View Full Version : IVF Insurance in MASS
jencam56
Sep 7, 2007, 08:12 AM
My husband and I just found out that we have to have IVF (in vitro)to conceive. We don't have any insurance right now, and we need to find who will cover this. There has been past failed pregnancies with the result of surgery as well. Do you know of any companies that will consider us?
Emland
Sep 7, 2007, 08:25 AM
I hope this doesn't sound rude, but if you don't have insurance and do manage to conceive, how are you going to manage the OB and hospital costs?
My girlfriend went through multiple IVFs and spent 10s of thousands of dollars out of pocket and was never able to conceive.
jencam56
Sep 7, 2007, 08:46 AM
My husband recently changed jobs so his insurance hasn't started yet. We just want to make sure we pick up the right policy to cover it.
Also, we are both veterans of the Army. All my OB costs and hospitals visits are taken care of.
That was rude. That was none of your business though. That was NOT what I was asking. I want to know what policy and who we should get the insurance through.
His company has Blue cross and we need to see if they cover this, but I don't know how.
LearningAsIGo
Sep 7, 2007, 09:32 AM
When his company gives him the information of what they offer, you'll have the informaton (contacts) in front of you. You can either call BCBS or his HR benefits coordinator at work to inquire about IVF specifically.
Its all very individual based on options his company chooses to provide. (I once had BCBS and my mother did as well but since we worked for different companies our policies were entirely different) If they don't you could start calling secondary insurance companies individually to inquire what you would be covered and at what cost to you.
*edit* BCBS = blue cross blue shield
jencam56
Sep 7, 2007, 09:38 AM
Thank you for that. I will look into it
ScottGem
Sep 7, 2007, 09:38 AM
If his company only offers one insurance program, then you need to speak to a benefits rep about what is covered. If IVF is not covered, then I doubt if there is a separate policy you can get.
As far as Emland being rude, I'm afraid you were offbase there. You may not fully understand how a site like this works. When you post a question or comment, you are opening yourself for others to comment on what you post. I think Emland's comments about considering the costs of parenthood when you don't have insurance was pertinent.
jef1056
Sep 12, 2007, 12:18 PM
IVF is mandated in MASS. All group products will pay for it.
Infertility Benefits
(Except a policy which provides supplemental coverage to Medicare or other governmental programs and
Dioceses)
______ According to M.G.L. c. 176G, § 4, policies “shall provide, to the same extent that benefits are
Provided for other pregnancy-related procedures, coverage for medically necessary expenses of
Diagnosis and treatment of infertility to persons residing within the commonwealth.. . [and]
‘infertility’ shall mean the condition of a presumably healthy individual who is unable to
Conceive or produce conception during a period of one year.” (See also Bulletin No. 95-08)
______
______
According to 211 CMR 37.05, “[s]ubject to any reasonable limitations as described in
211 CMR 37.08, insurers shall provide benefits for all non-experimental infertility procedures
Including, but not limited to:
(1) Artificial Insemination (AI);
(2) In Vitro Fertilization and Embryo Placement (IVF-EP);
(3) Gamete Intra fallopian Transfer (GIFT);
(4) Sperm, egg and/or inseminated egg procurement and processing, and banking of sperm or
Inseminated eggs, to the extent such costs are not covered by the donor's insurer, if any;
(5) Intracytoplasmic Sperm Injection (ICSI) for the treatment of male factor infertility;
(6) Zygote Intrafallopian Transfer (ZIFT).”
______ According to 211 CMR 37.06, “[I]nsurers shall not impose exclusions, limitations or other
Restrictions on coverage for infertility-related drugs that are different from those imposed on any
Other prescription drugs.”
______ According to 211 CMR 37.08(1), “[n]o insurer shall impose deductibles, copayments,
Managed Care: Health Maintenance Organization Ver. (053107) Page 23
Coinsurance, benefit maximums, waiting periods or any other limitations on coverage for
Required infertility benefits which are different from those imposed upon benefits for services
Not related to infertility.” Please confirm that the carrier complies with this requirement.
______ According to 211 CMR 37.08(2), “[n]o insurer shall impose pre-existing condition exclusions or
Pre-existing condition waiting periods on coverage for required infertility benefits. No insurer
Shall use any prior diagnosis of or prior treatment for infertility as a basis for excluding, limiting
Or otherwise restricting the availability of coverage for required infertility benefits.”
Hormone Replacement Therapy and Contraceptive Services
(Except contracts purchased by a subscriber that is a church