Anyone in MA with Tufts for insurance? IVF questions

Mrs.McIrish

Hello,

DH's insurance is Tufts navigator in MA. I am currently on my own insurance in RI and have to pay 20% OOP for meds/IF treatment. Apparenly DH's coverage would be 100% so we are looking to add me to his at the enrollment period in June.  I was told by the RE's financial office that Tufts had a FSH cutoff of 10.9 for IVF and would reject me for IVF since mine is higher. I'm going for acupuncture, taking DHEA and wheatgrass and was thinking of taking the risk that my FSH would go down for the particular IVF cycle month. If they reject me, I would pay the 20% for my co-pay (it is still a few thousand dollars so that's why I am trying to get it covered).

My question: how many IUI's did Tufts make you do before you could move to IVF? I'm on my 2nd IUI (one clomid/ one injectible).  If they made me do 6 before I could move on, I would just stay with my insurance since I am AMA/DOR. If it was 3 cycles, I could do that.

Thanks for any help.

dejavu

I have Tufts Navigator, and love it.  I can't comment on the FSH levels (mine are normal).  So I highly suggest you give them a call.  From my understanding from Tufts, as long as your RE feels IUI is working, you can do unlimited amounts, (NICE)!  You are however only allowed up to 5 lifetime IVF cycles.  Again this is based on your RE.  So if you are comfy doing IUIs, you can do them forever.  If you want to move to IVF, your RE just needs to get prior athorization from Tufts.  Since your DH is the one with Tufts he will have to call (until you are on his plan if you decide too), but here is the number for the IF coverage line,  617-923-5879.

GL!

 

PS>  I beleive you could be on 2 insurances at once, one is your primary.

Mrs.McIrish

Thanks for the #.  I want to move on to IVF in June. I was concerned that Tufts would require 6 IUI's before they would allow you to move to IVF. I don't want to do 4 more IUI's..  I will have DH call to see if I can get any info.

Your DS is SOOO cute.

dejavu

you might also find this useful.

https://www.tuftshealthplan.com/providers/pdf/mng/Infertility_Services_MA.pdf

 

Mrs.McIrish

dejavu:

you might also find this useful.

https://www.tuftshealthplan.com/providers/pdf/mng/Infertility_Services_MA.pdf

 

Awesome!! Thanks so much.

met_at_the_ball

Oh my gosh, I came across this post and am so thankful, i was thinking of switching insurance since we currently have a cap. This is VERY helpful, thank you!

MAbride0808

I have Tufts (not navigator though).  We had to 3 clomid iui's and then they wanted 3 IUIs with injectibles, however my RE pushed to jump to IVF and they accepted.