IVF insurance — The Bump
Infertility

IVF insurance

Girls, what insurance covers IVF? Any suggestions? Right now I have Blue Shield PPO and it does not cover ***t.
Me: 30 DH: 38
TTC since Fall 2015
Unexplained
1st IUI - Dec 31 2016 - BFN
2nd IUI - Jan 28 2017 - BFN
3rd IUI - Mar 2017 - BFN
IVF - May
1st FET - Jun 2017 -Cancelled 
2nd FET - Aug 31 2017-Transferred 2 Sprinkles  
BFP with one bean!
<3

 

Re: IVF insurance

  • Unfortunately, there are very few insurances that cover it. If there is coverage, it often has minimums you have to meet (i.e. must do three IUIs before IVF will be covered.) Most of us ended up doing medical or personal loans. Good luck!

    ---Trigger warning---

    Me: 31 DH: 27
    TTC since April 2013
    Two cancelled IUIs in Aug and Sept '15 due to low motility/count
    IVF round 1: January 2016
    ER: February 17, 2016; 9 retrieved, 7 mature, 7 fertilized
    Day 5 Blastocysts: 5 BB, 1 AB, all normal from PGS
    FET date: May 11, '16; transferred 1 AB embryo
    First beta: May 23, '16: 998!!  Second: May 25, '16: 1648
    EDD: January 27, 2017
    BabyFruit Ticker
    Heidiisboss
  • I have BCBS of NC PPO and it covered 3 IUIs, but no IVF. I know quite a few girls on this board do have some coverage for IVF though so I hope they can chime in. Unfortunately though, a lot of plans won't cover it. :(
    ***BFP & Child Warning***

    Me: 32, DH: 35 ~ Married Nov 2014
    IUI #1-3 (Nov 2015, Feb 2016, May 2016) = BFNs
    IVF (July 2016): 20R, 12M, 10F, 8B = 7 PGS normal
    FET #1 (Sep 2016) = BFP!  EDD 6/3/17
    DD Born May 30, 2017 ~ 7lbs 12oz, 19 3/4 inches
    FET #2 planned for early 2019
  • I have kaiser federal and it covered IVF but they took that away this year. It still covers IUIs and some meds. None of the plans that are available to me or my DH cover IVF
  • My understanding is that it is mostly the state laws  that dictates whether or not there is coverage for infertility/IVF. I live in Massachusetts and infertility coverage is mandated to be a part of all insurance with some exclusions for the self-employed. I have BCBS MA and had 100% coverage for any infertility treatment (meds, IUI, IVF) that was recommended as the standard of care by my RE. I actually had a friend move out of her state (Virginia) to seek IF treatment here. 

    I think it is absolutely insane that insurance companies can exclude infertility treatment, hopefully something changes at some point. Good luck to you---
    caseyw8784
  • Besides states that mandate coverage, it is really up to the employer, not the insurance company. I am fortunate to work for an employer that included some coverage in our insurance policy. Starbucks actually has IF coverage and I know a couple ladies who have worked part time (20 hours) per week for 3 months to get the coverage. I believe fertilityIq.com has a list of some other employers that have coverage.. most are tech or banking or CPG.  Not sure if moving or changing jobs is an option though.. there is also an episode on Beat Infertility about advocating your current employer to add coverage if you wanted to try that route!
    History in Spoiler

