has anyone used the Carefirst PPO Gold for IVF Donor Egg? If so, how much did you pay for treatment?

Anonymous wrote:

Anonymous wrote:For those that are Feds, have you kept both your federal insurance (in our case BCBS PPO) and insurance through the exchange or have you dropped your federal coverage when undergoing IVF. Will likely go through SG for services.

My husband and I are both feds and we already have 1 child, so we have the fed BCBS FEP Basic at the family rate. I bought a Carefirst PPO Gold plan from the MD exchange (actually I bought it straight from the Carefirst site for easier navigation but I found it through the exchange). My exchange plan covers just me and is considered my secondary plan after the BCBS FEP plan. It was too much detail to get my husband to understand how to switch the employer plan to remove me for a year and also not worth the cost differential between self+1 and family to deal with. If I had been covered singly on my own fed plan I would have seriously considered dumping it while on the exchange plan though.

ok that's helpful. that's exactly our situation. thank you!!!!

Anonymous wrote:For those that are Feds, have you kept both your federal insurance (in our case BCBS PPO) and insurance through the exchange or have you dropped your federal coverage when undergoing IVF. Will likely go through SG for services.

My husband and I are both feds and we already have 1 child, so we have the fed BCBS FEP Basic at the family rate. I bought a Carefirst PPO Gold plan from the MD exchange (actually I bought it straight from the Carefirst site for easier navigation but I found it through the exchange). My exchange plan covers just me and is considered my secondary plan after the BCBS FEP plan. It was too much detail to get my husband to understand how to switch the employer plan to remove me for a year and also not worth the cost differential between self+1 and family to deal with. If I had been covered singly on my own fed plan I would have seriously considered dumping it while on the exchange plan though.

For those that are Feds, have you kept both your federal insurance (in our case BCBS PPO) and insurance through the exchange or have you dropped your federal coverage when undergoing IVF. Will likely go through SG for services.

Anonymous wrote:I also did this and it worked well. I live in MD, work in DC, and my work insurance does not cover IVF. I got insurance through the exchange and dropped my work insurance. I got the Carefirst Gold plan and it's been great -- covered all costs of IVF basically, and has also been great at covering the costs of pregnancy. Haven't given birth yet, so I don't know how it'll shake out for that. I'll go back to my work insurance next year since it's cheaper, but I've been super happy with the MD exchange insurance.

OP here - great to hear!

Anonymous wrote:

Anonymous wrote:I also did this and it worked well. I live in MD, work in DC, and my work insurance does not cover IVF. I got insurance through the exchange and dropped my work insurance. I got the Carefirst Gold plan and it's been great -- covered all costs of IVF basically, and has also been great at covering the costs of pregnancy. Haven't given birth yet, so I don't know how it'll shake out for that. I'll go back to my work insurance next year since it's cheaper, but I've been super happy with the MD exchange insurance.

NP here. Thank you for sharing! Was there a waiting period to get the IVF coverage or was it immediate?

There wasn't really a waiting period. The challenge I ran into was that I had done the qualifying 6 IUIs (for a same-sex couple) under different insurance, and at first they insisted I do 6 more under their insurance. When I told them I would appeal that, they authorized me to go ahead.

It is great. Ended up paying about 9k a cycle with ultrasound fees and PGS testing and freezing.

There shouldn't be a waiting period. There wasn't for me (for both carefirst and kaiser). But you need to satisfy the prior authorization (trying for a year, endometriosis, or other conditions to have insurance to pay for IVF)

Anonymous wrote:I also did this and it worked well. I live in MD, work in DC, and my work insurance does not cover IVF. I got insurance through the exchange and dropped my work insurance. I got the Carefirst Gold plan and it's been great -- covered all costs of IVF basically, and has also been great at covering the costs of pregnancy. Haven't given birth yet, so I don't know how it'll shake out for that. I'll go back to my work insurance next year since it's cheaper, but I've been super happy with the MD exchange insurance.

NP here. Thank you for sharing! Was there a waiting period to get the IVF coverage or was it immediate?

I also did this and it worked well. I live in MD, work in DC, and my work insurance does not cover IVF. I got insurance through the exchange and dropped my work insurance. I got the Carefirst Gold plan and it's been great -- covered all costs of IVF basically, and has also been great at covering the costs of pregnancy. Haven't given birth yet, so I don't know how it'll shake out for that. I'll go back to my work insurance next year since it's cheaper, but I've been super happy with the MD exchange insurance.

Yes, you can purchase through the exchange. You can drop your work coverage and just use exchange coverage. Or if you want to keep your insurance, you have to get your spouse to purchase it through the exchange and have it cover both you and him. My spouse and I typically use my work insurance. My spouse purchases insurance through the exchange covering him and me. My work insurance covers me and him. My work insurance is my primary and his secondary. The exchange insurance is his primary and my secondary. The RE will first bill my work insurance and it will be denied and then they will bill the exchange insurance. If you have another insurance, you are not eligible for the subsidy. If you keep your work insurance, you can also drop the exchange insurance when you get pregnant or run out of coverage. I've done this multiple times, and it has worked.

I live in MD and work in DC - assuming the insurance through my work will not have to comply with the mandate, but does anyone know if I can purchase additional insurance through MD that will then cover IVF?
Would love to hear from anyone who has done this or knows more about the rules of the mandate. Thanks very much.