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IVF & Insurance

michantmichant member
in Infertility
Just wondering if anyone was not covered by their insurance to have IVF and appealed it?
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Re: IVF & Insurance

  • STL34STL34 member

    My insurance doesn't cover any fertility treatments.  Since my state does not require insurance to cover fertility treatments, I have nothing to appeal.  I really hate being OOP for IVF!

    If your insurance covers IVF, but requires you to have X number of IUIs first, then you could appeal that requirement.  I have seen a few ladies get pass that requirement.

     

     

    imageimage


    ~SAIF/PAIF/Everyone Welcome~ 

    Me= 37 and DH = 41 

    Dx: DOR, Endo, APA+ (really high beta 2 glycoprotein antibody and high everything else tested), heterozygous MTHFR mutation, positive for lupus anticoagulant, high FSH, low AMH and both tubes blocked (per HSG on 3/8/11)

    IVF #1 - long lupron (with HGH, intralipids, lovenox and BA); 4 retrieved, 3 fertilized; ET 2 blasts and 1 frozen = BFN

    IVF #2 - a version of antagonist with EPP (with HGH, intralipids, lovenox and BA); 6 retrieved, 4 mature, 3 fertilized, 2 blasts and 1 frozen blast transferred on day 5 = BFN.

    IVF #3 April was postponed to May, May was canceled. June/July was canceled. Had a cyst aspiration and then began IVF #3 in August. ER on 8/22; ET on 8/24 with AH. +HPT on 9/5. Beta #1 (11dpo) = 3; Beta #2 (15dpo) = 29; Beta #3 (17dpo) = 60; Beta #4 (19 dpo) = 118. Heartbeat at 6 weeks 6 days =132.  Lil is here!

    TTC#2:  Trigger + TI = BFN; Clomid + Trigger + IUI = BFN.

    IVF #4:  BCP + MDLF + Lovenox = 7R, 1F = Transferred 1 6-cell embryo on day 3 = BFN

    IVF #5:  MDLF + Lovenox = 4R, 1F = Transferred 1 10-cell compacting embryo on day 3 = BFN

    IVF #6:  (New RE):  Long Antagonist November 2014 (transferred two 8 cell grade 1 embryos and froze one blast) = BFN

    FET#1:  BFN

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  • kthappy76kthappy76
    It's usually pretty cut and dry in the policy whether or not you have coverage for IVF and IF generally, making an appeal difficult.  Assuming you have employer based coverage, you're only option is to appeal to them to offer something as a benefit.  GL!
    TTK 9/06 / TTC 10/08 / Twins 12/11 / Life Blog
    5 REs + 3 surgical hysteroscopies for septum/lap + 3 failed IUIs
    IVF w/ICSI/AH & acu = BFP!, unexplained spontaneous m/c @ 8w2d (our little girl),
    FET w/acu = BFP!, B/G twins!, lost MP @19w, dx w/funneling cervix @20w,
    twins nearly lost to IC @21w, saved by rescue cerclage, 17P & 16w of bedrest
    Our twins born @36w4d via CS when A came foot first

    Thankful for every day

    Baby Birthday Ticker Ticker

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  • Mrs. MoMrs. Mo member

    imagekthappy76:
    It's usually pretty cut and dry in the policy whether or not you have coverage for IVF and IF generally, making an appeal difficult.  Assuming you have employer based coverage, you're only option is to appeal to them to offer something as a benefit.  GL!

     Ditto. It's normally up to the employer what coverage they want to offer and IF is generally a rider/add-on. You could try asking your HR, but I don't think they could give just 1 person coverage as most are group policies. If your company self-insured for health care, they don't even have to follow the state mandates (if your state has one).



    "Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all." -- Dale Carnegie
    "Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time." --Thomas A. Edison
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