Hellobee Boards

We have 50% up until IVF (so IUIs, Clomid, etc) through our HMO (Kaiser). I don't know how it differs from your plan but it was really helpful. We got our BFP right before starting treatment but because I was in the HMO they covered a lot of our diagnostic and blood tests under my OBGYN coverage (so it cost us nothing) instead of making us pay 50%. We got a price sheet from Day 1 and knew how much everything would cost us and it allowed us to sign up for our FSAs during open enrollment to put a chunk of money aside before taxes to help pay for our projected expenses. Plus our billing and health info was all integrated so it was all really easy. But it was through Kaiser's own reproductive health center so again I don't know how it would differ from you. Anyways, we were a fan.

I think it definitely depends on the individual plan. We have an HMO through BCBS that technically doesn't cover infertility but for insurance, infertility treatment is usually defined as IVF (and variations of it) and injectible medications. Since our plan covers testing at 100% and many non-injectible meds with a copay, I just had to pick a fertility clinic I wanted to go to and call my PCP to put in a referral. Every plan will handle the copays differently but for us I only paid a copay for consults.

Other than the IUI coverage, how are the plans?

we have had an HMO (in MA so state mandated IF coverage). it worked out really well and made things super affordable, but we had the advantage that we didn't even need referrals as long as all the doctors were part of the same hospital network (which in Boston is pretty easy). the few times I had to get referrals for non-IF things it was no big deal, just call and they do it for you, no problem (call PCP's office and say "I have an appt with X can you send the referral). our HMO made my hospital birth and our IF treatments pretty cheap.

that said, I wouldn't make a job decision based on coverage. you don't even know how much it will save you and it's not worth ruining your day-to-day life. and if it's only IUI coverage, I would definitely consider the job over the insurance.

my DH just got a new job which means we will only have coverage for initial consults. it sucks after having almost full coverage, but I think it's worth it for the longer-term career implications for him. that may be different than what you are facing though.

@brownie: FWIW, I grew up with an HMO and went to Kaiser for one year and didn't like it at all. A lot of people love Kaiser, but a lot of people hate it also.

Also... why is it that you will never see your kid? I'm so sorry, but I don't know any of your back story.

@gingerbebe: Yea. A lot of people love it. And I think its just maybe getting used to the system. SoCal has some great looking Kaiser hospitals.

IUI's are relatively cheap (compared to IVF) so 50% coverage would not be worth it to take a job I think I might not like. Now if IVF was partially covered, thats a different story!

I also have HMO that covers 50%. My biggest headach is that you can only go to the doctor they assign, so if its an RE you don't care for your out of luck. Also, you need a referral from your PCP and I need re-referrals every few months.