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IVF Insurance coverage?? Cigna

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IVF Insurance coverage?? Cigna

Postby priceline » Thu Jun 09, 2005 6:39 pm

I work for forture 100 company in US and have cigna PPO plan. I was told that my insurance wont cover the IVF costs. We already tried once, but unfortunately it was failed. But on the message board, I read that cigna covers for this treatment.

Is it related to the company plan? or can I make any changes to the plan, so that it would cover? Or Is there any other places I can take insurance? What are my options? Thanks,
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Postby HM » Thu Jun 09, 2005 9:27 pm

state of connecticut has not passed a bill for insurance companies to cover infertility treatment. I know insurance companies in NY state are required to offer the coverage, employees have option to choose. The CT Governor is against the bill in my impression because it will only benifit a small group of people like us and increase the overall healthcare cost.

I have Cigna too under my husband's company's plan. It doesn't cover a dime. After searching around I finally end up with a clinic in NYC. Their cost per cycle is about 1/3 or so of the CT's clinics' cost.

If you work for Priceline.com in CT, traveling to NYC isn't a bad idea to get the treatment at a much cheaper cost.

Good luck.

HM
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Postby Mil » Fri Jun 10, 2005 1:09 pm

Hello! IVF coverage by insurance companies has nothing to do with the actual insurance company. It has to do with the company you or your spouse work for. The employer has to choose this option. However, many companies, unless required by the state, do not choose this option because of the cost associated with it. The employer has to purchase what is called an underwriting policy and they have to pay for each employee weather they will have the procedure or not.

For example, I have 10 employees and I purchase the policy and it costs $10 per employee so I have to pay $100 per year even if it is not used.

Here is a website I found that talks about the different state coverage. Many states are required to cover infertility but not IVF. My husband’s employer covers infertility & artificial insemination but not injectable meds or IVF.



I hope this helped! Good luck!
Me: 30 y/o DH 29 y/o
TTC: 3.5 yrs -- Severe Male Factor
IUI: 6 attempts... 2003-2004
1st IVF cycle: Cancelled... Jan/Feb 05
2nd IVF cycle (ICSI)... Apr/May 05 - POSITIVE
Due: 1/20/06
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Postby priceline » Fri Jun 10, 2005 3:01 pm

I live in WA. My wife doesnt work. Seems like I have to pay everything out of pocket. We are getting the treatment from Virginia mason. Is there any other hospitals in seattle area do the IVF?
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Postby Mil » Fri Jun 10, 2005 7:00 pm

Sorry to hear you have to pay for everything out of pocket. So did we. We tried IUI 6 times which our insurance company covered but it didn't work. Once we switched to IVF we had to pay for everything. I'm not pregnant so it was all worth it. In total it cost us about $15,000 with medication.

Here is a link to the CDC website which lists all the clinics in WA as of 2002 with their success rates.

http://apps.nccd.cdc.gov/ART2002/clinli ... p?State=WA
Me: 30 y/o DH 29 y/o
TTC: 3.5 yrs -- Severe Male Factor
IUI: 6 attempts... 2003-2004
1st IVF cycle: Cancelled... Jan/Feb 05
2nd IVF cycle (ICSI)... Apr/May 05 - POSITIVE
Due: 1/20/06
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Postby Sand » Fri Jun 10, 2005 7:05 pm

Mil ... I do hope that was a preggy typo, and you ARE pregnant ! :wink:

Sandra x
Me 41 yrs old - dh 49 yrs old. ttc 110 yrs.
1st cycle (ICSI)....Mar 04 -ve.
2nd cycle (ICSI)....Aug 04 -ve.
3rd cycle FET........May 05 -ve.
4th cycle (ICSI) ... Feb 06 -ve
5th cycle FET ..... Feb/Mar 11
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Postby HM » Sat Jun 11, 2005 1:41 pm

Thanks for forwarding the link. You are right, it's something to do with employers who offer employees the infortility coverage.

Here is a link that I read a week ago on Stamford Advocate.
http://www.stamfordadvocate.com/news/sc ... 6258.story

So you are saying that even employer offers the coverage, it will only cover for infertility but not IVF? About 2 years ago my husband worked for Walker Digital (one of Jay Walker's company, who is the founder of Priceline.com), and we had Oxford; it didn't cover anything we were looking for when we first started looking for medical help.
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Postby ogr1 » Sat Jun 11, 2005 2:20 pm

first i would like to welcome you to the forum..
this forum has helped me many of times.
and have found many wonderful friends..
it is great to beable to laugh and cry and go crazy with friends who no what i am feeling and have gone threw..

back to your question

call your clinic and ask them what insurance they have had
succces with getting paid ..
they normaly know what ones pay and what ones dont..

