Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I switched to Kaiser last year for the IVF coverage and was lucky to get 2 retrievals done. Not lucky that now the FETs won't be covered next year. However, Kaiser is very low cost compared to the other plans (at least last year) and I really loved the doctors I switched to. I think it's much better insurance than BCBS, which I used to have. So I'm going to stick with it and enjoy the lower premiums, I guess.

Just trying to look on the bright side here, for what little of one there is.

I had the same experience. I had BCBS, switched to Kaiser (though got luckily pregnant through IVF) and I'll be staying with Kaiser next year (though switching to the Basic plan from the High plan). I really liked my doctors and the whole process. It was virtually painless.

I'm now working with my HRMO office and OPM to see what we can do for 2018 plans. My hope is to try to bring some IVF benefits back for 2018 (when I may need to tap into my frozen embies).

What has been their response thus far?

As previously stated, OPM does not mandate benefits that health plans must provide or require FEHB carriers to provide coverage for In vitro fertilization (IVF) or other assisted reproduction techniques. It is not an requirement of OPM to remove the IVF benefit. It was the Plan’s decision. You can follow up with the Plans to discuss with them to reconsider dropping IVF.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I switched to Kaiser last year for the IVF coverage and was lucky to get 2 retrievals done. Not lucky that now the FETs won't be covered next year. However, Kaiser is very low cost compared to the other plans (at least last year) and I really loved the doctors I switched to. I think it's much better insurance than BCBS, which I used to have. So I'm going to stick with it and enjoy the lower premiums, I guess.

Just trying to look on the bright side here, for what little of one there is.

BCBS family for basic is $376 next year. Kaiser basic for family is $283 but has a deductible for x-rays, in patient at hospitals, and labs. KaIser high option is $406 monthly with no deductible. BCBS has no deductile. I'm debating switching from BCBS but I don't think Kaisers is cheaper.

I don't think you are looking at the Federal plans. I'm looking at the Kaiser plan right now, and under "Lab, X-Ray and other diagnostic tests" it says that you pay NOTHING for either the high or standard option. There is a co-pay for hospital stays, but is minimal. Under the standard option, it is $250 per day for up to $750 maximum per admission.

https://healthplans.kaiserpermanente.org/federalemployees/wp-content/uploads/sites/2/2015/09/2017-KP-MidAtlanticStates-Plan-Brochure-73-047.pdf

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: 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.

I actually heard differently. Based on a conversation with SG, keeping Aetna WILL still help get the negotiated rate next year even though the fed plan doesn't cover IVF anymore. The way I understand it - and someone should please check this and report back - even though the Aetna HMO FEHB plan will no longer cover IVF, other Aetna plans still will, and Shady Grove's contract is with Aetna generally, not specifically the FEHB plan. SG has no plans to change their contract with Aetna and as long as they keep that contract in place, if you have Aetna you'll get the negotiated rates. One catch might be they weren't able to tell me when that contract might expire or when it could be renegotiated. So there is a chance that could change the status quo - but the way I understand it, it could still be very worthwhile to keep Aetna's HMO plan if you are paying OOP for fertility treatments. I was planning to switch to BCBS but now it seems worthwhile to keep Aetna.

I just talked to my SG financial person about this and she quoted me $10,700 for ER/PGS/cryo/FET (price does not include meds or the PGS lab's fee). All in all, could be worse? The self-pay amount for the equivalent package is $15,500.

Anonymous wrote:

Anonymous wrote: 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.

I actually heard differently. Based on a conversation with SG, keeping Aetna WILL still help get the negotiated rate next year even though the fed plan doesn't cover IVF anymore. The way I understand it - and someone should please check this and report back - even though the Aetna HMO FEHB plan will no longer cover IVF, other Aetna plans still will, and Shady Grove's contract is with Aetna generally, not specifically the FEHB plan. SG has no plans to change their contract with Aetna and as long as they keep that contract in place, if you have Aetna you'll get the negotiated rates. One catch might be they weren't able to tell me when that contract might expire or when it could be renegotiated. So there is a chance that could change the status quo - but the way I understand it, it could still be very worthwhile to keep Aetna's HMO plan if you are paying OOP for fertility treatments. I was planning to switch to BCBS but now it seems worthwhile to keep Aetna.

Anonymous wrote:

Anonymous wrote:I switched to Kaiser last year for the IVF coverage and was lucky to get 2 retrievals done. Not lucky that now the FETs won't be covered next year. However, Kaiser is very low cost compared to the other plans (at least last year) and I really loved the doctors I switched to. I think it's much better insurance than BCBS, which I used to have. So I'm going to stick with it and enjoy the lower premiums, I guess.

Just trying to look on the bright side here, for what little of one there is.

BCBS family for basic is $376 next year. Kaiser basic for family is $283 but has a deductible for x-rays, in patient at hospitals, and labs. KaIser high option is $406 monthly with no deductible. BCBS has no deductile. I'm debating switching from BCBS but I don't think Kaisers is cheaper.

Anonymous wrote:

Anonymous wrote:I switched to Kaiser last year for the IVF coverage and was lucky to get 2 retrievals done. Not lucky that now the FETs won't be covered next year. However, Kaiser is very low cost compared to the other plans (at least last year) and I really loved the doctors I switched to. I think it's much better insurance than BCBS, which I used to have. So I'm going to stick with it and enjoy the lower premiums, I guess.

Just trying to look on the bright side here, for what little of one there is.

I had the same experience. I had BCBS, switched to Kaiser (though got luckily pregnant through IVF) and I'll be staying with Kaiser next year (though switching to the Basic plan from the High plan). I really liked my doctors and the whole process. It was virtually painless.

I'm now working with my HRMO office and OPM to see what we can do for 2018 plans. My hope is to try to bring some IVF benefits back for 2018 (when I may need to tap into my frozen embies).

Anonymous wrote:I switched to Kaiser last year for the IVF coverage and was lucky to get 2 retrievals done. Not lucky that now the FETs won't be covered next year. However, Kaiser is very low cost compared to the other plans (at least last year) and I really loved the doctors I switched to. I think it's much better insurance than BCBS, which I used to have. So I'm going to stick with it and enjoy the lower premiums, I guess.

Just trying to look on the bright side here, for what little of one there is.

Anonymous wrote:I switched to Kaiser last year for the IVF coverage and was lucky to get 2 retrievals done. Not lucky that now the FETs won't be covered next year. However, Kaiser is very low cost compared to the other plans (at least last year) and I really loved the doctors I switched to. I think it's much better insurance than BCBS, which I used to have. So I'm going to stick with it and enjoy the lower premiums, I guess.

Just trying to look on the bright side here, for what little of one there is.

Anonymous wrote: 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.

Anonymous wrote:I have carefirst blue choice and they covered IUI and fertility drugs and monitoring. And it looks the same plan will be available for 2017. The copay though went up. IVF was never and won't be covered. The one thing I hated about this plan is same meds I got for IUI and are covered are not covered for IVF. So anything that has to do with IVF is not covered. Looks like I'm keeping this insurance. Anyone knows about supplemental insurances through Obama Care that cover the cost of infertility?