Anybody changed insurances?

intheplanningstage

We were fortunate to have 50% coverage of 3 IVF/FET attempts under our insurance. Unfortunately, now we've run out of coverage. On the bright side, DH got a new job and we'll have new insurance next month, which has the same 50% coverage of 3 attempts. I called carefirst and asks if that coverage 'resets' since we are on a new plan (and group policy vs independent). She said she "assumes so". That would be amazing if we decided to go through with another FET eventually. Does anyone have similar experiernces? Thanks!

amyelise25

I have heard of others switching insurance in order to get additional benefits.  Whomever handles the insurance at your doctors office may be able to answer the question too.  I find them to be very knowledgeable.  I'm sure they have dealt with this many times.   Good luck!!

Mrs.McIrish

PAIF warning:


I switched insurances a few times but they always contained the same provision that previous cycles, even if paid by another carrier, counted towards the total lifetime allowable cycles (ie in MA, you get up to 6 IVFs under a lot of insurers but you could not get 6 from each carrier..if you did 3 and switched carriers, you did not reset to get another 6 with a new carrier).

jaztastic

::::LURKING::: PAIF WARNING

The specifics will depend on carrier and state you live in, but in general yes your benefits reset with new coverage as long as the policy is new. Same employer, different providers = New policy and benefits reset. New employer, same provider = new policy and benefits reset.  Of course I would call and inquire about any specific questions pertaining to your case as well as have your benefits verified with your RE office. 

>>>>>>>>Siggy Warning<<<<<<<

LeggyJeggy

Same as McIrish for me.  I'm in MA.  My first insurance had 10k procedure/5k meds for infertility coverage since I work for a company based in CA.  We paid more than 50% for 2 cycles.  We switched to an HMO and were told 6 cycles.  I called my HMO to find out if those cycles count and they told me no, but it was customer service and they wouldn't transfer me to the infertility coordinator again as I already left her msgs with no response.  However, I spoke with my insurance rep at my clinic yesterday and she told me that the 2 that were done under the previous insurance do count towards those 6.  It's based on your responses and outcomes and your chance for it to work the next cycle.  She also told me they've seen my HMO cover 7 cycles because it's not really something that can be mandated in this state.  For instance, she told me they would probably cover another cycle with my OE because my last cycle I had a HIP embryo and we would be switching around the protocol for the next cycle.  And then she said they should have no problem covering for DE after that due to my history.  It's all a case by case, but that's in MA.  Not sure if it's the same for you.  I would suggest talking to the insurance rep at your clinic and ask what their experience has been.  They're the ones putting in the request for coverage so I would trust them the most.  

intheplanningstage

thanks guys. If it's case by case, hopefully they approve mine. Two of my three attempts were "successful" but ended in losses. I guess I'll find out next month!