Anonymous
Post 09/01/2010 22:32     Subject: Federal Health Plans & IVF coverage
Great information, I am doing IVF and we have BCBS. Dr. said that she bills the monitoring/blood work under infertility. Thus, it should be covered.

Anybody know whether TESE is covered under this same plan?
Anonymous
Post 09/01/2010 21:14     Subject: Federal Health Plans & IVF coverage
Great feedback about the plans! Thank you all so much! Re: comment above. I was thinking exactly that about the meds-order from BC/BS before switching to an HMO! Glad that worked out!
Anonymous
Post 09/01/2010 13:08     Subject: Re:Federal Health Plans & IVF coverage
Last year we had BCBS and they covered all of the monitoring for our FETs. This year we switched to Aetna HMO, more of our doctors participate with Aetna than MDIPA, but we ordered all of our meds through BCBS before the end of 2009. Just something to think about if you are planning on switching from BCBS.
Anonymous
Post 09/01/2010 07:44     Subject: Re:Federal Health Plans & IVF coverage
Anonymous wrote:I did one round of IVF with BCBS Federal and it cost us 8900 at CFA. The drugs were covered but the monitoring b/w and u/s were not. (2009) If the interpretation is different now and the monitoring is covered, then hopefully the price for an IVF round will also be lower.

I've done 2 rounds of IVF under MDIPA and it cost 3900 per round. The drug copay was about the same as BCBS. For us MDIPA was much cheaper. I don't like MDIPA overall but it was worth it for the IVF coverage. HMOs are a PITA. I cannot wait to go back to BCBS this open season.


This was my experience, as well.

One thing I will say is that bloodwork and monitoring are small expenses compared to the retrieval, culture of embryos, transfer (esp. the retrieval when you are being sedated). MDIPA (once we had our diagnosis) was significantly cheaper.
Anonymous
Post 08/31/2010 20:04     Subject: Re:Federal Health Plans & IVF coverage
I did one round of IVF with BCBS Federal and it cost us 8900 at CFA. The drugs were covered but the monitoring b/w and u/s were not. (2009) If the interpretation is different now and the monitoring is covered, then hopefully the price for an IVF round will also be lower.

I've done 2 rounds of IVF under MDIPA and it cost 3900 per round. The drug copay was about the same as BCBS. For us MDIPA was much cheaper. I don't like MDIPA overall but it was worth it for the IVF coverage. HMOs are a PITA. I cannot wait to go back to BCBS this open season.
Anonymous
Post 08/31/2010 19:40     Subject: Re:Federal Health Plans & IVF coverage
Anonymous wrote:PP here, we got coverage with Federal BC/BS (minus copays and deductables). 'Services and supplies related to ART procedures' refers to sperm banking, ICSI, freezing embryos.... None of that is included.
BUT: Monitoring = ultrasounds, exams, labs and drugs,... during ART treatment are covered!

It says just before that line on page 38 that: 'treatment of infertility' is covered, except: (and then it lists the procedures only)

The procedures are expensive enough. We were pleasantly surprised (if that's possible) with what was left to pay by us for all the other items.

I find it upsetting that one of the financial persons at SG told one of the PPs otherwise - but I don't know if they can get a refund after the fact, they should!

Ah, I just read the policy in the booklet and see where you are going with this, paying for ultrasounds, exams, etc. Interesting. With the cost of the drugs and the uncertainty of an HMO, this may be the way to go.
Anonymous
Post 08/31/2010 19:28     Subject: Federal Health Plans & IVF coverage
It seems like such a toss up between BCBS and MDIPA. BCBS has awesome drug coverage, but no procedure coverage, while MDIPA is just the opposite. I've never had an HMO either, so that is scary too. I talked to the SG finanical counseler today and she was pushing toward the BCBS vs. MDIPA. Maybe open season will bring some good surprises. You would think with so many Fed plans to choose from, ONE would really stand out in this area.