i was on blue sheild '/ blue cross and when i was 4 months pregnant they
dropped me cause i did ivf..

we paid for all of our ivf and all the test and all the meds and then had to go back and re pay the insurance company for what they had pay..

i dont know about the clinics there..
mine was in spokane wa.. and dr. robbins and his staff where great.
i was able to get pregnant twice threw them and they where right by my side all the way..

sometimes if you switch insurance they will put a clause and not cover anything to do with trying to get pregnant or cover if you do get pregnant
.. this can be for 3 years..

i hope this helps some..

insurance companies can be very tricky.. read all of the fine print.....
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Postby priceline » Fri Jul 22, 2005 8:27 pm

My company is also offering HMO. I called HMO insurance, and I was told that it will be covered if I take comprehensive. But I am still in doubt whether they actually cover for IVF.

Is there any specific codes to ask the insurance companies to find out exactly?

One of the doctor with VM has left and she is trying to setup a new hospital. VM hasn't recruited anybody yet. So probably we will wait until next year for the next cycle.

Whenever we think about the process, we are litterally scaring..:(, well, atleast we have a hope as it is working after some attempts..
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Postby HM » Sat Jul 23, 2005 9:15 pm

I know your concern, money is a big issue when it comes to such an important decision. All I know is that most insurance companies only cover for qualified infertility treatment, but not IVF. But I want to tell you my story.

When we first decided to do IVF, we have searched a few IVF clinics, and only blood and scan works were covered by insurance, but not the IVF part. So we decided to wait for a while and try to get pregnant by ourselves. Then a year and a half passed by, we still had nothing. Our insurance plan hasn't changed. We are getting older, my husband turned to 42, and I turned to 36 this years; chances are not favoring older couples like us. We finally went for the IVF at our own cost. Now I'm 8 weeks pregnant with triples. We only spent a bit over $10,000 for 1 cycle including hormone medication. Of course the cost depends on individual's case and health condition. The joyful result make us think that money well worth spent.

If you are sure that you will get a coverage in some later time, and you are not too old to start, I would say you should wait; otherwise, you should get started as soon as possible because the old the woman's age, the less chance to succeed. I don't want to scare you or try to urge you to do what you are not sure about. IVF decision is so personal. It's just my thought that having a baby is such important thing in our life, and your life too, so that I would do anything to get it done.

Good luck to both of you and pray for you to have the solution soon. Remember, the earlier the better.

Love to hear from you soon.
HM
June 05: EC 22; ET 3; FE 12.


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Postby priceline » Mon Jul 25, 2005 4:08 pm

Thanks HM.

Yeah, she is 31 and I am 32. Anyway I have to wait for couple of months as there is big changes happening in my area for IVF treatment. Few doctors are setting up a new facility, etc.,

So we probably wait for 2 more months and see if my insurance will cover. Worst case, I can max out my FSA for the next year.
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Postby LISA@BELLASALES » Tue Jul 26, 2005 9:26 am

MOST INSURANCE COMPANIES WILL NOT COVER THE ACTUAL IVF. THEY WILL COVER ALL THE EXPENSES LEADING UP TO IVF. ie MEDS, SONO, BLOODS. WE HAVE TO PAY FPR THE ACTUAL EC & TRANSFER. THAT IS NOT THAT MUCH MONEY , ALL THE OTHER STUFF IS WHAT IS EXPENSIVE. OUR MEDS IF WE HAD TO PAY OUT OF POCKET WOULD BE OVER $6000.00. :shock: EACH COMAPNY IS DIFFRENT AND YOU HAVE TO REALLY RESEARCH YOUR BENEFITS. GOOD LUCK.
LISAMARIE
Me 36 DH 31
April 2007 - BFP!!!!!

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Re: IVF Insurance coverage?? Cigna

Postby alstonamos » Tue Apr 12, 2016 5:11 am

So we probably wait for 2 more months and see if my insurance will cover. Worst case, I can max out my FSA for the next year???



== Solitaire ==
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Re: IVF Insurance coverage?? Cigna

Postby xenia » Tue Apr 26, 2016 3:32 pm

I just stumbled across this link w*w.self.com/trending/2016/04/american-women-are-traveling-abroad-to-get-ivf-treatment/ and found it useful. If yr insurance doesn't cover ivf, may it worth considering overseas clinics? I have read comments and reviews on various fertility forums, where ladies praise fertility clinics particularly in Poland cause of affordable prices.x
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Re: IVF Insurance coverage?? Cigna

Postby rahulkumar123 » Wed Oct 26, 2016 9:47 am

If yr insurance doesn't cover ivf, may it worth considering overseas clinics? In India, it can be cost effective for you
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