PP: You will need to find a PCP for MDIPA. I found one, lined up an appointment with her the first week of January and got a referral from her and was able to start my first IVF cycle in February. I was already a patient at CFA and once I had that first referral, CFA took care of obtaining all other authorizations and approvals.

PP that just got back from RE's office here:
To be fair, the office admin literally said it's 6 of one half a dozen of the other....

I do not have a PCP - do I just need one to provide the referral to the RE once, or do I need one every time? Also, if I'm already an established patient there, how does that work with MD IPA?

sorry to be a pain, but I find that when I call the insurance companies, they NEVER give me the truth because they're just selling something.

I'm at GW Fertility and we currently have Aetna CDHP (which sucks if you need to actually use it!) and TRICARE thru most of december. Right now, we're just seeing if we get bills and have no referrals.

Is it better to have a PCP send a referral, or should I wait until I've changed insurance?

Anonymous wrote:At the RE's office, the administrator said that the plans are 6 of one, half a dozen of the other - that with MD IPA you need to have a referral for EVERYTHING, but with Aetna, you've got more flexibility....and that with Aetna working on co-pays for office visits vs. 50% cost sharing, it ultimately evens out for the most part.

Is this a good assessment based on some of your experiences?

Also, if you do cycles with one insurance plan and they aren't successful, and you switch plans, does it start over?

We're dealing with male factor - dso we do have a diagnosis.

PP is right - meds with Aetna can add thousands to your bill. Plus, many people have reported huge hassles getting authorized for the meds by Aetna, even for refills in the middle of the stims. We haven't had any issues with MDIPA. Getting referrals from your PCP is easy, and you don't need them for OB stuff once you get pregnant.

I'd say the administrator at your RE's office is not making a good recommendation here. I'd go with MDIPA again in a heartbeat.

The RE's office doesn't have anything to do with the meds. The meds on Aetna are WAY more expensive than they are through MDIPA.

At the RE's office, the administrator said that the plans are 6 of one, half a dozen of the other - that with MD IPA you need to have a referral for EVERYTHING, but with Aetna, you've got more flexibility....and that with Aetna working on co-pays for office visits vs. 50% cost sharing, it ultimately evens out for the most part.

Is this a good assessment based on some of your experiences?

Also, if you do cycles with one insurance plan and they aren't successful, and you switch plans, does it start over?

We're dealing with male factor - dso we do have a diagnosis.

Anonymous wrote:I'd also be curious about the 2013 plan changes - I have Aetna CDHP which I've read is changing, and currently covers very little. However, for what I've needed, it's been great.

Now that we've been told we need IVF (male factor), we need to switch. We currently have TRICARE thry most of December, so I'm hoping to get most of the testing and all that done before, and hopefully an RX for the drugs since Tricare pays for all of it - and then start a cycle in January or whatnot.

It looks like MD IPA is still the best - they cover 50% of 6 attempts per lifetime.

I'd be curious how the ACA affects this since there are now not supposed to be lifetime caps...but I don't know.

This year, MDIPA covered 3 attempts per live birth. Not sure about the lifetime cap or how it's affected by the ACA. I highly recommend them, though, they've been great for us (I only needed one IVF though, not sure how they are with authorizing repeat procedures).

I'd also be curious about the 2013 plan changes - I have Aetna CDHP which I've read is changing, and currently covers very little. However, for what I've needed, it's been great.

Now that we've been told we need IVF (male factor), we need to switch. We currently have TRICARE thry most of December, so I'm hoping to get most of the testing and all that done before, and hopefully an RX for the drugs since Tricare pays for all of it - and then start a cycle in January or whatnot.

It looks like MD IPA is still the best - they cover 50% of 6 attempts per lifetime.

I'd be curious how the ACA affects this since there are now not supposed to be lifetime caps...but I don't know.

I am headed into open season and planning for a second try at IVF next year. Does anyone know if the plans discussed 2009-2011 have made major changes as we head into 2013?

It sounds like MDIPA might be the best plan for us. I am curious if there are any updates that folks are aware of as we head in to open season.

Run, run, run as fast as you can away from Aetna! It is a total rip off! As a pp mentioned they charge you double so your 1/2 is really full price!

I've used both Aetna and MDIPA and would choose MDIPA hands down.

I had done three timed intercourse cycles with injectibles the year before I switched to MDIPA, and they approved my IVF right away. I have endometriosis, though, so that may have exempted me from any requirements.

We had and have a great experience with MDIPA. Covered the meds in full, and approved everything we asked for. What's also great is that once you get pregnant, you only have one copayment for your maternity care. And your children will have no copayments at the pediatrician. It also seems that most doctors accept this insurance.

Aetna sucks. We switched to it last year and will switch again this year because their coverage is a disaster. We paid over 5k for meds for one cycle because they a) make you use their pharmacy, and b) they charge triple the price for insured customers, so you end up paying the same as you would if you paid out of pocket. I think having Aetna only shaved about a 1/3rd off our total IVF costs. MDIPA is considerably better, from what I've been reading on this forum all year.

I think we're actually going to switch back to BCBS next year, since we have ended up paying out of pocket for most of these costs anyway. BCBS sucks for fertility but it's great for all our other needs.

Does anyone know what MDIPA requires to get ivf? Aetna requires 3 injectible IUIs before ivf. Has anyone switched from aetna to MDIPA to get ivf? Do they make you start over with cycles or can you just go to ivf?

Anonymous wrote:Federal employees living in VA (like me) can do MDIPA. I am currently doing a cycle and have paid $290 for meds and $3026 for IVF (without ICSI, AH, etc.) at SG. There was a thread earlier that implies I may actually get some of that back.

Our take on Kaiser and Aetna is that they wouldn't, in our case, pay nearly anywhere as much (I'd already had all my diagnostics, so that may have been why- I can't remember).

I'm the PP living in VA who bumped this old thread. Thank you for this information - I am looking into this with more hope. This is tough to navigate esp as I'm somewhat unclear on how they'd cover my individual situation.

MDIAP is much cheaper than Aetna. I've done IVF on both. Paid 250.00 for meds with MDIPA and 6K with Aetna. You'll save 5 - 6K with MDIPA. Aetna doubles the cost of their meds so 50% off is really full price. Plus they are a nightmare to work worth in terms of the speciality pharmacy. Even once approved for IVF you have to go through a process for approval of the meds. Big pain whereas MDIPA is all covered.

Federal employees living in VA (like me) can do MDIPA. I am currently doing a cycle and have paid $290 for meds and $3026 for IVF (without ICSI, AH, etc.) at SG. There was a thread earlier that implies I may actually get some of that back.

Our take on Kaiser and Aetna is that they wouldn't, in our case, pay nearly anywhere as much (I'd already had all my diagnostics, so that may have been why- I can't remember).