Same boat. Chance we will have to go to IVF. Going into 3rd IUI and not optomistic.
Anonymous
Post 08/31/2010 13:38     Subject: Federal Health Plans & IVF coverage
BCBS standard option under the federal plan does cover meds and monitoring...not IVF or IUI procedures however. We are switching to MDIPA in open enrollment b/c there is a chance we may have to go with IVF...MDIPA will cover 50% of IVF proecedues.
Anonymous
Post 08/30/2010 23:35     Subject: Re:Federal Health Plans & IVF coverage
PP here, we got coverage with Federal BC/BS (minus copays and deductables). 'Services and supplies related to ART procedures' refers to sperm banking, ICSI, freezing embryos.... None of that is included.
BUT: Monitoring = ultrasounds, exams, labs and drugs,... during ART treatment are covered!

It says just before that line on page 38 that: 'treatment of infertility' is covered, except: (and then it lists the procedures only)

The procedures are expensive enough. We were pleasantly surprised (if that's possible) with what was left to pay by us for all the other items.

I find it upsetting that one of the financial persons at SG told one of the PPs otherwise - but I don't know if they can get a refund after the fact, they should!
Anonymous
Post 08/30/2010 15:33     Subject: Re:Federal Health Plans & IVF coverage
http://www.fepblue.org/benefitplans/2010-sbp/bcbs-2010-RI71-005.pdf -- Pages 38-39 tell you what's covered and what's not.

I still don't get how people are getting their monitoring covered since it says "services and supplies" not covered. But good for them if it works out! The 2011 benefit plan should be out soon.
Anonymous
Post 08/30/2010 15:03     Subject: Re:Federal Health Plans & IVF coverage
So, with Federal BC/BS PPO, BC/BS covered the monitoring? I have BC/BS now and know the drug coverage is great and the diagonostic testing, but I didn't realize it coveraged ANYTHING else with the procedure/monitoring.

I'm trying to decide between BC/BS PPO and MDIPA as I go into 2011 open season for IVF. I can't imagine the plans will change than much this year.

Thoughts???
Anonymous
Post 08/28/2010 22:28     Subject: Federal Health Plans & IVF coverage
Anonymous wrote:What kind of federal government BC/BS do you have? I'm almost done with my first IVF and I find it amazing that I can't tell definitively if any parts of the monitoring during the cycles (BW and ultrasounds) are covered. We paid the full 9,500 for IVF which includes all monitoring but I really wonder if this is necessary and since this a major expense it's frustratign to me. I don't really trust the guy at SG's financial office in DC who told me that monitoring is considered treatment... he doesn't really seem so great at his job in general.

PP here, it's Federal BC/BS PPO. Oh, no, really the Shady Grove guy is wrong! In our case (DF) we were offered a package price just for the ART procedures versus a 'complete package' price for the ART plus monitoring/lab/US+drugs, but that would have been much more expensive, and we didn't need it, because all monitoring and drugs during ART was covered! So we could take the 'procedures only package'.
Anonymous
Post 08/28/2010 22:08     Subject: Federal Health Plans & IVF coverage
Very interesting. I too have federal standard BCBS...our monitoring and medication are covered...just not the IUI our IVF procedure.
Anonymous
Post 08/28/2010 19:03     Subject: Federal Health Plans & IVF coverage
i have federal bc/bs (standard option) and i had iuis in feb. and april. all of my diagnostic tests were covered, but not the IUIs, not the medication, and not the monitoring. My husband and I put approx. $7500 in our health savings account and we were maxed out by March.
Anonymous
Post 08/28/2010 17:04     Subject: Re:Federal Health Plans & IVF coverage
I'm pretty sure BC/BS changed their interpretation last year and started covering regular monitoring during an IVF cycle. I know my REs previously both said if I did IUI or IVF, I would have to pay for monitoring, but last Spring (April 09) they said that had changed, and I did several IUIs where monitoring was paid for by BC/BS and I only paid for the IUI procedure itself. I was told it would be the same for IVF. I would push on that.