Trouble TTC

New Jersey Health Insurance ???? anyone

Good Morning Ladies, 

   So after finding out we need to do IVF and my insurance will not pay for any part of it, we MAY have a glimmer of hope.   My Cousin who has gone through IF for years told me about her health insurance in New Jersey, she was given 3 tries,  as mandated in New Jersey. My hubby works in New Jersey, so I told him to go right into the HR office today and find out about getting us on his works plan. Does anyone else here live or have insurance in New Jersey, if so can you give me more info, or even tell me if this is accurate??    

Thanks so much,


Daisypath Anniversary tickers

TTC since March 2014, but was NTNP since 2007.
Found out in May I have 2 blocked tubes.
Waiting too see my doctor again to decide next steps. 







Re: New Jersey Health Insurance ???? anyone

  • Here's a summary from RESOLVE:https://www.resolve.org/family-building-options/insurance_coverage/state-coverage.html#NewJersey

    Also, if you Google "New Jersey infertility mandate" you can read the actual mandate. I think it's the 3rd result down. (It's a pdf, so I can't link it.)

    I live in a mandate state, and the infertility part of my insurance policy pretty much reads exactly word-for-word like the mandate.

    Also, be aware that there are some exceptions to the mandate, and satellite branches in states without mandates may or may not fall under the mandate. I really hope they do though!
    **siggy warning**  **everyone welcome**

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    DS- 11.07.02
    DSS- 6.26.04
    Married- 6.29.13
    TTC Again- Sept. 2013
    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    Test Results/Diagnosis- HSG & SA totally normal
    DX: 3/2014 Prolactinoma/Hyperprolactinemia- Started cabergoline 2/2014
    5/2014 Possible mild PCOS in addition to hyperprolactinemia??
    7/2014 Adding probable tubal factor to the diagnosis list
    9/2014 And now adding hypothyroid to the list- Started synthroid 9/2014
    Cycles 1-4 - Sept.-March- All Anovulatory 
    IUI #1 March/April-  Clomid 50mg + Clomid 100mg +Trigger + IUI #1 = BFN
     IUI #2 April/May-Clomid 100mg + Clomid 150mg + Trigger + IUI #2 + Endometrin=BFN
    IUI #3- June- Follistim 75iu + Trigger + IUI #3  Benched due to a 40 mm cyst. :-(
    IUI #3- July- Follistim 75iu + Trigger + IUI #3 + Endometrin = BFP! on 7/25/14
    Slowly rising betas - Ectopic suspected on 8/8/14 & confirmed on 8/11/14
    Methotrexate on 8/12/14 -HCG negative on 9/2/14
    IVF #1- November- Antagonist protocol: 11/1: start stims, 200iu of Follistim; 11/12 ER 17R/14M/14F; 11/17 5 day transfer of two blasts, 2 blasts and 2 expanding morulas frozen; 11/22 BFP!! (On FRER at 5dp5dt)
    Betas: 9dp5dt 205, 11dp5dt 497, 14dp5dt 1,709
    u/s at 5w0d- 1 sac; u/s at 6w0d 1 baby with heartbeat, another sac without a heartbeat
    image


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  • Thank You SO much!!!


    Daisypath Anniversary tickers

    TTC since March 2014, but was NTNP since 2007.
    Found out in May I have 2 blocked tubes.
    Waiting too see my doctor again to decide next steps. 







  • Thank You!! 



    Daisypath Anniversary tickers

    TTC since March 2014, but was NTNP since 2007.
    Found out in May I have 2 blocked tubes.
    Waiting too see my doctor again to decide next steps. 







  • I hope you can get the coverage. As long as your DH's company employs over 50, you should be eligible.
    **SIGGY WARNING**

    Me: 32 DH: 35  TTC#1 since March 2012
    Dx: Poor Embryo Quality, Arcuate Uterus, Poor Uterine Blood Flow, Mild Endo, 
           Protein S Deficiency, Sjorgen's Syndrome 

    IUI #1-5: BFN
    Laparoscopy & Hysteroscopy: minimal endo, partial septoplasty
    IVF #1: 10R/6M/6F ~ Day 3 ET = BFN
    IVF #2: 14R/9M/5F ~ transfer canceled ~ all embryos arrested at 1-2 cell stage
    IVF #3: 9R/5M/5F ~ 1 frosty!
    IVF #4 (FET #1): BFN

    IVF #5 (DE IVF #1 with Dr. KK protocol): Currently PREGNANT!!!!!!
    Synthroid + Prednisone + Metformin + Baby Aspirin + Supplements Galore = 15+ pills a day
    Lupron + Lovenox + Delestrogen + IVIG + B/W = 2-5 pokes a day
    19R, 17M, 17F - transferred two Grade A blasts 11/16, four frosties!!!
    Beta #1 11/24 (13dpo/8dp5dt) = 367 ~ Beta #2 11/26 (15dpo/10dp5dt) = 709
    Beta #3 11/29 (18dpo/13dp5dt) = 1,997 ~ Beta #4 12/1 (20dpo/15dp5dt) = 3,403

    imageimageimage

    My Blog: Running and Dreaming for Two ~ All are Welcome!
  • I work in NJ and through our employer they offer multiple plans to chose from, though unless you have a major life event (wedding/divorce etc) you have to wait until open season to switch and then it takes effect in the new year. 

    Last year we switched to GHI/Emblem Health, they cover 3 IVF's and meds (all my follistim was an $80 copay).  So far we have had a good experience with them, though since we chose the standard plan, we have to go in-network for coverage and that means going to IVF NJ (we love the RE we see there so it works out).  The high option (which was triple the price) you get 50% coverage for out of network.  We don't have a deductable, just a co-pay. 

    they were the only plan that we could chose from that covered IVF, a few covered IUI's but I see that won't help in your case.

    Me: 34, DH: 32
    TTC Since September 2012
    Dx-PCOS, Anovulation, highly irregular cycles
    March 2013 Comid 50 mg+ TI #1: BFN
    April 2013 Clomid mg + TI #2: BFN
    IVM#1 Aug 2012: BFN
    20 FEB 2014:  CP
    IUI #1 Clomid 100mg  24 FEB 2014: BFN

    IUI #2 Clomid 100mg  21 MAR 2014: BFN

    IUI#3 Follistim & trigger 21 May 2014: BFN

    IVF #1 Follistim & Menopur: 14R, 9M, 7F, transfered 2 day 3 8 cell embies

    Beta #1: 7/30: 41  Beta #2 8/1: 96   Beta #3 8/4: 796   EDD:4/9/15

      

     

     

    imageimageimage

    All Welcome 

  • My husband has Cigna; nothing fertility related is covered (only dr. visits). This September I will be taking back my coverage through my job (Horizon). I believe they cover a lot of the costs. I believe there is state mandate coverage. Usually the billing dept./HR at your job or the dr's office has the answers to all the questions. It's frustrating to pay OOP. The best thing is the insurance company told us they consider fertility treatment a "luxury". Ha. 
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