Insurance coverage for iui & ivf?

[TTCsince626]

Just got back from my first RE appointment and am very excited. They make things so clear and are so helpful. According to them IUI and IVF is completely covered with Horizon blue cross blue shield.... I'm so excited but find it hard to believe.... Is this possible? I THINK We're just going to do an IUI with clomid and a trigger shot for this cycle..... Any input?

 

[waitingongod1]

Wow that's great news. My insurance wouldn't cover a thing. That sounds good for a first iui. Hopefully it works but if it doesn't my doctor always likes to change things. Like maybe next iui try injections instead of clomid. He also didn't think it was worth it to do more than 3 before going to ivf. Everyone is different though. ..I have heard of people getting pregnant on that 6th iui haha. I did 2 iui and 1 ivf and got pregnant off the ivf. Good luck!

 

[rebecca822]

I also have Blue Cross and they cover both iui and ivf, up to $15,000 for the lifetime of the policy.
Basically once I hit 15 grand they won't pay anymore.

 

[TTCsince626]

I'm so happy to see people respond!
Waitingongod, I would love to just go straight to ivf but think I have to first attempt iui.... So great to hear you had success with iui


Rebecca, any chance you have nj Direct? They didn't tell me any caps. I believe they Said I have unlimited iui treatments

 

[rebecca822]

No I have Bcbs of Iowa. They told my clinic that my plans maxes at $15000

 

[Topanga053]

Call your insurance company and get a copy of your plan. If they cover it, it's not uncommon for there to be limits or conditions (ie must do a couple of IUIs before IVF, etc). I would read your specific plan yourself and not rely on the clinic to tell you what's covered. Personally, I also wouldn't trust the insurance company representative either--I've just had so many experiences where they're wrong and I have to point them to the language in my plan that says they're wrong. When you're dealinf with expensive treatments, I think you should absolutely have and read the plan for yourself.

 

[bunyhuny]

Like Topanga said, definitely get a hard copy of your policy. The few insurance companies that do cover IVF generally have a very specific set of things you have to try first unless you meet certain exemptions. If you're being covered due to state legislation, there definitely is an exact way insurance companies will do things. Lots of times you're required to do a certain number of IUI's before moving on to IVF, unless you're missing a tube or your DH has sperm numbers that are under certain thresholds.

If you can jump straight to IVF, that's definitely the fastest way to get pregnant, but that's going to really be up to your insurance policy.

Finally, CONGRATS on having insurance coverage for infertility. Not a lot of people have it and in a sea of crappy LTTTC struggles, the financial aspect is just a terrible additional burden. (You should see our credit card statements... ) I'm guessing you're in one of the states that mandates it. That's awesome!

 

[1nceUponATime]

I have bcbs, and they cover IUI and IVF (IUI has to be tried first unless there is a really good medical reason)....and there is no ceiling the policy said....but we paid for the most expensive insurance because we knew we had fertility issues before we signed on for the insurance plan....so we wanted a great policy.

 

[Mrs Pecan]

That is wonderful news! Be sure to confirm with your insurance company yourself just to be sure. Our RE's financial coordinator called to check our coverage for us, but we had already known we had zero fertility coverage. I have BCBS as well, but as of this past year our workplace switched to a lower tier plan so we lost our fertility coverage. Be sure to check if they insurance company has any conditions for covering treatment. Some will only cover IVF if you've done 3-6 IUIs or will only cover ICSI if the repeated SAs show certain conditions. It's also helpful to know how many rounds of IVF they cover, just in case. Some plans have a deductible, and coverage will only kick in until you've paid that amount (which ranges a lot: $2,000-$10,000) depending on the plan. It can be helpful to know if you have any out of pocket expenses first before coverage kicks in. Wishing you lots of luck!!