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I have Carefirst Blue Cross Blue Shield through a county school system and they pay for 3 cycles. I am one of the lucky ones! Although I am getting ready to start cycle number 3 and no luck yet.

Some states mandate coverage for infertility if it's an employer-sponsored plan, with certain qualifiers (e.g., self-insured groups are exempt from this rule). I'm sure you can find which states mandate coverage on the web.

Good luck, Laura

I really do feel your frustration. When we went through IVF the first time, my friend and her husband were going through it too. Her insurance paid 80% of all of her IVF costs! I am not sure what insurance company. My insurance company will pay for any diagnostic testing to see WHY that you are infertile but none of the treatments.

I wonder how we would go about getting this changed?

Hi. I am with Horizon Blue Cross Blue Shield and they paid for everything. But I think the rules change from one state to another. I'm in NJ, and I'm not 100% sure but I think that it's mandatory for insurance companies to pay for that kind of treatments here in Jersey.

I agree with all of you, it should be part of regular care.
I gues if we don't reproduce, they won't have to pay for extra human beings! If that's their logic!!!

Fiso

Congrats Fiso!! Great to see your upcoming due date!!

All: I believe RESOLVE does a lot of this campaigning for insurance coverage. Getting involved in RESOLVE may be one way of maximizing leverage of voices. They may have excellent on-line resource database about coverages.

NY State has a limited grant program based on your income etc. Only 14 clinics in NY participate. It is through the Dept of Health. You have to fill out a bunch of paperwork and wait and wait and no guarantee.

My coverage UHC is pathetic. $10K lifetime max. Some companies might have riders to extend coverage, mine does NOT. According to one knowledgable person that I saw on a fertility show, the way most insurance companies structure coverage is based on "positive outcomes". As I understood this person, the reason insurance covers certain procedures (whether IVF or something else) is the success rates. If you have a high percentage of negative outcomes of a procedure, coverage is limited or non-existant so as to discourage folks from seeking such procedures. So for example, Viagra is covered by most insurance because it has a high positive outcome rate (for the male) with little risk (albeit the warnings by your physicians, etc).

There is an excellent section about coverage, finances,etc in a book called the "(In)Fertility Handbook" by Elizabeth Swire-Faulkner. It is fairly recent and my library even had it. SHe really did her homework. I love her book for all the sections-tremedous, clear,logical resource.

Much babydust to all !
Diana

The insurance angle is frustrating. I live in Virginia where we are working on a petition for our state legislature to mandate coverage and there seems to be good Senate support so I hope they do respond responsibly.

I really get annoyed listening to the Right wing conservatives talk against gay marriage because marriage is "between a man and a woman" with the implied reason that society only needs and therefore should only support a couple that can have and raise children. If they really believe that goverment needs to be part of defining marriage as well as the Right's positions on "culture of life" and family planning you would think that they would care enough to help the thousand of women who are desperately trying to create life and are doing so despite the insurance/financial hurdles. This process as you all know is really stressful enough it does not need to be made more so by difficult insurance companies.

My BC/BS says it covers 70% and we are just starting this IVF with RE so I will see how they respond but I am assuming it will be the same as with the IUI, clomide, etc I did with my OB which is first to deny all coverage and force us to appeal, appeal ,appeal. Oh well on the possitive side this at least gives one thing for DH to take the lead on, shoulder all the stress and I think it makes him actually feel more involved.

I agree that insurance should have to cover infertiltiy. I live in PA were they are not mandated to pay for that type of treatment. I have Health America and they do not cover IVF or tubal reversals, only limited testing to see what the infertiltiy factor is. I dont understand how they cannot cover something so important!

Christine

Ladies,

I also agree that is egregious for insurance companies to cover drugs such as Viagra but not fertility treatments! >:(!

I just had my third IUI and I think I may have to move to IVF. I have United Healthcare and it has a lifetime coverage of 20,000 - something but still in relative terms not that much.

It worries me since I worry about using our savings to have a baby then being broke.

We need to really rally our senators and reps to mandate coverage for fertility treatments.

Kiki06:

I have UHC, but only 10K max, so you have a better version of the policy depending on what your company negotiated. I agree with all your statements.

In NY STATE, you can apply for a grant. It is on the website of the NY Dept of Health. Phone=518-474-5368 and ask for Jane Vet. She has a voicemail and is responsive. She can tell you the 14 clinics in NY State that participate in the "DEMONSTRATION" program as they can this grant thing. No idea why it is called "demonstration"....that seems absurd to me....Apparently ALbany votes on some bill at some yearly cycle and disperses monies in some fashion.....I am being vague here, because I have not yet gleaned what bill and when. But that's what my local state senator is here for. Lastly, I have zero clue if such a "demonstration" program exists in any other states.

I was dinking around on the internet...there's a clinic in Lexington, MA doing 2 studies for women 21-35 (I think I have the ages right) and providing one FREE IVF cycle and meds....it just started July 2006 and is published on their web-site. I googled fertility clinic and somehow this Lexington MA place showed up. I recall the location, just not the outfit's name.

If your clinic participates, then be prepared to fill out a bunch of financial paperwork, paystubs, etc and it has to be notarized. The form itself is only one page. My clinic even had a notary, so I didn't have to find somebody in my community that might flap lips.

ALSO, I believe RESOLVE chapters throughout the USA have a lobbying efforts on-going for insurance coverage. Cindy Margolois(most downloaded woman on the internet) is the national spokesperson for RESOLVE. Talk about high profile. I mentioned a book previously called "Infertility SURVIVAL handbook" by Elizabeth Swire Faulkner. On Amazon and an excellent section on finance options beyond insurance coverage. The rest of the book is very well worth a serious read too-all the technology is up to date and clearly and linearly explained.

Yup, I depleted my college fund already....but hey....no kiddies....then the college fund is really useless....I still have many good years to work and replenish the fund and going for living well into my 90s and seeing my grandchildren. So we shall see... Wishing everyone a marvelous Monday! Diana

[quote author=LMA526 link=board=8;threadid=2391;start=0#20503 date=1150256224]
Some states mandate coverage for infertility if it's an employer-sponsored plan, with certain qualifiers (e.g., self-insured groups are exempt from this rule). I'm sure you can find which states mandate coverage on the web.

Good luck, Laura


[/quote] ::)


Well I talked with my doctor about the frustration about insurance not covering infertility. He stated it is not the price to cover the treatments it is the money needed to pay another employee to do your job while you were out. UGH. Ho slefish.

Melane Marsh