Does your insurance cover IF?

[belle55]

I just found out mine does not and I'm a little (okay, a lot) upset about it. Granted, I am not at the point where I am needing to use it but it's now an added stress about when or if we ever need to and more pressure to make this happen naturally. I'm looking at trying acupuncture at $220 for 4 visits. Anyone else in this boat? My company's insurance coverage is terrible and really operates more like a catastrophic plan. So frustrating and stupid.

[HoneySpider]

Mine covers testing but nothing on actual treatment. Unfortunately it's pretty common for insurance to not cover IF.

I'm not sure how long you've been trying but I would not stress out right now about something you may or may not need. When the time comes, you'll deal with it if that's what you want/need to do.

(But yes, it sucks)

[ginkgoleaf]

Jul 14, 2014 13:31:54 GMT -5 HoneySpider said:

Mine covers testing but nothing on actual treatment. Unfortunately it's pretty common for insurance to not cover IF.

This for me, too.

[King26]

Most states won't cover it. I'm in a state that mandates it so I have most things covered (testing, surgery, 3 IUI's, 3 IVF's) I do have to pay for some medications and I have to pay to freeze any embryos. I'm thankful for the coverage I have, but the bills still add up, even with insurance.

[lizz]

Mine covers 50% of testing and treatment up through IUI. All drugs and IVF are not covered. Both me and DH have several plans and companies to choose from and this seems to be as good as any of them get. I've started doing testing but haven't gotten any bills yet so I'm curious to see how the costs break down.

Anybody that doesn't mind sharing, what states require IF coverage?

[belle55]

Jul 14, 2014 14:40:48 GMT -5 lizz said:

Anybody that doesn't mind sharing, what states require IF coverage?

Interested in knowing this, too.

[jessnpaul]

Jul 14, 2014 14:47:12 GMT -5 belle55 said:

Jul 14, 2014 14:40:48 GMT -5 lizz said:

Anybody that doesn't mind sharing, what states require IF coverage?

Interested in knowing this, too.

I'm also in a state that requires IF coverage (NJ).

Mine covers up to 3 rounds of whatever... IUI/IVF... I don't think you can do 3 of each... just 3 total, from my understanding. But I'll take it!

[jt325]

www.resolve.org/family-building-options/insurance_coverage/state-coverage.html

A quick Google gave me these results.

[grover]

When I last looked at our policy, I believe it covered either 3 or 6 IUIs. However, when I mentioned it to H, he wasn't ready to pursue treatment yet (currently on cycle 15) so I didn't look too closely at it.

[preppy]

I am fortunate to live in a state where coverage is mandated.

I am happy to see you are trying acupuncture. I am trying it out as I live very close to one of the biggest acupuncture schools and can get treatments at a low rate. I start next week!

[feistypants]

DH's company pays for up to $15k in treatments and $7500 in meds. We are the exception rather than the rule, and we are very lucky.

[belle55]

Jul 14, 2014 16:36:20 GMT -5 preppy said:

I am fortunate to live in a state where coverage is mandated.

I am happy to see you are trying acupuncture. I am trying it out as I live very close to one of the biggest acupuncture schools and can get treatments at a low rate. I start next week!

I am looking forward to trying something else. AF is due Friday so of course there's a chance I won't need it. One of my best friends swears by it and is certain she got pregnant recently because of it. You are lucky to get it for a low price!

[belle55]

Jul 14, 2014 16:39:12 GMT -5 feistypants said:

DH's company pays for up to $15k in treatments and $7500 in meds. We are the exception rather than the rule, and we are very lucky.

I am going to look into my husband's policy to see if it's any better. Not holding my breath, though. It's disappointing that any coverage at all is so rare.

[krystee]

I live in Illinois, with mandated IF coverage. My plan covers unlimited IUIs and four egg retrievals for IVF. I am very lucky.

[belle55]

Jul 14, 2014 15:23:57 GMT -5 jt325 said:

www.resolve.org/family-building-options/insurance_coverage/state-coverage.html

A quick Google gave me these results.

Wow, only 15 states.

[belle55]

Jul 14, 2014 13:31:54 GMT -5 HoneySpider said:

Mine covers testing but nothing on actual treatment. Unfortunately it's pretty common for insurance to not cover IF.

I'm not sure how long you've been trying but I would not stress out right now about something you may or may not need. When the time comes, you'll deal with it if that's what you want/need to do.

