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Insurance-Infertility

kristylangkristylang member
in Infertility
Hello ladies.  I wanted to share that I spoke to my insurance company yesterday, which is Blue Cross and Blue Shield and now instead of infertility coverage only covering 4 IVF cycles a lifetime, they now changed it to 4 IVF cycles a year!  This is huge as my husband and I already have done two rounds and both have failed. Our next step was going to be donor egg, but now since they cover 4 a year we are back to zero and we are going to go to another doctor to get a second opinion and see if they can help us with our dream.  Just wanted to share with everyone to check with their insurance if they have fertility insurance! 

Hope this helps some of you out! 
Kristy
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Re: Insurance-Infertility

  • mackenzie07mackenzie07 member
    Where are you located? I have Blue Care Network and as far as I know they cover 50% if a iui and for injectable medicine i have to pay 20%
    Married for 3 years
    Me: 28 DH: 33
    Together for a total of 6 years
    Fur mommy to two rescue dogs
    DX: PCOS and Insulin Resistance

    History:
    Irregular Cycles
    2010: Laproscopy with Hystroscopy ablation. Tubes were clear.
    1/5/2016 : DH sperm analysis is excellent.
    February: Switched to a new RE
    Two failed clomid rounds
    March 2016: New HSG and found tubes are open
    April 2016: Round one Letrozole 2.5 mg. Ultrasounds day 13 &16. No follicle grouth
    May 2016: Had to take a month off
    June 9th 2016: Started Letrozole again but at 5mg
    July 5th: bfp beta 31
    July 7th: Beta 97
    July 9th: Beta 231
    July 11th: Beta 500
    July 13: Beta 1400
    Beautiful son born 3/16/17 @ 1:38pm




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  • KLake42KLake42 member
    I think it depends on the state.  I haven't seen a BCBS policy in GA that covers any infertility treatment (outside of some diagnostic tests).
    Me- 39 (turning 40 in April), TTC for the first time ever (since Jan 2015), low ovarian reserve
    Married 3/14/14 to my wonderful wife, but her sperm count is rather low
    TTC with frozen donor sperm and science

    7 IUIs, 7 BFNs.
    2 IVF attempts, both cancelled and converted to IUI, both BFNs.
    Decided that my tired old ovaries are ready to retire.
    Next step- reciprocal IVF, using my wife's eggs, my uterus!  
    fresh 5 day transfer (2 embryos) 4/17/17- BFP! 
    Identical twins "due" 1/2/17 (but anticipated arrival sometime December)

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  • AandDM2014AandDM2014 member
    Wow! Lucky you! I'm assuming you have employer provided health insurance? In general, in California, you can only get infertility coverage from an employer provided plan, and never from an individual plan. As I don't work and the DH works for a company of about 12 people, we have to purchase our own insurance. I don't even have coverage to find out why I don't ovulate as it is considered fertility related, even though it is really a medical condition that affects more than just fertility. It would be worth checking out though. Thanks for the tip!
    About us:
    Me - 28, Lean PCOS
    DH - 31
    Married June 2010, TTC since March 2014
    Blog: ourbinarystar.com

    FET cycle #3 Transfer July 28th 2016, Triplets born healthy on February 26th 2017 at 33w1d!

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  • 2015dee2015dee member
    Yes, it is definitely dependent on what state and what kind of plan you have. That's amazing that you have such wonderful coverage though! I don't have any. :(

    <3 *Loss & bfp mentioned*

    me 28 (Lean PCOS, hypothyroid) dh 33
    TTC #1 since early 2011
    May 2011- natural pregnancy (metformin only); m/c @ 9 weeks + D&C
    July 2011- lap to remove dermoid cyst
    August 2012-current- 9 rounds of Clomid, 1 cycle of Femara, several cycles of soy isos, 1 IUI, O'd every cycle, BFN
    August 2014- lap to remove uterine septum. Everything else looking good.
    Moving onto IVF Feb/March 2016 Just kidding. Natural bfp 1/30/16.     1st beta 2/1 = 110. 2nd beta 2/3 = 332.