    Age: 30 (same with DH). Together since 2006, Married June 2013 and TTC since August 2015
    Diagnosis: Mild Endo, DOR (AMH of 1.5), Poor Quality Eggs/embryos, Displaced Window of Implantation (ERA Post Receptive)
    March-May 2016: 1 TI and 2 IUIs- BFN 
    June 2016- Laproscopy- found/removed mild endo and confirmed only 1 normal healthy ovary.
    August 2016- IVF #1 with Antagonist Protocol- Cancelled (2 lead follies), converted to IUI- BFN
    Oct-Nov 2016- IVF #2 with Estrogen Priming Micro Lupron Protocol, 2 eggs retrieved, day 3 transfer of 1- BFN
    January 2017- New RE, IVF#3 with Estrogen Priming Antagonist Protocol, 12 eggs, 8 mature, 6 fertilized, 2 day 5 early blasts transferred (none to freeze :(), BFN
    May 2017- Sept 2017- Starting Donor Egg process! Waiting for donor to be available... and then she is pregnant at baseline :(
    Oct 2017- Donor #2: 25R, 22M,18F, 12 blasts frozen! Fresh transfer cancelled due to thin lining with fluid :(
    Nov 2017- Hysterscopy to remove polyp
    Dec 2017- DE FET #1 on 12/8 on 2 perfect blasts- BFN and devastated
    Jan-Mar 2018- ERA #1- Post receptive by 24 hours, ERA #2 RECEPTIVE with 4 days of Progesterone
    Apr 2018- DE FET cancelled for lining issues :(
    Jun 2018- DE FET #2 of two 1AA blasts- first BFP ever! Beta 10dp5dt- 378, Beta 14dp5dt- 2840, Beta 16dp5dt- 4035, beta 18dp5dt- 10916. Due on 2/20 with one baby after a vanishing twin
    laurad75adiratAlohaKumuartemis618
  • Echoing @JamieH2000 -- a lot of it employer-related and what they choose to cover unless you are in a state that mandates coverage. If you are at a company with a good and flexible HR, and you aren't afraid of retaliation or losing out because they think you'll be pregnant soon, try mentioning something to them about the problem with IF coverage. Someone did this at my company several years ago, and they changed our insurance plan to cover meds but not procedures. While you have to pay for IUIs/IVF procedures, all meds are covered under our typical Tier 1/2/3 copay plan, even those being used off-label. While it isn't full coverage, it does take a BIG bite out of costs.

    DH & I: Both 29
    TTC #1 June 2016 
    IF Dx: Premature ovarian insufficiency and luteal phase defect associated with genetic condition
    BFP 2/23/17. Said goodbye to our baby girl at 14 weeks.
    IVF+PGD September 2017 - two healthy embryos
    FET November 2017 - loss
    FET December 2017 - success! 
    Hyperemesis + pre-eclampsia
    Baby S born September 2018
    artemis618
  • Like a couple of the others said, it's not the insurance but the plan you are on which is chosen by the subscriber's employer.  

    For example, I was on my employer's BCBS of MA  HMO plan last year and they covered almost everything for IVF with a deductible and co-pays and up to 6 cycles lifetime.  I switched to my husband's employer's plan this year which is BCBS Anthem EPO so everything is covered as long as we are in network but the medication coverage was capped at $15,000 (which we hit after one round of stims) and they only cover 3 cycles lifetime.  

    If you have BCBS through your employer, it might be worth your while to let them know that it is lacking infertility coverage.  If they make a change it won't help you until next year but its still worth a try.  I know my husband is talking to his HR department to make sure they understand that 3 cycles may not be enough for everyone and the $15,000 medication cap with the preferred pharmacy only covers one cycle.  

    Good luck!
    BabyFruit Ticker

    TTC history in spoiler: 

    Me: 42
    DH: 41
    Married: 5/7/16
    TTC #1: May 2016
    IUI #1 10/31/16 - BFN
    IVF - ER #1 2/10 (3R, 3F, 1B for PGS - 0 viable for transfer)
    IVF - ER #2 3/24 (2R, 1F- 0 viable for transfer)
    IVF - ER #3 5/15 (1R- 0 viable for transfer)
    June 17: Starting the process for DE IVF
    Aug 17: Donor chosen! Anticipating a Nov cycle after testing is complete. 
    Nov 17: DE IVF ER 11/27 (35R, 19 F) Dec 2nd Transfer!
    Dec 12: BFP! EDD 8/20/18


  • I have Humana PPO in Ky, and have a $5000 bucket of infertility money. It helped for some IUI costs, etc. But not meds or the heavy duty IVF  stuff. But this wasn't because they don't cover but my clinic's divided between the lab and the doc's office. The lab costs are never run through anyone's insurance so that screwed us. We ended up doing a medical loan for one cycle through Arc Fertility. Things for me, like ultrasound and bloodwork are covered as medical through the Humana, but anything with retrieval,  sperm, embryos or transfer are from the lab side. 
    Just FYI.

    Married: October 2014

    Me: 35 DH: 39

    TTC since November 2014

    Diagnosis: Anovulation from PCOSish without syndrome, Male factors - low motility and morphology issues

    April-Sept. 2015 - Clomid and TI - BFN

    Dec. 2015- HSG - Clear tubes

    Jan., Feb., March 2016 - Letrozole 7.5mg and TI with HCG trigger= BFN

    April, May, June 2016 - Letrozole 7.5mg and IUI with HCG trigger= BFN

    September 2016 - IVF round #1;ER 9/26 with ICSI on 14 eggs - developed mild OHSS. 

