Infertility

IVF OOP vs. Coverage Poll

I am 100% OOP for any and all IVF attempts and was just wondering how many of us are in the same boat.

[Poll]

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Re: IVF OOP vs. Coverage Poll

  • I have Rx drug coverage for 3 IVFs, and no coverage for any the rest of it.
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  • Since we just met with two RE's, we haven't planned the IVF yet although IUI's are not looking hopeful. We have no coverage for any of it, including testing...
  • I have a lifetime IF max of $10K (that includes IUI, IVF, testing, surgical procedures, etc.)

    However we have a separate drug benefit plan that is not part of the $10K IF coverage. For our drug benefit plan we have up to $100K lifetime benefit coverage.

    EDIT: we also pay a 10% co-insurance for our IF plan and the regular office visit copay (which is between $20 and $45 each visit)

  • I pay 20% after my deductible has been met, insurance pays the rest and I do not have limited IVF attempts or a life time coverage.  I don't know what my prescription coverage is technically, but I just paid 187 yesterday for all my IVF meds. I know we are blessed with the insurance and I wish everyone here was as well.
  • my health insurance through work is practically free, but no ART coverage at all.

    It's going to cost $350/month to put me on DH insurance and we will have a $9500 deductable which = $13,700/year

    The $13,700/ year is still less than the $15,000/cycle that it will cost if we're completely OOP on my insurance.

    For the $13,700/year, we have 4 lifetime IVF attempts, unlimited  FETs and unlimited IUIs (should DH's #'s ever improve). Meds will be covered as well, with copays.

    Financially, even though it's still a fortune, going on DH's insurance makes more sense.  That way if we get any embies to freeze, we can have multiple cycles in a year.

    Dx: MFI, DOR, 9 Fibroids and homozygous MTHFR

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  • On DH's insurance we have 10K for meds and 10K for and Fertility treatments, on my insurance I have 6 covered IUI's.

    Our Journey from two to three! 3 IUI's, 2 IVF's, decided to move to foster/adopt. 12/24/2009 Baby C born, 2/1/2010 placed with us, 5/17/2011 Adoption final- we are finally a forever family! Baby Birthday Ticker Ticker
  • I voted other.

    IVF is covered by my insurance - as long as I go to an in-network clinic.  However, I really was frustrated at the pace / protocols followed at my first clinic (in NYC, large well-known teaching clinic) so swtiched after IUIs with injectibles to a more aggressive, private clinic that doesn't take insurance.  In addition to being OOP, their rates are much higher but I get excellent care. 

    5 IUIs | 4 IVFs | 2 sweet little girls Baby Birthday Ticker Ticker Baby Birthday Ticker Ticker
  • i'm 100% covered for 4 IVF attempts (NJ state mandated)
    S/PAIFW
    Tara & Dave - TTC since September 2006
    PCOS - dx 1999 (amenorrhea) | freakishly long fallopian tubes
    Hypoglycemic | thyroid issues | severely anemic
    Multiple Clomid cycles of 50, 100, 150 - absolutely no response
    Follistim 50/100 | Follistim 75/125 | Follistim 100/150 IUI - all BFNs
    Converted IVF - BFP - m/c | FET - BFN | IVF #2 = BFN
    IVF #3
  • i voted that we have 100% IVF coverage for a limited number of cycles (4).     but we have a high deductible plan, so that coverage doesn't start until after we pay OOP for a big chunk of change each year.   mind you, it is no where NEAR what people who are totally OOP pay, but its substancial, so we're going to try to smash in as many treatments as possible before our deductible resets on January 1.     even after our deductible is met, only medical is covered at 100%.    pharm is at 80% coverage until we meet a secondary OOP max.  
    Brought to you by IVF, ICSI, limited fert, and oocyte cryopreservation.
    Because we're fancy like that.

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  • imagepsychmusetls:
    i'm 100% covered for 4 IVF attempts (NJ state mandated)

    NJ State may be mandated, but the loopholes are so big, i can drive DH's SUV through them.

    I live and work in NJ. I am an RN working in a hospital. Hospital = self insured.... if you are self insured, you do not have to provide IF benefits.

