Hi everyone, I'm hoping you can help me. I am officially FED UP with my insurance covering NOTHING related to infertility. My company is always listed as a top company in working mother's magazine and we always talk about how we are so big on women's issues, but we offer nothing for infertility coverage. It seems kind of hypocritical to me. I'm writing a letter to our director of human resources and I'd like to have some examples of other large companies that do offer coverage. If any of you lucky women out there get any infertility coverage, would you please respond and let me know who your company is? I'm looking mainly for large companies. Thanks so much for your help and wish me luck!

Michelle

I work for Goodrich Corporation. After 1 year of appeals, I finally got them to pay for diagnosis, u/s, and blood work. They will not pay for infertiltiy drugs, IUI or IVF.

My insurance benefit covers all infertility include IUI and Injectable IUI, but it does not cover IVF. My insurance is under my DH's company. (Kaiser)

I am covered under my DH's insurance (Health Assurance) and they have been pretty good so far, they pay a lifetime max of 2500.00 for infertility testing which includes things like sperm analysis, etc. All my ultrasounds and bloodwork were covered because my RE put everything as diagnostic so the insurance company would pay which was great. The only thing we've paid for is the meds and the IUI so luckily out of about 20,000 we've only spent about 2,000 Best of Luck

Amanda
12w4d with twins

I don't know any that do cover, I can tell you BLUE CROSS does not cover shat!! 2,500.00 lifetime max! JESUS I spent that on my second round of injections! http://www.healthboards.com/ubb/mad.gif

I am covered through DH's Blue Shield of California and I'm almost embarassed to tell you about my coverage.

Our company covers everything at 100% for the price of a $15 copay. This includes x-rays, blood tests, sperm wash, meds (pills and injectibles) as well as unlimited cycles of IUI and IVF.

I have no clue as to why our coverage is so good - our doctor's nurse has even commented on it (she calls us The Ones With The Good Insurance) - but I certainly thank God we have it, no question.

ESP. since I found out today that we're going through the whole ball of wax on this cycle - Clomid Challenge, another IUI with Clomid, plus the SuckAssTogram - you all know the one of which I speak (OUCH!)

My insurance has covered my consults , HSG , all u/s and 3 IuI's so far . They have not covered any meds up till now + I have spent almost 8 grand on meds to date . Supposedly my coverage just changed and now they will cover meds but its not retroactive coverage . I am probably going to do 1 more cycle If they actually will cover it

[This message has been edited by old flo 1 (edited 06-11-2003).]

Michelle,
I work for Blue Cross Blue Shield of Texas, and my coverage pays 100%, no deductible, $10 co-pay. Our corporate office is in Richardson, if you decide to switch jobs to get better coverage.

You need to check with your state and see if they are required to cover Infertility treatments. I know the state of MA does, however we have insurance through the military so they are not required to cover it http://www.healthboards.com/ubb/frown.gif As soon as I can find the link as to which states are required to cover it I will post it!

Insurance for infertility depends on what your employer is willing to pay for. I've had Aetna with 3 different employers and Company 1 had diagnostic coverage only, no treatment/no meds; Company 2 covered diagnostic, unlimited IUIs, 1 egg donation, 1 IVF and 1 frozen embryo transfer, NO injectibles; Company 3 covers diagnostic, 6 lifetime IUI, NO IVF, but does cover injectibles.

Most national insurance companies have the coverage available in one of their plans, but it is up to the employer if they want to pay for that additional coverage for their employees.

My DH works for MetLife. They have great coverage! Up to 4 IUIs per month, 3 IVFs lifetime (max of $25,000) and $8 copay for a 3-month supply of all drugs. Copay for dr. visits is $15.

I have bc/bs of MT and they cover everything except IVF. I have to pay $20 co-pay for office visits but not any u/s. The thing that does suck is that all my lab work is applied to a $750 deductible and when I had surgery last year they covered 60% of the outpatient hospital bill. I am on a preferred provider plan so it's good but it's not - know what I mean?

