Post # 1
Member
797 posts
Busy bee
- Wedding: September 2017 - California
I called up my insurance company to get more information about my infertility coverage and they were not able to give me any information whatsoever about whether or not the new IVF mandate that’s supposed to go into effect in January in NYS will apply to my plan. I don’t want to ask my HR department because I assume they won’t have any more information and I don’t want to reveal that I’m looking into IVF. I asked them very generally about changes to the plan in January and they just told me that changes to the plan generally don’t happen until the following coverage year (which won’t start until Fall 2020). Does anyone have any idea whether or not the new mandate will require insurance plans that qualify to start covering IVF in January or only in the next plan year? Has anyone been successful in getting information from your insurance company or are there any good resources about the law that give more detailed information? So far I’ve been able to find basically nothing other than a few news articles which describe the new mandate at a very general level. It’s so frustrating! I can’t even find the text of the law itself. Anyone have any better luck getting information? Thanks!!
Post # 2
Member
3801 posts
Honey bee
A quick google search tells me that all large plans (100+ employees) are required to include this mandate. How big is your company? If they are smaller or your plan is not insured through your company, you likely would not be covered. Going into effect on 1/1/20 means that this will take effect for the 2020 plan year (which we are currently in open enrollment for).
Post # 3
Member
797 posts
Busy bee
- Wedding: September 2017 - California
whitums : Thanks, yes I saw the same things when Googling which gave me some hope because my company *seems to* fit within the parameters (size etc.) but insurance can get so complicated. My open enrollment is already over. My company’s plan year isn’t January – December, it’s October – September. I’m hoping that doesn’t mean that the new rule, assuming it applies, only goes into effect in October 2020.
Post # 4
Member
3801 posts
Honey bee
zstbee84 : I work for a company that helps small businesses find health insurance. It’s basically our job to gather health insurance policies from carriers all over the country and host them online. Insurance carriers have to have their plans for each plan year approved by the state for coverage, rates, etc. If there is a requirement that hits January 2020, your plan should cover that even if your open enrollment is at a different time. The thing is, the carrier is required to give you all of your plan coverage information, so it makes no sense that they basically did not know the answer. I would keep calling them until someone gives you the full listing of coverages for 2020 for your specific plan. It’s crazy that they told you they didn’t know! You could also ask your HR department for your plan details (not just a summary of benefits, but the full plan). You don’t have to specifically ask for infertility services.
Post # 5
Member
797 posts
Busy bee
- Wedding: September 2017 - California
whitums : It really does seem crazy! I have called twice so far and both insurance company reps told me the same thing. I am going to give if a couple of weeks then call again in December. Separately my HR rep said the currrent plan details are in effect until next October. They weren’t aware of any changes coming in January and just said that generally once the plan is set they won’t make changes until the following October. I didn’t ask about changes in the law and how that might require earlier changes to the plan, so maybe they were not thinking of that.
Post # 6
Member
797 posts
Busy bee
- Wedding: September 2017 - California
Any other bees living in New York State and navigating this issue?
Post # 7
Member
797 posts
Busy bee
- Wedding: September 2017 - California
Anyone? It boggles the mind how difficult it is it just fine the full text of this law. I tried searching the NYS government database of laws and found nothing. None of the news articles seem to link back to the law. They give super general information but nothing about when the law kicks in if you are mid-plan year in January. Nothing about RPL and if that counts as “infertility” since it is a distinct condition.
Post # 8
Member
797 posts
Busy bee
- Wedding: September 2017 - California
I am planning to call my insurance company for a third time on Monday. They seem extremely disorganized in light of the fact that they knew this law was coming down months ago. Some of these news articles are from the Spring so it’s not like some kind of surprise.
Post # 9
Member
4995 posts
Honey bee
zstbee84 : how absolutely frustrating. Can you call the fertility agency and ask them if anyone’s coverage has changed// service coverage has changed?
Post # 10
Member
3651 posts
Sugar bee
- Wedding: April 2016 - Manhattan, NY
zstbee84 : I’m a NYS employee and my insurance plan does cover IVF already, but when I got my authorization letter (I’m pursuing IVF) it mentioned that as of January 1, 2020, 3 rounds of IVF will be covered. There is prescription drug coverage as well but it was a very general statement. I hope you’re able to get more information!
Post # 11
Member
797 posts
Busy bee
- Wedding: September 2017 - California
lifeisbeeutiful : Did you mean call my fertility clinic? I called them but they just said they were aware of the law but had no info on how it might impact their patients specifically.
Post # 12
Member
797 posts
Busy bee
- Wedding: September 2017 - California
ladyvictoria : Thanks for sharing! That’s interesting about the Jan 1 note in your authorization letter — it does sound like there was a change in your coverage as a direct result of the law.
Post # 13
Member
3473 posts
Sugar bee
Took me less than 60 seconds to find your answer.
You won’t be covered until the date your next plan year starts (October 2020).
https://assembly.state.ny.us/leg/?default_fld=&leg_video=&bn=A02817&term=2019&Summary=Y&Memo=Y&Text=Y
Look at the Effectivr Date section in the summary.
Post # 14
Member
797 posts
Busy bee
- Wedding: September 2017 - California
zl27 : Thanks, not sure why I had such a hard time! Unfortunately I will be almost 37 at that point so the timing is quite bad for me and not sure it makes medical sense for us to wait an entire year more. Ugh. I will still call the insurer to confirm but if that is accurate I am pretty irritated that we bothered to wait and miss our clinic’s last IVF cycle of the year and that the insurance company couldn’t at least tell me this on the phone when I called. I specifically asked if they at least knew when any changes would come into effect and I specifically told them that my plan was renewed in October and asked what the impact of that would be given that my HR department said that that meant nothing would change until next October.
Post # 15
Member
797 posts
Busy bee
- Wedding: September 2017 - California
zl27 : Also, just out of curiosity, how did you find that? When I run searches for “infertility” on the website it keeps pulling up bills that have not been passed into law. I must have been doing something wrong with my searches but not sure what!
EDIT: Never mind, figured it out. Apparently it pops up pretty easily on Google. Makes me feel like a crazy person because I searched and searched before today and found nothing. I wonder what terms I was using that I did not find it. So bizarre!
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