Anonymous
Post 07/12/2018 10:12     Subject: Federal Health Plans & IVF coverage
yes they are as of this month.
Anonymous
Post 07/11/2018 20:41     Subject: Federal Health Plans & IVF coverage
Is Shady Grove still honoring Aetna contract prices, if you’re a federal employee? We’re currently on BCBS, but we could change to Aetna during open season. Seems like a long-shot.
Anonymous
Post 03/25/2018 06:57     Subject: Federal Health Plans & IVF coverage
Has anyone heard of Natera being in network for PDG testing if you have FEderal employees health benefits Emblem GHI
Anonymous
Post 02/08/2018 21:24     Subject: Re:Federal Health Plans & IVF coverage
Anonymous wrote:
Anonymous wrote:I am new to this forum. My husband is beginning federal employment this week in Virginia. We have to select an FEHB this week and I am not sure which to pick. We will definitely need to do IVF with ICSI. I have already done all of the pre-cycle workup and testing in Florida (which our current insurance, Tricare, covered for the most part). All that is left is to initiate the actual IVF cycle.

With DH's new job we will not be allowed to keep Tricare (it doesn't cover IVF anyway), so we need to select an FEHB. I will also need to select a new facility in Virginia, Maryland, or DC area to do IVF and I see that Shady Grove seems to be very popular on this forum.

My questions:
1. Which FEHB will be most beneficial and curb the costs of IVF (please include info on plan names, monthly premiums, caps, out of pockets, etc.) ?
2. Which facilities are the best for pursuing IVF in the above mentioned areas?
3. Any additional helpful info would be much appreciated!

Thank you!


Unfortunately no coverage for IVF for Federal plans. DH chose the GEHA plan because it provided the best multi-state coverage at the lowest cost since we have older kids who live in different states. It covers testing and diagnosis of infertility, but no ART for Federal plans. I read a ton on this forum after the IVF coverage was taken away for Federal employees right before we moved here, even for those in IVF mandated states, and got the Carefirst BlueChoice HMO Silver 3500 plan based on other Federal employee's recommendations. I did not buy on the exchange since I don't qualify for a subsidy anyway and I heard the prices were inflated on the exchange for people who don't qualify (true cause I found my quote was cheaper direct from Carefirst).

We were completely OOP for our multi-cycle IVF costs before we moved to MD. I just had my first consult at Shady Grove Fertility and started preliminary testing. I'm not sure how it is all going to bill out, but I hope it bills out as specialist, which is not subject to deductible. Anyone else have any experience as to how IVF treatments bill out with the Carefirst BlueChoice HMO Silver 3500 plan??

I believe the specialist not being subject to deductible is new to the 2018 plan, but I'm not sure. All I know is the SGF financial person who explained my benefits had never heard of it not being subject to deductible. She told me we have to pay the $3500 deductible up front, which I wasn't too happy about because I chose the more expensive Silver plan because IVF was not supposed to be subject to deductible with that plan vs the Bronze plan.



Co-pay & Co-insurance are two different financial terms that get mixed up & used interchangeably. Co-insurance counts towards your deductible & is %amount that you (member) have to pay normally 15-20% of service cost while your health plan pays the remaining 80-85% towards service. Co-pay is a fixed negotiated amount that a member pays for certain office visits..... I found myself in the same boat when IVF was covered in the 2016 year but not 2017/2018 when my spouse accepted a federal position. fortunately my previous employer (CA) paid up to 3 IBF attempt with a max 100k lifetime. was only able to complete one cycle. In hindsight I should have completed another fresh IVF cycle with my employer prior to moving to the DMV area. So now we paying OOP @ SGF.
Anonymous
Post 01/29/2018 19:03     Subject: Re:Federal Health Plans & IVF coverage
Anonymous wrote:I am new to this forum. My husband is beginning federal employment this week in Virginia. We have to select an FEHB this week and I am not sure which to pick. We will definitely need to do IVF with ICSI. I have already done all of the pre-cycle workup and testing in Florida (which our current insurance, Tricare, covered for the most part). All that is left is to initiate the actual IVF cycle.

With DH's new job we will not be allowed to keep Tricare (it doesn't cover IVF anyway), so we need to select an FEHB. I will also need to select a new facility in Virginia, Maryland, or DC area to do IVF and I see that Shady Grove seems to be very popular on this forum.

My questions:
1. Which FEHB will be most beneficial and curb the costs of IVF (please include info on plan names, monthly premiums, caps, out of pockets, etc.) ?
2. Which facilities are the best for pursuing IVF in the above mentioned areas?
3. Any additional helpful info would be much appreciated!

Thank you!


Unfortunately no coverage for IVF for Federal plans. DH chose the GEHA plan because it provided the best multi-state coverage at the lowest cost since we have older kids who live in different states. It covers testing and diagnosis of infertility, but no ART for Federal plans. I read a ton on this forum after the IVF coverage was taken away for Federal employees right before we moved here, even for those in IVF mandated states, and got the Carefirst BlueChoice HMO Silver 3500 plan based on other Federal employee's recommendations. I did not buy on the exchange since I don't qualify for a subsidy anyway and I heard the prices were inflated on the exchange for people who don't qualify (true cause I found my quote was cheaper direct from Carefirst).

We were completely OOP for our multi-cycle IVF costs before we moved to MD. I just had my first consult at Shady Grove Fertility and started preliminary testing. I'm not sure how it is all going to bill out, but I hope it bills out as specialist, which is not subject to deductible. Anyone else have any experience as to how IVF treatments bill out with the Carefirst BlueChoice HMO Silver 3500 plan??