(But yes, it sucks)

You are right, I know that I'm unnecessarily stressing. The cost of the hospital stay for birth is already so expensive on my health insurance. I hate thinking of using all the money we've been saving for that just to get the baby in my ute in the first place

[starburst604]

I'm in MA, so yes it's covered here. I don't know the details of under what circumstances they will cover of what the limitations of my plan are yet. I have an appointment with an RE next week and suppose I'll know more after that.

[Deleted]

Some of the states where it is mandated doesn't mean it's actually covered. For instance, in TX, the insurance companies have to offer plans with coverage BUT employers don't have to, in turn, offer those plans to their employees.

I live in NJ which mandates coverage but even then there are exceptions, like only IUI has to be covered, and for employers with 50+ employees.

My H works for one of the big banks and we have unlimited IVF after 6 IUI (3 Clomid, 3 injectibles) and unlimited storage of embryos.

[belovedbride07]

Jul 14, 2014 16:51:58 GMT -5 belle55 said:

Jul 14, 2014 15:23:57 GMT -5 jt325 said:

www.resolve.org/family-building-options/insurance_coverage/state-coverage.html

A quick Google gave me these results.

Wow, only 15 states.

And for some of those (such as California), the requirement is that the insurance company offer it to the employer, and then it's up to the employer whether they want to include it in their plans. I am grateful that my employer does include IF coverage (50% after deductible, with a lifetime max of $11k); DH's does not.

[miamigirl]

I'm hoping we don't need it, but you guys made me curious so I checked my insurance plan (UHC) and apparently it does cover some fertility treatments (up to 3 IVF rounds if necessary), so that's a relief. Again, hoping we won't need it.

It's so sad that the US health system is so bad though...

[ginkgoleaf]

Jul 14, 2014 18:23:50 GMT -5 @mrsspunky said:

Some of the states where it is mandated doesn't mean it's actually covered.

Yep, I'm in illinois which is one of the mandated ones, but since DH's employer is based in a state that's not mandated, their insurance doesn't cover anything besides testing.

[kellikans]

our current insurance (through my work) covers pretty much nothing. we are switching to DH's insurance in September. his company luckily is based out of Massachusetts and they cover infertility treatments 100% with no limit on treatment cycles or dollar cap. hoping we don't need to use it, but very thankful that it's covered if we do.

[christy082]

I had no idea if I had coverage, so I just went and looked. This is what I have:

Basic Infertility Expenses: Coverage is for the diagnosis and treatment of the underlying medical condition causing the infertility only. 80% after deductible.

Comprehensive Infertility Expenses: Artificial Insemination (Maximum Benefit 6 courses of treatment per lifetime) and Ovulation Induction (Maximum Benefit 6 courses of treatment per lifetime). 80% after deductible.

[EllieT]

I live in socialist Sweden with universal healthcare. All testing is part of the normal healthcare so you pay the same as for any other type of doctor - 200 sek ($30 ) per visit but no more than 1100 sek ($160) per year. That includes all blood tests, HSG or whatever needed.

I'm currently on Clomid, it cost me about $10 for a month. I pay full price for all medicine but it's capped at 2200 sek ($320) per year, once I reach that oop any medicine is free for the rest of that 12 month period.

So the medication part of IUI and/or IVF will never cost me more than $320 per year. I'm not sure if I will have to pay extra for any monitoring if we do injectables or if those are included in the normal fee.

IVF is covered as well, you get 3 fresh cycles plus 2 FET's per fresh cycle (if you end up with any frozen ones) so a maximum of 9 transfers at the public university hospital. However there is a waiting list, 3 month minimum but possibly up to 6 months so many people go private and pay. Or you go private if your public attempts failed. Or if you want a sibling since that's not covered.

I know the clinic I go to charge 29000 sek ($4250) if you do IVF through them. So if we end up needing IVF I guess we will have to switch clinics as I don't feel like paying if I don't have too.

[daisy]

I'm not sure what if anything my insurance covers. I guess I should look into that before our next open enrollment.

[pooh8402]

Mine covers testing but once I get the diagnosis, no treatment. We've been OOP on all 5 of our IUIs and will be OOP for our IVF this fall.

TX is a "mandated state" but in our state, the insurance companies are only required to offer IVF coverage, the employers don't have to purchase it.