    Sept 2016 - 12 non-PGS embryos frozen (5 5AAs)

    FET #1 Jan 16, 2017 - BFP!- MC at 6W5d

    FET #2 May 8, 2017 - BFP! EDD 1-24-2018

  • Also always keep in mind do FSA if you can- that's $2600 (Max) tax free so that saves some money too
    Siggy Warning--------


    CP #1- due April 2017 lost 5.5 weeks
    cp #2- due May 2017 lost at 4.5 weeks
    iUI #1- BFN
    IUI #2-BFN
    IVF#1- transfer 2- BFP! Due October 2017 c/p#3 lost at 3.5 weeks
    artemis618Heidiisboss
  • I'm making a claim for the whole of the $2600 this week and it will cover almost half the cost of my meds this cycle
    Siggy Warning--------


    CP #1- due April 2017 lost 5.5 weeks
    cp #2- due May 2017 lost at 4.5 weeks
    iUI #1- BFN
    IUI #2-BFN
    IVF#1- transfer 2- BFP! Due October 2017 c/p#3 lost at 3.5 weeks
  • @laurad75 that's a great suggestion to talk to HR.. I may do that.  

    I have Carefirst Blue Choice through my employer and it covers 90% of 3 IVF/FET cycles per live birth and then I have small copays for meds.  I live in Maryland.  We do consider ourselves very lucky we have coverage at all and most of our expenses have been for freezing sperm and embryos.  But 3 cycles covered may not be enough for us and it likely isn't for many.  
    TTC since:  1/2015
    11/16:  IVF #1.  BFN
    2/23/17:  FET with a BFP on 3/8/17.
    EDD: 11/11/17 with a baby GIRL!

  • We have Neighborhood Partners in MA and we are very lucky my husband's insurance covers everything 100% (IVF, PGS and PGD, and meds.) We are very lucky that the plan has a $0 deductible, so the only thing we have to pay is the copays.
    laurad75
  • So jealous of those with great insurance!!! We are already $30k deep...... Ugh :/ 
    Siggy Warning--------


    CP #1- due April 2017 lost 5.5 weeks
    cp #2- due May 2017 lost at 4.5 weeks
    iUI #1- BFN
    IUI #2-BFN
    IVF#1- transfer 2- BFP! Due October 2017 c/p#3 lost at 3.5 weeks
  • So I live in NJ which is a mandated state. However my insurance policy did not cover any fertility treatment at all (not even clomid or IUI). My company has another office in a non-'mandated state so our ins policy was based out of there which is how it was avoided the mandate. We ended up getting married a year earlier than planned in part bc my husbands insurance covers 4 IVF retrievals and unlimited transfers in full but he's a state employee (has BCBS NJ)  we did end up dipping into 401k for the genetic testing funds but feel incredibly lucky we had the option of using his insurance
    DH: 34 | Me: 35
    DS1 9/24/13
    DX Diminished Ovarian Reserve, Factor V Leiden Mutation, Secondary Infertility
    MFI (SA #1Count 11mill, Motility: 18%, Morphology: 1%)
    MFI (SA #2Count 7 mill, Motility: 18%, Morphology: 1%)
    AMH .328 | FSH 13.2 
    Oct. 2016: Clomid + TI
    IVF: ER 3/1/17; 5 retrieved, 3 mature & fertilized
    Results: 2 PGS normal embryos
    Planned on August 2017 transfer
    **TW**
    Natural BFP 4/3/17,Expecting baby boy via RCS 12/7/17

  • @Marley629 I have 4 retrievals too (procedure - not meds- paid for at 90% after deductible is met). But I am a poor responder so I already blew through 1. There is no room for if you are as challenged at IF as you are at getting/staying pregnant in the first place. Boo. 
    Siggy Warning--------


    CP #1- due April 2017 lost 5.5 weeks
    cp #2- due May 2017 lost at 4.5 weeks
    iUI #1- BFN
    IUI #2-BFN
    IVF#1- transfer 2- BFP! Due October 2017 c/p#3 lost at 3.5 weeks
  • I have emblem health ghi cpb. iui is covered and ivf is covered for 3 rounds at 75% after 6 rounds of iui. I'm not sure about the meds but I have a feeling they're not covered because my clomid wasn't covered. I'm still working my way through iuis so I'm not 100% sure how it all works with ivf. previously i had united healthcare and i'm pretty sure ivf was covered but United was HORRIBLE so i wouldn't be surprised if full coverage wasn't true. 
    TW*** Child and loss mentioned
    Married 10/12
    DS 11/14
    Ectopic 2/16
    PCOS/Ovulation Dysfunction 11/16
    IUI x 3- BFN
    Laparoscopy 3/17 Endo and tubal damage
    IVF- 4/17- 40 eggs retrieved, 10 blasts, 7 pgs tested embryos
    FET- 6/17- BFP!
    Due Feb 15, 2017
  • artemis618artemis618 member
    500 Love Its 500 Comments Second Anniversary First Answer
    edited February 2017
    Ditto as far as my employer determining coverage.  I am capped at two lifetime cycles (with zero blasts from the first) on my employer's UHC CDHP (similar to the PPO) plan, but I did not have to go thru IUIs in advance - the only condition is transfer within 90 days of the second retrieval (assuming I get anything to transfer).  I pay 10% after my deductible for everything in network (30% out of network) up to my OOP max(es), I think including the drugs (I got my drugs last calendar year for this Jan/Feb cycle, so not exactly sure what that rate was as I technically changed plans this year).  