I believe the specialist not being subject to deductible is new to the 2018 plan, but I'm not sure. All I know is the SGF financial person who explained my benefits had never heard of it not being subject to deductible. She told me we have to pay the $3500 deductible up front, which I wasn't too happy about because I chose the more expensive Silver plan because IVF was not supposed to be subject to deductible with that plan vs the Bronze plan.
Anonymous
Post 01/07/2018 23:20     Subject: Re:Federal Health Plans & IVF coverage
Anonymous wrote:I am new to this forum. My husband is beginning federal employment this week in Virginia. We have to select an FEHB this week and I am not sure which to pick. We will definitely need to do IVF with ICSI. I have already done all of the pre-cycle workup and testing in Florida (which our current insurance, Tricare, covered for the most part). All that is left is to initiate the actual IVF cycle.

With DH's new job we will not be allowed to keep Tricare (it doesn't cover IVF anyway), so we need to select an FEHB. I will also need to select a new facility in Virginia, Maryland, or DC area to do IVF and I see that Shady Grove seems to be very popular on this forum.

My questions:
1. Which FEHB will be most beneficial and curb the costs of IVF (please include info on plan names, monthly premiums, caps, out of pockets, etc.) ?
2. Which facilities are the best for pursuing IVF in the above mentioned areas?
3. Any additional helpful info would be much appreciated!

Thank you!


No FEHB cover IVF; however, Shady Grove does appear to be honoring contract prices negotiated with Aetna so from a cost perspective, it may make the most sense to go with Shady Grove and Aetna.

As to other places to look into in the area, the most commonly used are Columbia Fertility Associates, Dominion Fertility, and GW.
Anonymous
Post 01/07/2018 14:46     Subject: Federal Health Plans & IVF coverage
Anonymous wrote:
Anonymous wrote:Aetna Basic gets you the discount too (at least it has in the past). And yes, there's a discount for IVF, FET, etc...


So how much does IVF cost with the discount?


It’s about half the price with an Aetna FEHB plan at Shady Grove. FETs even less than half the price: $1850 vs $4600 (or thereabouts)

Medicine of course not covered so that’s the same.
Anonymous
Post 01/07/2018 14:09     Subject: Re:Federal Health Plans & IVF coverage
I am new to this forum. My husband is beginning federal employment this week in Virginia. We have to select an FEHB this week and I am not sure which to pick. We will definitely need to do IVF with ICSI. I have already done all of the pre-cycle workup and testing in Florida (which our current insurance, Tricare, covered for the most part). All that is left is to initiate the actual IVF cycle.

With DH's new job we will not be allowed to keep Tricare (it doesn't cover IVF anyway), so we need to select an FEHB. I will also need to select a new facility in Virginia, Maryland, or DC area to do IVF and I see that Shady Grove seems to be very popular on this forum.

My questions:
1. Which FEHB will be most beneficial and curb the costs of IVF (please include info on plan names, monthly premiums, caps, out of pockets, etc.) ?
2. Which facilities are the best for pursuing IVF in the above mentioned areas?
3. Any additional helpful info would be much appreciated!

Thank you!
Anonymous
Post 11/30/2017 11:17     Subject: Federal Health Plans & IVF coverage
Anonymous wrote:Aetna Basic gets you the discount too (at least it has in the past). And yes, there's a discount for IVF, FET, etc...


So how much does IVF cost with the discount?
Anonymous
Post 11/27/2017 17:22     Subject: Federal Health Plans & IVF coverage
Anonymous wrote:Aetna Basic gets you the discount too (at least it has in the past). And yes, there's a discount for IVF, FET, etc...


Thank you very much!
Anonymous
Post 11/27/2017 16:57     Subject: Federal Health Plans & IVF coverage
Aetna Basic gets you the discount too (at least it has in the past). And yes, there's a discount for IVF, FET, etc...
Anonymous
Post 11/27/2017 16:31     Subject: Re:Federal Health Plans & IVF coverage
Anonymous wrote:I spoke w SGF today and they are still upholding the negotiated rate for Aetna patients. FET would be $1850. I asked if there’s any indication if this would change for 2018 and was told that they have not heard anything. SGF said that they are typically informed a few months prior to any changes in benefits.




Does this include IVF? Do you know if it is covered in the Aetna HMO High Option only? Or also the Basic Option?
Thanks!!
Anonymous
Post 11/22/2017 17:15     Subject: Re:Federal Health Plans & IVF coverage
Anonymous wrote:
Anonymous wrote:WHAT is SGF? I am not sure, but looking for IVF coverage under federal plans. Also, some states require that IVF treatment be included like TEXAS and Illinois, but I did not see it in the local plans.

Please help, if anyone has information.


SGF: Shady Grove Fertility


From my understanding, even if it is mandated in the state you live in, it won’t be included in the federal plans. Federal is not subjected to State law. I am a fed employee and live in MD. MD is one of the states that mandates IVF coverage. I am going to opt out of the plans offered by my job (fed gov) and buy a plan on the open market. It will be more expensive per month but I will have IVF coverage.
Anonymous
Post 11/09/2017 16:24     Subject: Re:Federal Health Plans & IVF coverage
Anonymous wrote:WHAT is SGF? I am not sure, but looking for IVF coverage under federal plans. Also, some states require that IVF treatment be included like TEXAS and Illinois, but I did not see it in the local plans.

Please help, if anyone has information.


SGF: Shady Grove Fertility