Need to find an insurance that will cover infertility treatments?
Thursday, July 1st, 2010 at
4:47 pm
Please can anyone help me. I have AETNA as my insurance provider. But it will not cover any infertility treatments. I really want to have a baby. My clock is ticking "35" So I will appreciate any info. I can get. THANK YOU!
Tagged with: aetna • clock • infertility • infertility treatments • insurance • insurance provider
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Actually there are some health insurance policies that cover some aspects of fertility. Unfortunately they vary widely by state. Some states even have laws regarding how much an insurance has to offer for fertility.
"Since the 1980s, 14 states, Arkansas, California, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia, have passed laws that require insurers to either cover or offer coverage for infertility diagnosis and treatment. Twelve states have laws that require insurance companies to cover infertility treatment. Two states, California and Texas, have laws that require insurance companies to offer coverage for infertility treatment. While most states with laws requiring insurance companies to offer or provide coverage for infertility treatment include coverage for in vitro fertilization, California and New York have laws that specifically exclude coverage for the procedure."
- http://www.ncsl.org/Default.aspx?TabId=14391
(from this link you should be able to find laws specific to your state.
If you are paying for your own insurance (not through employer) then there are some things you should remember.
First: DON’T TELL THEM. They can deny you coverage if you do.
Second: A lot of infertility stems from issues that a women might want to resolve whether or not she was to want to get pregnant. Thyroid, Progesterone, nearly any test for hormones.
Third: It’s all about the billing codes. As per #2 up there, learn to ask the right questions, chart your cycle and take it in to your gyno to ask why you don’t seem to be ovulating. If you go in saying "I want my body to work the way it was intended to work" they won’t be able to bill it as infertility.
Fourth: Most insurance that covers things that can really ONLY be related to fertility (IUI’s) are usually only through employers that get the extra package of fertility insurance to lure in couples to the company.
I personally am not lucky enough to be in a state that requires anything to be covered (Florida) HOWEVER I have an amazing OBGYN that is helping be get my hormones in check, which is going to (incidentally) bring me closer to being more fertile. She also doesn’t see anything wrong with using my pap as a time to discuss my ovulation.
I’ve worked in the insurance industry and as far as I know there is absolutely NO plan that will cover infertility treatments, as it is optional and not related to bettering your health. In fact that would actually cost the insurance even more money later on if you were to conceive they’d have to cover you’re OBGYN and birth costs (if pregnancy is even covered in your plan…many plans don’t or charge extra). AETNA is one of the very best insurance plans, if they don’t offer it I feel pretty safe saying no one else would. Sorry
( But if you really want it there are other ways. Double up on jobs for a while 
)
What state to you live in? I’m in NJ and if you’re a teacher you’re provided wonderful IF coverage. I worked for a hospital and got 50% coverage through them.
Blue Cross/Blue Shield individual policies in many states will cover infertility treatments (IVF for up to 6 cycles, for instance). However, you have to have the insurance for a period of time (18 months to 2 years, I can’t remember) before they would cover anything. However, my policy did not cover the drugs needed and that was around $2,000.
Also, I agree with acidgiltogo. There are a lot of things that can be covered if the word ‘infertility’ is not mentioned. Prepregnancy check up covers a lot of things including a lot that is ordinarily considered infertility treatment.