TAZ

I found this chart (hope it works) that shows which state are required to cover what:

Legislative History



State Date Mandate to Cover Mandate to
Offer
IVF
Coverage
Excludes
IVF
IVF
Coverage only

Arkansas 1987 X X
California 1989 X X
Connecticut 1989 X X
Hawaii 1987 X X
Illinois 1991 X X
Louisiana 2001 X
Maryland 1985 X X
Massachusetts 1987 X X
Montana 1987 X
New Jersey 2001 X X
New York 2002 X
Ohio 1991 X
Rhode Island 1989 X X
Texas 1987 X X
West Virginia 2001 X



(Underlined = Mandates to Offer)


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Mandates to Offer States:

Mandate to offer is a law requiring that health insurance companies make available for purchase a policy

Texas: Mandates insurance carriers to offer coverage of IVF.

THis may be more helpful and easier to read:

Mandates to Offer States:

Mandate to offer is a law requiring that health insurance companies make available for purchase a policy, which offers coverage of infertility treatment (but the law does not require employers to pay for the infertility treatment coverage).

California: Mandates insurance carriers to offer only group policyholders coverage of infertility treatment, excluding IVF, but including GIFT.

Connecticut: Mandates insurance carriers to offer coverage of comprehensive infertility diagnosis and treatment, including assisted reproductive technology procedures, only to group policyholders.

Texas: Mandates insurance carriers to offer coverage of IVF.


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Mandates to Cover States:

Mandate to Cover is a law requiring that health insurance companies provide coverage of infertility treatment as a benefit included in every policy (policy premium included cost of infertility treatment coverage).

Hawaii: Mandates insurance carriers to cover only one cycle of IVF, and only after several conditions

Illinois: Mandates insurance carriers to cover comprehensive diagnosis and treatment of infertility, including assisted reproductive technology procedures, but limits first time attempts to 4 complete oocyte retrievals, and to 2 complete oocyte retrievals for a second birth. Insurance carriers are not required to provide this benefit to businesses (group policies) of 25 or fewer employees.

Louisiana: Mandates insurance carriers to cover the "diagnosis and treatment of correctable medical conditions." Thus, insurers may not deny coverage for treatment of a correctable medical condition to someone solely because the condition results in infertility.

Maryland: Mandates insurance carriers to cover IVF only, and only after several conditions have been met.

Massachusetts: Mandates insurance carriers to cover comprehensive infertility diagnosis and treatment, including assisted reproductive technology procedures.

Montana: Mandates only HMO's to cover infertility treatment only as a "preventative service" benefit (thus excluding IVF).

New Jersey: Mandates insurance carriers of cover comprehensive diagnosis and treatment of infertility, including assisted reproductive technology procedures, but limits first time attempts to 4 complete oocyte retrievals. Insurance carriers are not required to provide this benefit to businesses (group policies) of 50 or fewer employees.

New York: Mandates insurance carriers to cover the "diagnosis and treatment of correctable medical conditions". Thus, insurers may not deny coverage for treatment of a correctable medical condition to someone solely because the condition results in infertility. In addition, the state of NY will appropriate $10 million to a pilot project to help pay for in vitro procedures for a small number of people who receive care from those facilities that will be the beneficiary of grants awarded via the pilot program.

Ohio: Mandates only HMO's to cover infertility treatment only as a "preventative service" benefit (thus excluding IVF).

Rhode Island: Mandates insurance carriers to cover comprehensive infertility diagnosis and treatment, including assisted reproductive technology procedures, and permits insurers to impose up to a 20 % co-payment requirement for said benefit.

West Virginia: Mandates only HMO's to cover infertility treatment only as a "preventative service" benefit (thus excluding IVF).

Just to clarify, because we deal all the time with the confusion from this.
The "mandate to offer" only means that the Ins. Company must offer this coverage to every group. If your company elects not to pay the extra premiums for this coverage, then you're pretty much SOL.
People often confuse this, thinking that the individuals must have this coverage offered to them.

thanks everyone for the insurance input. I do live in Texas which is a mandate to offer state. Seems kind of pointless because my employer just turns down the coverage. Anyways, I appreciate all the help. Hopefully I can make a good appeal to HR.

Michelle