transitioned to maternity care after that).

Thanks PP. From my discussion with SG, sounded like it would be all the costs you described, plus and addition $1750. Maybe I am just not understanding how tihs all works. I'll reach back out to them.

I gave my deductible as a down payment for IVF, but in the end, I never used all of it during IVF. I ended up paying about $2400 to SGF for copays for testing and monitoring and other charges from my retrieval and transfer. On top of that, embryo freezing was another $1800 as it is not covered by insurance. Drugs were extremely cheap and I only paid $385 in Copays. If I'm correct, the only plan with a lower deductible was $1000 and a "value" plan? As someone who paid OOP for my first IVF, the potential for a few hundred dollar difference doesn't seem like much to me. And from experience, I can tell you that I had no issues with things being covered with my $1750 plan, and I'd be a bit weary of what's not covered to make the $1000 a "value" plan.

Hiya there. Hoping someone can chime in on what your ivf cost is for this year if you have this plan. I just spoke with my financial coordinator who said that IVF was subject to the $1750 deductable for this plan. When I was researching this plan last year, it looked like I would have only paid co-pays for outpatient retreivals, monitoring, etc and of course no one at the time at the insurance company would give me a straight up answer.

Happy that I have this coverage but so frustrated as I would have chose a different plan had I known.