    Loophole... 

    See my post above.

    Dx: MFI, DOR, 9 Fibroids and homozygous MTHFR

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    "If dandelions were hard to grow, they would be most welcome on any lawn."

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  • The drugs for IVF are covered under my insurance but everything else related to IVF is 100% OOP. 
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  • No coverage at all. Not even testing. If you even mention infertility they won't cover it.
    imageimage

    image
  • I live in a state that mandates coverage and yet I am still OOP... gotta love insurance companies!
    SAIFW
    TTC since 2008 dx PCOS & MFI
    Clomid/Femara no "O"
    IVF #1 BFN
    FET #1 cancelled for biopsy
    FET #1.2 c/p, July 2012 c/p
    IUI #1 & 1.2 canceled
    IVF #2 ER 12/1, Freeze all due to OHSS
    FET #2.1 cancelled due to DVT risk, FET #2.2 Jan 2013
    my blog
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  • Hi, I voted other.

    Under my current plan I am completly OOP for all fertility treatment.  Diagnostic testing is covered but drugs, IUI, etc are OOP.  If I don't get pregnant with IUI (we will do 3) we will proceed to IVF and then I will switch to DH's plan which provides $2000 lifetime max in fertility treatment.  $2K isn't much but it's something.

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  • I had 50% coverage of IVF with no drug coverage. Fell in the cracks of my MA IVF mandate and had to purchase a high premium plan not with my employer to cover that amount.
    A lot of years and a million tears finally led me to you.
    After 7 years trying to concieve, 3 failed IUIs and 2 failed IVFs, my third IVF was a success!
    My Christmas baby turned into a turkey bird! Dillon Richard was born at 34 weeks, 5 days on November 28, 2009 after 10 weeks on bedrest for preeclampsia.
    <a href="http://smg.photobucket.com/albums/v705/arriinthere/PJ/?action=view
  • My Insurance covers 3 Fresh & 3 Frozen IVF cycles at 75%, which leaves me with a 25% co-pay.
    May 06: Natural PG= m/c, July 09: TI= m/c, November 09: TI=BFN, December 09: IUI= c/p
    IVF#1: start stims 1/26; ER 2/8; ET 2/13= BFN; FET#1: May 2010= m/c *NEW CLINIC Jan 2011* IVF#2: start stims 1/12; ER 1/22; ET 1/27= BFN; IVF#3: TBD
    ~SAIFW/PAIFW~
  • I work for a company with an excellent group plan in a mandated state.

    I have full coverage for 6 IVFs, no lifetime max. I have unlimited IUI cycles, but once I do IVF, I can't go back to IUIs.

  • I just got coverage that covers 100% up to $20,000.  We have to do PDG IVF so that should give us one fresh and at least one FET.  If we did not have this coverage, we would not be able to do IVF anytime soon. 
  • $20k IVF coverage (testing, sonograms, blood work, etc) but meds 100% OOP.
  • I said other

    I have coverage for 3 retrievals and 3 frozens in network and I am responsible for 25% of cost.  If I go OON they will reimburse up to 70% of cost but it is usually lower and what they think the rate should be.

    Unilimited IUI's and IVF meds with 25% copay.

    Unfortunately, we're MFI and none of DH's procedures, u/s and most of his b/w are not covered at all! :(

    image
    Worrying does not empty tomorrow of its troubles, It empties today of its strength. ~Corrie ten Boom
    Courage doesn't always roar. Sometimes courage is the little voice at the end of the day that says I'll try again tomorrow. ~Mary Anne Radmacher (thank you beadinglady)

    It's been a long journey. TTC since 9/06. multiple IUI's and IVF's and 4 m/c's. IVF#3 = BFP, twins, induced at 34w6d due to baby b passing away (no explanation). Delivered on 35w1d, Baby A - baby girl, and Baby B - baby boy, our little angel.
    MTHFR A1298C & C677T, Immune Issues and Factor II
  • We are OOP for the IVF attempts but all my meds are covered except for the $5 co/pay. At least we are able to catch a small break!
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