    All other infertility services are covered at the same 90% after deductible's met, so maybe we'll go backward and try IUIs after this next cycle? Trying to get a handle on which codes exactly have the lifetime max to quantify how much an OOP cycle will cost us.  I haven't been able to get an answer on any sort of cap on meds.
    About me:
    ***TW***
    Married 6/18/16 (Me 40.5, DH 43), TTC #1
    Natural BFP 8/10/16 --> mc our NIPT-normal little girl at 11w5d on 10/1/16 :(
    As of 12/2016:  AMH 1.42, FSH 6.1, AFC ~10
    Self-benched Nov-Dec 2016 for
    IVF #1 Jan-Feb 2017 (OCP, testosterone primed antagonist w/HGH - ER 2/2/17 - 12R, 7M ICSI'd, 3F, 0B)
    IVF #2 Mar-Apr 2017 (testosterone primed agonist/luteal lupron w/HGH - ER 4/8/17 - 10R, 8M, 8F, 5B, 1 PGS normal)
    IVF #3 May-Jun 2017 (testosterone primed agonist/luteal lupron w/HGH - ER 6/4/17 - 14R, 5F, 3B, 0 normal)
    **New RE**
    IVF #4 Sept 2017 (natural start microdose lupron flare w/HGH - ER 9/28/17 - 33R, 18F, 10B, 4 PGS normals!)
    FET #1 (medicated) of one PGS normal XX 11/2/17 - Beta #1 11/11/17 (153), Beta #2 11/13/17 (324), mc at 5w1d on 11/19/17 :(
    IVF #5 Dec 2017 - Insemination of 9 frozen eggs from 2012 (8F, 1B, 0 normal)
    Jan 2018 - Natural cycle ERA (normal/receptive) & stimming for
    IVF #6 Jan-Feb 2018 (natural start microdose lupron flare w/HGH - ER 2/3/18 - 17R, 6M, 4F, 0 blasts)
    IVF #7 Feb 2018 (natural start microdose lupron flare w/HGH - ER 2/26/18 - 19R, 9M, 9F, 4B, 2 PGS normals)
    FET #2 (natural cycle w/o trigger, w/P4 support) of one PGS normal XX 4/5/18 - Beta #1 4/14/18 (67), Beta #2 4/16/18 (231)
    Rainbow baby girl due 12/21/2018!

    Lilypie Pregnancy tickers Pregnancy Ticker


  • My insurance didn't cover anything but I told my nurse that and she was able to help out with some donated meds. It helped a lot!! It saved us about $3000-$4000. Good luck 
  • I have Tricare and I believe they cover some testing and IUI through Obgyn and some stuff covered at private clinics. They cover 100% of everything only at the designated Military Infertility programs which I believe are only in Washington DC and San Diego. I was able to get into the San Diego program. You either have to be active duty or full retired, my husband is retired. We are fortunate to get full benefits for life. I had great insurance at work but they didn't cover anything infertility (not even bloodwork) so I switched to Tricare.


    Me: 37 / Hubs: 42
    TTC: April 2013
    DOR: AMH .3 - 1.31 (it varies); FSH: 5.1
    Clinic NMCSD
    IUI #1 July/Aug 2016
    IVF #1 Sep/Oct Microdose Lupron Protocol - IVF cancelled only 1 follicle
    IVF #2 Feb/Mar Antagonist protocol w/estrogen priming - 0 eggs retrieved (empty follicle syndrome) 
    Donor Egg Cycle as soon as we find a match
  • We have United Healthcare but there are several policies under them that don't have IVF/Fertility coverage. I think my husbands company opted in for the coverage. Our coverage is 15k per person lifetime maximum so basically one cycle. Too bad my husband can't carry a baby and use his 15k. 
    Me- 30 DH- 31
    Mild endo
    3 IUI's, Responded "too well" to meds, almost missed ovulation twice and 3rd IUI canceled due to missing it.
    IVF March/April 2017

  • I'm in NJ and have Aetna  through my employer and IVF was covered at 100%. No deductible just copays. As others have stated, it really comes down to your employer. 
  • This is just a thought for us, I'm not sure that we'll be able to... Wanted to put it out there in case anyone is looking for options. 

