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When we first started our IF journey, we didn't have coverage for anything infertility related. We paid for a lot of the testing, medication, and 3 IUIs out of pocket.
Before we started IVF, DH got a new job with very generous insurance benefits and we do have coverage for fertility treatments. I feel very fortunate to have this considering our first IVF was unsuccessful, and our second ended in a loss. We will be pursuing FETs next.
Unfortunately I agree with @Mrs. Polish, I think far too many people have the ignorant attitude that infertility isn't a disease. They don't understand what it is like to go through it, and therefore won't do anything to help people who are. Until you've lived it, you can't truly understand.
@alphagam84: A lot of the issues causing infertility do make you sick, very sick in fact. Between PCOS on hypothyroidism, they cause many other medical issues for me besides the infertility.
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@ShootingStar: ah. My company used to offer BCBS which was so much better. They only offer United plans now which pale in comparison.. DH has been toying with the idea of a new job so I'm truly he'll find one that offers a plan with better coverage, especially if the next round does not work. Or at least a huge raise to pay for it lol
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@Mrs. Polish: I agree that a majority of people don't get it. And part of the problem, I think, is that we don't talk about it...and there are government officials that are willing to say that, just because they haven't had any personal experience, it's not a legitimate concern. As so many pp's have said, it's really sad that concerns about the cost of conceiving a child should dictate anyone's family size...or lack thereof.
@alphagam84: This is exactly the problem. And you could use the same argument to say that insurers shouldn't have to cover antidepressants, medication for erectile dysfunction, or birth control. Cause aside (and some of the myriad causes do make people quite ill), infertility can be every bit as stressful and hazardous to individuals' mental well-being as a cancer diagnosis.
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Our provincial insurance covers the diagnostic and even monitoring during a TI or IUI cycle but there is no coverage for IVF unless you have bilateral tubal blockage. My work covered $2,500 in meds which took no time to use up!
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I live in Oregon and have yet to see a policy that covers IF treatments - there is no state mandate here. My insurance comes from a catholic organization, so they especially wouldn't cover it even if mandated I think. Funny though, that they will cover you having 1,000 babies naturally but not with help. I mean, I get it, but it still sucked when I needed IF coverage. We paid totally out of pocket. Thank God it only took one IUI for us. Even that cost us about $2500.
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Just diagnosis, which was gone a long time ago. I do have prescription med coverage as long as it's a med that can be used for other things besides fertility. If it's just for fertility, it's a big fat no.
My insurance does cover acupuncture/chiropractor. Never been to a chiropractor before.
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@bluestriped bee: I was similarly amazed that some of my FET meds were covered... And, of course, BCPs were free!
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@PurplePumps: Yep, BCBS in MA. I knew IVF was covered in one form or another, so I just waited for my clinic to submit all my tests, request the approval for IVF, and waited for that to arrive. Calling to ask in advance didn't give me a lot of confidence.
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@alphagam84: I do respect your opinion as everyone is entitled to one. However, as previous posters have mentioned, I believe some education is needed to make a well-informed decision regarding your statement of IF not being a disease. I never chose to be diagnosed with infertility, as other ladies who have been diagnosed with infertility well know. What I have experienced has been both mentally & physically draining & I would wish it upon no one. I live a relatively active & healthy lifestyle so to say that this is not a disease that insurance should cover, in my honest opinion, is like a slap in the face. I'm on the hook to pay for other people's diseases such as obesity (which may or may not be a lifestyle choice as well) so is it not right that I receive assistance with an issue that is pertinent to me?
I am grateful that I have infertility coverage which includes testing, bloodwork, ultrasounds, meds, & IUIs. Unfortunately, IVF & IVF meds are not covered (which is odd since some of the injectable meds are covered if it's for IUI). I'm happy that I do have this coverage as so many others are financially limited in their ability to have a family. I've actually asked my clinic if I could donate my unused meds so that other women in the clinic would not have to pay exorbitant amounts for the same meds that cost me $5. Alas, they said they aren't allowed to accept mine. Apparently it would be illegal if I were to give them away too.
