Insurance and Fertility Treatments
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Insurance and Fertility Treatments
May 2008
Hi all, my husband and I have been trying to conceive our
first for several years now. We've even done a round of IVF.
And now
we are going to have to do a second one, but nether of us has
coverage for it and raided our retirements to pay for the
last
cycle. Since I'm not really in love with my job I'm tossing
around the idea of getting a new job at a place that has
coverage for IVF, even if it is part time. Does anyone know
of
a resource to find out what employers offer coverage for IVF?
Or does anyone work for a company that offers coverage?
Thanks!
Not Fertile Myrtle
There are two sources that I know of...
1. http://www.ivfconnections.net - go to All Boards (I think
you'll have to become a member but it's free and the best
resource out there about IVF). Then select the board called
Financing IVF. I saw one woman posted a list Nov 07 of
companies that have at least some coverage.
2. http://www.inciid.org/article.php?c...rance101&id+243 - this
is another list with more detailed info on the coverage.
Good luck!
anon
Kaiser Permanente employees who opt for the mid or high level
plan get supplemental coverage which covers IVF. And I heard
that their Fremont fertility is one of the top 5 in the country
for IVF success (or fertility success - not sure which).
Considered IVF
Check out Conceive Magazine. I perused it while at the doctor's
office and they had an article about the best companies to work
for based on adoption and fertility coverage.
anon
Oct 2007
I am going to see a reproductive specialist in a week and a
half. A friend of mine who has been through IVF told me that
when her husband got a sperm analysis he was dropped by his
insurance carrier. She has since been deemed uninsurable after
taking Clomid. The reason she said was because insurance
companies realize that with fertility treatments the chances of
multiple births and early delivery rise. They were both using
individual plans.
I am starting to freak out because my husband and I have an
individual plan, and because of our careers will probably never
be on a group plan where this sort of thing doesn't happen.
Has anyone had experience going through fertility treatments
while enrolled in an individual health plan?
I should also mention that I am paying out of pocket for my
treatments because I know that my plan does not cover fertility
treatment.
Any advice that anyone has on this subject (soon) would be
greatly appreciated!
Freaking Out
I am no expert on insurance companies and really, really feel
for you. As someone who paid for private insurance through a
long fertility process, I want to let you know that my
insurance SAID that they did not cover ANY fertility
treatments. But, in actual fact, they covered most of the blood
work and of course all of the hospital; birth, amniotic
testing,..... thousands of dollars.
I had to pay my endicrinologist and the pharmacy myself, but a
whole lot more than I expected was covered.
Of course they jacked up the rates as I went along! Started
pregnancy at $300 a month by the end, they had me at $750!
After the medical OK, I switched policies and started second
pregnancy at $200something and ended it at $830ish..... of
course I had to drop it and now my children have coverage but I
don't. (What? Am I going to charge it? When could I pay it
back? Never so, and it's been several years now....a check up
is under $100, so, no accidents!)
In the final accounting, it was a lot less $ to have insurance
than pay as you go. Plus, if there were medical problems.....
Been through the mill, but have healthy kids!
you can be dropped from an individual policy for fertility or
anything else ranging from breast implants to cataract
surgery. you cannot be dropped from a group policy for the
same things. best advice is to get group insurance through
work. if that isn't possible, you can occasionally get a rider
w/ your policy. good luck!
self-employed MD
Insurance companies cannot drop you once you have a policy in
place unless you have lied or omitted information about health
issues, including past or ongoing fertility treatments. If they
could drop you for having fertility treatments, they could drop
you for any catastrophic issue, like organ transplants or
cancer. Because they can't drop you, they make you go through
a rigorous underwriting process, and they can pull your medical
records. Carriers can also decline to offer you coverage. For
instance, they will not offer you coverage if you are pregnant,
or if you are a man who is expecting a baby with anyone, even
if the partner and baby are not coming onto the plan with you.
The insurance companies can raise your rates based on claims
history. The rates can be anywhere from 25 to 100% higher than
standard if your health history or claims history with them
warrants it. Most individual insurance plans do not cover
fertility treatments.
I would recommend consulting an independent broker who
specializes in individual and family plans to help you.
Anon
Dec 2006
Hi and thanks for any information that you can offer us, we had have not the best
experience with Kaiser at Oakland, Our insurance doesn't cover infertility I can
not even pay for this separately, Kaiser business policy or wherever. My wife Oby
there, make us think that there is not hope, when there is not a test yet
confirming anything wrong. I'm dessapointed, frustrated, and getting old. I saw
the advices about fertility centers but I'm not sure to what health insurance we
should switch, anyway, if somebody can recommend us also fertility doctors would
be great, we decided to start all over. Thanks, best for you all
Jeff
Hi There!
My husband and I have 7 month-old twins and went to a wonderful fertility center called RSC out
in San Ramon (there is also one in Orinda). We worked with Dr. Galen who is the head guy there
and a real expert who's been in the field since the begining. We live in Kensington, but
strange enough the only woman I've met so far with twins near my age-- she's also in the
neighborhood-- also went to the same center and doctor! She had a very good experience there
as well. She used to attend a twins group out in Walnut Creek and most of the women in the
group were also Dr. Galen's patients.
We had Kaiser, but they discontinued fertility coverage just a few months after we began the
whole process. We ended up paying for IVF out of pocket. The cost is around 12,000 depending
on the amount of drugs you'll need. But, hey, most people spend twice that on a car . . .
You can go to RSCbayarea.com
Good luck!!
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