    First ultrasound 2/19 - one baby with a heart rate of 127! EDD 10/11/2016


    BabyFruit Ticker
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  • kristylangkristylang member
    We live in IL and I am a teacher, so our insurance is through my district.  We are definitely very very lucky to have wonderful coverage.  We pay 10% until our out of pocket is covered and then after that my insurance covers 100%.  

    I wish everyone had insurance like we do.  
    Kristy
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  • twomommiestobetwomommiestobe member
    2015dee said:

    Yes, it is definitely dependent on what state and what kind of plan you have. That's amazing that you have such wonderful coverage though! I don't have any. :(

    Same here. :disappointed:

    RE DX for me: Anovulatory cycles/Mild PCOS  RE DX for DW: Endometrioma on left Ovary.
    Reciprocal Ivf Feb 2016. DW eggs and I am carrying. EDD: 10/27/16

    Pregnancy Ticker
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  • SapreenamareeSapreenamaree member

    I know someone who works for a large company as a sales rep. The home office is based in Illinois, and she has excellent fertility coverage. I work for a much smaller firm with home office locally, and our small group plan doesn't cover anything :(

    I say anything, but really the diagnostic testing is covered. But any fertility "treatments" are "expressly excluded" from my policy. So, depending on how our RE visit goes in a few weeks, we will have some mega decisions to make regarding cost and treatment. So difficult!

    Married February 2014

    Me:34 DH: 34
    TTC since May 2014

    Jan. 2016: 1st round of Clomid - stopped due to OHSS

    Feb 2016: 1st RE apt - diagnosed with PCOS still possible uterine septum. Put on BC for cysts, HSG will be in March

    March 2016: HSG showed both tubes blocked (right tube holding fluid), no uterine septum, need surgery

    April 2016:  Surgery to remove right (hydrosalpinx) fallopian tube and adhesions from the left - all went well!

    May 2016: Waiting to start 3 months of un-monitored cycles in July with metformin and letrozole. If no success, going straight to IVF!

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  • mandasdmandasd member
    I'm in California (San Diego) and used to have Blue Shield - they covered nothing, not even basic tests. I had the PPO plan. I was told that the employer has to allow for the additional coverage in the policy. Now I am on Tricare Prime - My husband is retired military. It is excellent coverage but they will not cover IVF - they may cover some tests and meds as long as I use one pharmacy and one testing facility that is not very close to me at all, maybe an hour! All tests and meds have to be ordered from my PCP/GYN. Seems like a lot of red tape!
    Me: 37 / Hubs: 42
    TTC: April 2013
    DOR: AMH .3 - 1.31 (it varies); FSH: 5.1
    Clinic NMCSD
    IUI #1 July/Aug 2016
    IVF #1 Sep/Oct Microdose Lupron Protocol - IVF cancelled only 1 follicle
    IVF #2 Feb/Mar Antagonist protocol w/estrogen priming - 0 eggs retrieved (empty follicle syndrome) 
    Donor Egg Cycle as soon as we find a match
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  • takethelongwaytakethelongway member
    @kristylang I'm also a teacher in IL! I am so thankful for our insurance. We would not be able to do this without it.
    Me: 31 PCOS + Homozygous A1298C MTHFR DH: 32 A-OK!
    December 2015-IVF 24 eggs retrieved, 16 mature, 14 fertilized with ICSI, 9 frozen blastocysts
    January 2016-FET #1-BFP!
    February 2016-MC @ 7w3d
    April 2016-Hysterscopy and D&C
    May 2016-September 2016-Prepare to move to Qatar and TTC is on hold
    October 2016-Natural BFP & MC @ 6w
    December 2016-Natural CP
    April 2017-FET #2-BFP-It's TWINS!
    Follow our journey! 
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  • UnknownUnknown
    edited April 2016
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  • ultratomatoultratomato member
    I live nj and work for the state and I'm lucky to have everything covered by insurance. If I had to have the stress of finances as well I don't think I would keep it together. Good luck ladies
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  • Caroline351Caroline351 member
    Color me jealous! I have Blue Care and it covers everything BUT IVF with PCP approval (which is really pretty absurd, but whatever I have to do to get them to pay...) I worked for a large corporation once that covered EVERYthing and even had adoption assistance. Now I work for a non-profit...at least I know I can get help looking for a grant :) 
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