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@FliegepilzHut: I understand what you mean when you say "we don't talk about it". It's hard to talk about though. It is exhausting and at the same time you're going through treatments with your eye on the prize, and it's all so draining. Also, most people end up getting pregnant and moving on, so it's hard to keep the focus on it after "graduating".
It's tricky and sucky.
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@Mrs. Polish: That wasn't meant as a criticism...I just feel like it really is an invisible problem at times. If enough of us kick a fuss, surely things will have to change...someday.
I am planning to write my newly elected (though I sure as heck didn't elect them) Congressmen!
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@FliegepilzHut: I didn't take it as a criticism at all! I have thought about it a lot is all
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@Mrs. Polish: I see. You're right, then. It IS tricky...
I just wish we, as women, could band together...because if it's not our issue specifically, we should advocate because it's our friend's or sister's, shouldn't we?
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@FliegepilzHut: yes, we should. The issue I see though is that while infertility IS a disease, it isn't life or death. I've never heard of anyone dying because they couldn't get pregnant.
It's hard to make it a priority issue when the majority of people see it as just not getting what you want.
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@Mrs. Polish: I wonder how it happened in all of those other countries (parts of Scandinavia, England, Israel)? Maybe because of a population downturn? Maybe it'll never happen while the market is majority private? I wonder how it worked in MA???
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@ShootingStar: @Shutterbug: @ineebee: Do you all know how the IF coverage came about in MA? Was it part of the original legislation?
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@FliegepilzHut: I'm not sure what you mean by original legislation. It's been around for a few years now.
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@FliegepilzHut: I found this:
Summary
Mass Gen Laws Ann. Ch. 175 and Ch. 176 and 211 CMR 37.00, enacted in 1987 and amended in 2010, mandates that insurance companies in Massachusetts must cover infertility diagnosis and treatment for individuals, which certain limits and exemptions, but covering the following procedures:
Artificial Insemination (AI); In Vitro Fertilization and Embryo Placement (IVF-EP); Gamete Intra fallopian Transfer (GIFT); 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; Intracytoplasmic Sperm Injection (ICSI) for the treatment of male factor infertility; Zygote Intrafallopian Transfer (ZIFT). -
I cant remember where I saw the info, but its been mandate in MA since 1987 or 89.
And on http://www.resolve.org/family-building-options/insurance_coverage/state-coverage.html
it actually says:
MASSACHUSETTS
1987
Mass Gen Laws Ann. Ch. 175, Section 47H, ch. 176A, Section 8K, ch.176B, Section 4J, ch 176G, Section 4, and 211 CMR 37.00Definition of Infertility/Patient Requirements
Infertility means the condition of a presumably healthy individual who is unable to conceive or produce conception during a period of one year.
CoverageAll insurers providing pregnancy-related benefits shall provide for the diagnosis and treatment of infertility including the following: artificial insemination; IVF; GIFT; 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; ICSI; ZIFT.
Insurers shall not impose any exclusions, limitations or other restrictions on coverage of infertility drugs that are different from those imposed on any other prescription drugs.
The law does not limit the number of treatment cycles and does not have a dollar lifetime cap.
ExceptionsInsurers are not required to cover (but are not prohibited from covering) experimental infertility procedures, surrogacy, reversal or voluntary sterilization or crypopreservation of eggs.
Employers who self-insure are exempt from the requirements of the law.Which is definitely not true in my case. I have lifetime max for procedure and meds, and I think the other MA bees have a 6 cycle max too. There must be other loop holes for ins to not provide what this says. I work at a company of 80k, so we're definitely not small.
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@PurplePumps: lol jinx
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@Shutterbug:
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@Shutterbug: @PurplePumps: Wow! Thanks! Again my current state has a mandate that passed in 1989...but it's completely worthless because it exempts HMO's...and therefore applies to almost no one.
I am planning to write my newly elected (though I sure as heck didn't elect them) Congressmen!
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