Post # 1
Admittedly, I’m a bit ignorant to the medical insurance world. I’ve typically worked for small companies where our insurance coverage options are limited and I just go with what they’ve got.
My current insurance covers infertility treatment up to IUI (so no IVF). Our RE will do 4 cycles of IUI before wanting to move to IVF, so our fourth cycle will be November if we do them each month starting with our next cycle.
We do not currently have enough stashed away for IVF. If we go down the IVF route, we want to do our clinic’s guarantee program (you get 6 cycles for $20k, if you don’t have a healthy baby by the end you get your money back). We just purchased a home and are rebuilding our savings, so we’d have to wait probably 1 year before being able to pay for IVF. Since our last cycle will be close to open enrollment, is it a bad idea to look at the marketplace to see if there are any insurances that cover IVF? I know we will be paying more each month, but if we did it for 1 year then next year switched back to my company’s, it may be less than $20k and would be spread across months.
Post # 2
I think it is worth at least looking into. It would really depend on the premium increase and any other trade-offs whether or not it’s worth it. For example, if you have to go with a significantly higher deductible it might not be worth it. Hopefully, your IUI will be successful and ths will be a moot point.
Post # 3
I did this. Kind of. Except we switched from my husband’s work policy(only IUI coverage) to mine (state mandates 3 IVF cycles) , didn’t use the marketplace. I would honestly be surprised if you can find any marketplace policies that cover IVF given so few private employers cover it at least not affordably. Also keep in mind many policies that cover IVF will require you to do a certain amount of IUIs first. Even if you do some IUIs this year using your work policy, you may need to start all over again with IUI in order to qualify for the Ivf coverage under the new policy. I agree with the previous poster to really check the cost. Some policies cover the procedures and office monitoring but not medicines. Others cover medicine only. I spent almost $10k per round on meds (totally uncovered) so just as much as the global ivf fee at my clinic. Even with insurance I spent about $5k per round of IVF for co pays so if I was paying super high premiums on top of that, you may not save enough to make it worthwhile. I’d suggest looking into a part time job at Starbucks. Their insurance coverage provides IVF coverage for all employees even part time after 3 months (I think). I’ve known a few Ivf friends that went that route and found it very easy to qualify.
Post # 4
We have great insurance and even then it only covers part of the doctor’s fee for IVF. Facility fees, anesthesiologist and genetic testing, and embryologist are not covered. And in California, there are ZERO embryokgiists who contract with insurance companies. We also have prescription med coverage which brings the price of one medication down to the bargain of $1450.00.
It is almost cheaper to cash pay because some pharmacies and doctors offer a lower cash pay rate than insurance rate.
Post # 5
6 cycles for $20k is a steal. Seriously, it’s $16-17k for one cycle where I am (I’m on day one of stims). The meds alone are $6000-7000. I’d do your IUIs and save your money. I think it’s incredibly rare for marketplace insurance to cover ivf (ivf is rarely covered and it would most likely be excluded due to pre-existing condition of “infertility”). Doesn’t hurt to look, but workplace group insurance is your best bet. Or get a job at Starbucks!