IVF insurance- IUI required and how many?

somewhereinnyc

Hi, for those of you whose health insurance covers ivf, did you have to do iui first? If so, how many? And any requirements for the drugs used with iui (clomid or injectibles)? I’m particularly interested if anyone has Empire blue cross blue shield and/ or used WINFertility. Thank you! 

linxyz

6 iuis for me before proceeding to ivf, only used clomid which had no requirements.

somewhereinnyc

@linxyz Thank you! What was your insuance?

marijaa333

I have aetna open choice, no requirement.

mockingjay1

*lurking*

We have BCBS and did not have to do a certain number of IUIs before IVF. I would just call your insurance today and ask them.

somewhereinnyc

@mockingjay1 thanks! Asking on here because we are switching in January to a different plan from our employer that covers ivf if we aren’t pregnant by then. Because I don’t currently have the insurance, they wouldn’t answer any questions :-/

mockingjay1

somewhereinnyc said:

@mockingjay1 thanks! Asking on here because we are switching in January to a different plan from our employer that covers ivf if we aren’t pregnant by then. Because I don’t currently have the insurance, they wouldn’t answer any questions :-/

Ah gotcha! From what I've read if insurance that covers IVF does require IUIs first, it's usually 3 or 6 of them. Ugh that's frustrating that they won't give you any info. Good luck!

linxyz

@somewhereinnyc GHI plan with city of new york. You are better off asking your clinic financial advisor(at least in mycase). Calling the insurance itself is useless. When I was about to do IVF and was deciding on which insurance carrier, I asked my clinic. Since the clinic sees patients with all types of insurances in new york, they have a better idea of what each plan covers.

anared

@somewhereinnyc I do not have the same health insurance as you but I did 6 IUIs thinking I needed it for IVF. When we went to submit the authorization, the financial office at my fertility clinic told me I would probably get denied and have to do two more with clomid since I was doing natural cycles. Well, after weeks of trying to get through to the people at my insurance, I actually got in touch with the person that is in charge of authorizing the IVF and she not only approved me, but she said I would have been approved just based on my husband's SA. She said the IUIs weren't necessary, fortunately they were covered we just lost those 6 months of time. If you call insurance you may just get a representative that just reads you the policy. Ask to speak to the people that are in charge of the authorization. It is not as black and white as it seems. They consider everything and will approve or deny each procedure based on your specific situation. I also live in NYC and I believe it was the NYC Healthline that got me in touch with that office. 

melcab7

I have Health Alliance and it is required to do 3 IUIs before moving on with IVF!

ChristenMA83

I have aetna.  Typically they require 6 medicated or IUI cycles before proceeding to IVF.  However in some circumstances (like ours) you can bypass the requirement if you have been diagnosed with severe MFI or I think severe endometriosis.  So if you have a diagnosis other than unexplained it may be worth calling your insurance and checking if there are any circumstances that let you bypass the requirement.  Aetna has a women's health program that I had to enroll in prior to getting coverage and they helped me through all the requirements.

ndz2018

I have NJ BCBS Direct 10 PPO we weren’t required to have any IUIs. Went straight to IVF after our diagnosis, MFI. A friend of mine also has NJ BCBS but a different plan and she had to do 6 IUIs prior to IVF because they were unexplained.

Drove2u

I have Aetna. And I had to do six iuis before ivf but everything was covered 100 percent besides co pays at each visit. Even though I would’ve moved on to ivf after 3 iuis I can’t complain too much. ;-)

knottie64b25b7a6d714fde

When considering IVF insurance coverage, inquire about requirements for intrauterine insemination IUI beforehand. Policies may specify a minimum number of failed IUI cycles before approving IVF coverage. Understanding these requirements helps manage expectations and plan financially for fertility treatments, ensuring smoother, navigation of the insurance process.

ivfmeerut

For those with health insurance covering IVF, many plans, including Empire Blue Cross Blue Shield, often require trying IUI first. The number of IUI attempts and specific drug requirements (Clomid or injectables) vary by policy and provider.

knottieb0032984468268ca

I Had Aetna PPO when I was working for Apple and they covered absolutely everything. It was amazing while it lasted. Aetna also has a dedicated person on their staff that will answer all of your questions regarding fertility treatments, Procedures, medicine, etc.