Anonymous wrote:

Anonymous wrote:OP here - Thank you to those who responded and helped to provide a few data points for the discussion. I just finished typing up my notes and will transfer them to my slide templates this evening before the session. For those who asked about the broker and the MD infertility Mandate:

I didn't end up speaking to a broker today because I was busy at work. I think they must be easy to reach as at least 4 called me today. I did speak with Kaiser directly however and while I wasn't able to get someone well versed on the infertility benefits and how much things would cost, they did assure me that you would not pay more than your oop maximum in any calendar year and that includes medication coverage. Both Kaiser and BCBS cover up to 3 IVFs per live birth up to a maximum of $100,000 per the MD infertility mandate. I saw a few plans on the Kaiser site (Kaiser platinum for example) where for monthly individual premiums of $470 or so, the max oop was about $6-$7K for the year. The particular plan I looked at had no deductibles and so I am not quite certain how one's copays would work for the various IVF procedures/charges but at least its a start. Of note, MD open season runs from November 1st to December 15th so I wanted to get this topic in during that time.

West Virginia is also an Infertility mandated state near us. I just didn't have any time to research their plans.

The last thing I stumbled on was a website that had some additional info on the infertility mandate and also provided info. on some private companies (like UPS and starbucks) which offer good infertility coverage. Here's the link to that site: https://yourfertilityfriend.com/state-laws-related-to-insurance-coverage-for-infertility-treatment/

Again - this is just a quick and dirty summary.

I've actually been researching this today and I'm surprised to hear that. My understanding was that Kaiser made infertility treatment an exclusion from the OOP maximum in 2017. I would just double check the explanation of benefits before choosing coverage based on that assumption.

Op here - so I just looked at the plan brochure again and didn't see anything that indicates that for the Kaiser Maryland Plan on the exchange that infertility did not count towards the oop max. Page CS8 which lists oop maximum exclusions only lists three things: eye glass lenses, frames, etc.; adult routine eye exams and dental services. If you can point me in the direction where you heard or read this I would appreciate it. My session starts in the next few minutes so I will leave the oop max issue out for now until I hear back from you.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have united health care. I did 4 cycles of IUI - 3 letrozole cycles and 1 injectables cycle with follistim (which worked). I can tell you that the meds were not covered by insurance; for 3 rounds of letrozole plus one round of follistim (by far the most expensive one) plus several doses of the ovidrel trigger shot I paid, entirely out of pocket, about $2600. However, much of the monitoring / bloodwork / ultrasounds / appointments / the IUIs themselves were at least partially covered by insurance - and my bill from the doctor for everything (all 4 rounds) was only $1300. I don't know what it would have been without insurance coverage though - I'm guessing a lot more.

Which plan? Back when uhc offered it under the federal plan meds were covered. They we're like $300 which was insane and clearly why they dropped off coverage in subsequent years.

Choice Plus

And oh wow! Honestly I was pretty pleasantly surprised when we got the bill from the RE - each cycle included several monitoring ultrasounds and blood draws in addition to the IUIs themselves; I had been expecting to owe more

Op here - yes those were the good old days. In hindsight, while we loved the fact that back then you could pretty much get a cycle covered at $3000-$4500 with meds and then not pay anything else for other cycles that calendar year because your deductible had been met, clearly that wasn't sustainable and it's no wonder that UHC/MDIPA was one of the first to drop coverage along with Aetna that same year if I recall correctly followed by Kaiser a year or two later.

Anonymous wrote:

Anonymous wrote:I have united health care. I did 4 cycles of IUI - 3 letrozole cycles and 1 injectables cycle with follistim (which worked). I can tell you that the meds were not covered by insurance; for 3 rounds of letrozole plus one round of follistim (by far the most expensive one) plus several doses of the ovidrel trigger shot I paid, entirely out of pocket, about $2600. However, much of the monitoring / bloodwork / ultrasounds / appointments / the IUIs themselves were at least partially covered by insurance - and my bill from the doctor for everything (all 4 rounds) was only $1300. I don't know what it would have been without insurance coverage though - I'm guessing a lot more.

Which plan? Back when uhc offered it under the federal plan meds were covered. They we're like $300 which was insane and clearly why they dropped off coverage in subsequent years.

Choice Plus

And oh wow! Honestly I was pretty pleasantly surprised when we got the bill from the RE - each cycle included several monitoring ultrasounds and blood draws in addition to the IUIs themselves; I had been expecting to owe more

Anonymous wrote:

Anonymous wrote:OP here - Thank you to those who responded and helped to provide a few data points for the discussion. I just finished typing up my notes and will transfer them to my slide templates this evening before the session. For those who asked about the broker and the MD infertility Mandate:

I didn't end up speaking to a broker today because I was busy at work. I think they must be easy to reach as at least 4 called me today. I did speak with Kaiser directly however and while I wasn't able to get someone well versed on the infertility benefits and how much things would cost, they did assure me that you would not pay more than your oop maximum in any calendar year and that includes medication coverage. Both Kaiser and BCBS cover up to 3 IVFs per live birth up to a maximum of $100,000 per the MD infertility mandate. I saw a few plans on the Kaiser site (Kaiser platinum for example) where for monthly individual premiums of $470 or so, the max oop was about $6-$7K for the year. The particular plan I looked at had no deductibles and so I am not quite certain how one's copays would work for the various IVF procedures/charges but at least its a start. Of note, MD open season runs from November 1st to December 15th so I wanted to get this topic in during that time.