    I'm on my DH's employer's health plan. His coverage is better than my work coverage, so we decided to go with his plan- it's actually one of the best health plans in our area (no IF coverage though). But the other day, he mentioned wanting to change jobs eventually, and what would we do for insurance?

    I went to a big college and so did DH- turns oUT our college alumni insurance plans are awesome- mine actually covers IF medications.

    Definitely worth considering if you're looking for options and went to a big school!

    Me: 34 DH: 35
    TTC #1 since Nov 2015.
    dx: unexplained
    Dec 2016 - Apr 2017 - IUI + clomid x 4 - all BFN
    July 2017 - IVF#1 - 4 frozen embryos, medical freeze
    Oct 2017 - D&C
    Nov 2017 - Apr 2018 - 3x FET - all BFN
    Sep 2018 - IVF#2 w PGS - 3 frozen normal embryos
    Nov 2018 - FET #4 - BFP

    laurad75artemis618
  • @funkykey I didn't know that was even a thing.  How interesting. 
    BabyFruit Ticker

    TTC history in spoiler: 

    Me: 42
    DH: 41
    Married: 5/7/16
    TTC #1: May 2016
    IUI #1 10/31/16 - BFN
    IVF - ER #1 2/10 (3R, 3F, 1B for PGS - 0 viable for transfer)
    IVF - ER #2 3/24 (2R, 1F- 0 viable for transfer)
    IVF - ER #3 5/15 (1R- 0 viable for transfer)
    June 17: Starting the process for DE IVF
    Aug 17: Donor chosen! Anticipating a Nov cycle after testing is complete. 
    Nov 17: DE IVF ER 11/27 (35R, 19 F) Dec 2nd Transfer!
    Dec 12: BFP! EDD 8/20/18


  • @laurad75- I looked because I thought: "any new job he gets will have a worse plan" - and generally the bigger the plan the better the options... now we're thinking about signing up before he changes jobs even. Our educations were expensive! Would be nice to derive a little more value.  ;)

    Me: 34 DH: 35
    TTC #1 since Nov 2015.
    dx: unexplained
    Dec 2016 - Apr 2017 - IUI + clomid x 4 - all BFN
    July 2017 - IVF#1 - 4 frozen embryos, medical freeze
    Oct 2017 - D&C
    Nov 2017 - Apr 2018 - 3x FET - all BFN
    Sep 2018 - IVF#2 w PGS - 3 frozen normal embryos
    Nov 2018 - FET #4 - BFP

    AlohaKumu
  • I have Independence Blue Cross Personal Choice...I switched to it because it covers everything...it is very lucky.  I am a teacher and it's our PPO option.  I don't even have co-pays.  The interesting part is this: the injectables are ONLY covered through my medical insurance...not my prescription.  At first the pharmacy didn't believe me, but the billing woman at my dr. helped figure it all out.  I have to go through my medical insurance for the injectables and can only use Walgreens Specialty Pharmacy.
    Me: 32, DH: 40
    Married: July 2015
    July 2016: IVF #1 (froze embryos)
    Aug. 2016: Hysteroscopy to remove a few polyps & Laparoscopy
    Oct. 2016: FET #1 BFN
    Nov. 2016: FET #2 BFP (ended in CP)
    March 2017: IVF #2 Fresh Transfer of 2 Blasts = BFP!!! (EDD: 11/27/17)
    Froze 5 Blasts
    DS born on 11/2/17!!!  I was induced due to Pre-eclampsia, but baby is perfect <3


  • @funkykey I never even thought about whether my college offers an alumni insurance plan or what it would cover but it's definitely worth checking out.  My current insurance covers testing and treatment for underlying conditions, but it does not cover anything IUI or IVF related.  H has essentially the same coverage as I do so it makes no difference if we use his or my employer's insurance.


    Me: 29 H: 32
    NTNP: 03/2015-05/2015
    TTC #1: 06/2015...
    Dx: MFI, ovulatory dysfunction
    IVF ER: 11/2017 - 6 on ice
    FET: 01/2018 = BFP - EDD 10/5









    funkykey
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