West Virginia is also an Infertility mandated state near us. I just didn't have any time to research their plans.

The last thing I stumbled on was a website that had some additional info on the infertility mandate and also provided info. on some private companies (like UPS and starbucks) which offer good infertility coverage. Here's the link to that site: https://yourfertilityfriend.com/state-laws-related-to-insurance-coverage-for-infertility-treatment/

Again - this is just a quick and dirty summary.

I've actually been researching this today and I'm surprised to hear that. My understanding was that Kaiser made infertility treatment an exclusion from the OOP maximum in 2017. I would just double check the explanation of benefits before choosing coverage based on that assumption.

Op here - I will double check the plan brochure which they sent me (I did not see that limitation upon initial review and if I can't confirm will call them back tomorrow).

Anonymous wrote:I have united health care. I did 4 cycles of IUI - 3 letrozole cycles and 1 injectables cycle with follistim (which worked). I can tell you that the meds were not covered by insurance; for 3 rounds of letrozole plus one round of follistim (by far the most expensive one) plus several doses of the ovidrel trigger shot I paid, entirely out of pocket, about $2600. However, much of the monitoring / bloodwork / ultrasounds / appointments / the IUIs themselves were at least partially covered by insurance - and my bill from the doctor for everything (all 4 rounds) was only $1300. I don't know what it would have been without insurance coverage though - I'm guessing a lot more.

Which plan? Back when uhc offered it under the federal plan meds were covered. They we're like $300 which was insane and clearly why they dropped off coverage in subsequent years.

I have united health care. I did 4 cycles of IUI - 3 letrozole cycles and 1 injectables cycle with follistim (which worked). I can tell you that the meds were not covered by insurance; for 3 rounds of letrozole plus one round of follistim (by far the most expensive one) plus several doses of the ovidrel trigger shot I paid, entirely out of pocket, about $2600. However, much of the monitoring / bloodwork / ultrasounds / appointments / the IUIs themselves were at least partially covered by insurance - and my bill from the doctor for everything (all 4 rounds) was only $1300. I don't know what it would have been without insurance coverage though - I'm guessing a lot more.

Anonymous wrote:OP here - Thank you to those who responded and helped to provide a few data points for the discussion. I just finished typing up my notes and will transfer them to my slide templates this evening before the session. For those who asked about the broker and the MD infertility Mandate:

I didn't end up speaking to a broker today because I was busy at work. I think they must be easy to reach as at least 4 called me today. I did speak with Kaiser directly however and while I wasn't able to get someone well versed on the infertility benefits and how much things would cost, they did assure me that you would not pay more than your oop maximum in any calendar year and that includes medication coverage. Both Kaiser and BCBS cover up to 3 IVFs per live birth up to a maximum of $100,000 per the MD infertility mandate. I saw a few plans on the Kaiser site (Kaiser platinum for example) where for monthly individual premiums of $470 or so, the max oop was about $6-$7K for the year. The particular plan I looked at had no deductibles and so I am not quite certain how one's copays would work for the various IVF procedures/charges but at least its a start. Of note, MD open season runs from November 1st to December 15th so I wanted to get this topic in during that time.

West Virginia is also an Infertility mandated state near us. I just didn't have any time to research their plans.

The last thing I stumbled on was a website that had some additional info on the infertility mandate and also provided info. on some private companies (like UPS and starbucks) which offer good infertility coverage. Here's the link to that site: https://yourfertilityfriend.com/state-laws-related-to-insurance-coverage-for-infertility-treatment/

Again - this is just a quick and dirty summary.

I've actually been researching this today and I'm surprised to hear that. My understanding was that Kaiser made infertility treatment an exclusion from the OOP maximum in 2017. I would just double check the explanation of benefits before choosing coverage based on that assumption.

OP here - Thank you to those who responded and helped to provide a few data points for the discussion. I just finished typing up my notes and will transfer them to my slide templates this evening before the session. For those who asked about the broker and the MD infertility Mandate:

I didn't end up speaking to a broker today because I was busy at work. I think they must be easy to reach as at least 4 called me today. I did speak with Kaiser directly however and while I wasn't able to get someone well versed on the infertility benefits and how much things would cost, they did assure me that you would not pay more than your oop maximum in any calendar year and that includes medication coverage. Both Kaiser and BCBS cover up to 3 IVFs per live birth up to a maximum of $100,000 per the MD infertility mandate. I saw a few plans on the Kaiser site (Kaiser platinum for example) where for monthly individual premiums of $470 or so, the max oop was about $6-$7K for the year. The particular plan I looked at had no deductibles and so I am not quite certain how one's copays would work for the various IVF procedures/charges but at least its a start. Of note, MD open season runs from November 1st to December 15th so I wanted to get this topic in during that time.

West Virginia is also an Infertility mandated state near us. I just didn't have any time to research their plans.

The last thing I stumbled on was a website that had some additional info on the infertility mandate and also provided info. on some private companies (like UPS and starbucks) which offer good infertility coverage. Here's the link to that site: https://yourfertilityfriend.com/state-laws-related-to-insurance-coverage-for-infertility-treatment/

Again - this is just a quick and dirty summary.

I have Kaiser. With Kaiser, you need to do initial diagnostic testing through Kaiser, then they refer you to Shady Grove Fertility for treatment. Our plan covered 50%. Below are 2018 costs for diagnostic tests and IUIs. I put in total costs and then our costs in parentheses. It is a little confusing because the providers charge a certain amount, but then the insurance has a lower negotiated rate and that's what actual costs below are based on.

2018 diagnostic and IUI costs through Kaiser and Shady Grove Fertility
Initial consult with OB for infertility through Kaiser: $80 (our costs: $40)
Day 3 bloodwork through Kaiser: $450 (our costs: $225)
Semen analysis through Kaiser: $40 (our costs: $15)
HSG through Kaiser: $200 (our costs: $100) – this seemed very low to me, I think Shady Grove’s price list had something like $1,600 for the HSG, but it is what they charged
Consult with Shady Grove Fertility RE: $100 (our costs: $50)
Genetic disease carrier testing: $350 (for each partner)
Clomid IUI cycle through Shady Grove Fertility including meds, initial monitoring appointment and two follow-up monitoring appointments: $1,200 (our costs: $600, but note that I believe this does not include the costs of hormonal support for some reason these were fully covered)
Hybrid Femara and Gonal-F IUI cycle through Shady Grove Fertility including meds, initial monitoring appointment and one follow up monitoring appointment: $1,500 (our costs: $750, we lucked out on this cycle because I was ready to trigger after first follow up monitoring appointment so we didn’t need another monitoring appointment, also this time I think the estrace was fully covered by insurance but the prometrium was not).

I’m an adult adoptee (which might blow the anti-adoption poster’s mind) and I also chose to adopt. I did an international adoption from the same country I was adopted from. This was in 2009 so fees aren’t the same today but then it was $22k. The process took 14 months and most of that was waiting on the us govt’s review and approval.

Anonymous wrote:We went through 9 rounds of IVF. 4 with my one eggs and 5 with donor eggs. We were in the SG Shared Risk 3:1, which was about 30K in 2012-2013. None of it worked.

In 2016-2017 we we signed up with an adoption agency and our son was born in 2017. The home study, agency fees, travel, hotel , etc. cost around 50K all in. Our son is worth every penny. He is an absolute joy and the very best thing we've done as a couple.

Op here. Thank you so much for sharing your story. I am so glad it all worked out for you. I won't respond to that previous poster but for others wondering - tonights sessions is about the costs associated with the different options of growing your family so having just a few days points on all options is helpful.i have friends who've done adoption and surrogacy suvcessfully. I've also known people who had failures in both departments along the way but luckily were successful in the end.

For some people adoption is an option they are considering even without going through infertility treatment. My goal is to eventually have a session dedicated specifically for special topics like surrogacy and adoption where I have friends who have gone through both options share their experience with the group.

We went through 9 rounds of IVF. 4 with my one eggs and 5 with donor eggs. We were in the SG Shared Risk 3:1, which was about 30K in 2012-2013. None of it worked.

In 2016-2017 we we signed up with an adoption agency and our son was born in 2017. The home study, agency fees, travel, hotel , etc. cost around 50K all in. Our son is worth every penny. He is an absolute joy and the very best thing we've done as a couple.

Anonymous wrote:Adoption is not a solution to infertility. Please listen to adult adoptees and natural/first mothers before you suggest “just buy a poor woman’s baby!” to infertile couples. I deal with infertile foster parents all the time who try to sabotage family reunification so they can adopt an infant and then cut off all connection that child had to their birth family&birth culture.

Don’t feed this troll, OP.

Adoption is not a solution to infertility. Please listen to adult adoptees and natural/first mothers before you suggest “just buy a poor woman’s baby!” to infertile couples. I deal with infertile foster parents all the time who try to sabotage family reunification so they can adopt an infant and then cut off all connection that child had to their birth family&birth culture.

I paid out of pocket for my IUIs at $1500 a pop. This did not include meds (femara in my case), which were covered by insurance so I’m not sure of OOP cost. Yeah