IVF with insurance coverage?

Question

If you have fertility coverage under your insurance what did it look like as far as what you paid out of pocket?
I went for my consult and they can't give me an exact breakdown yet because my new insurance doesn't start until Jan 1 - but the fertility center I go to is technically in network but they don't bill the surgery (retrieval or transfer) to insurance at all - and that is technically "out of network" - so it's $3500 retrieval and $2k per transfer. My insurance next year is a $25k lifetime fertility coverage and $10k fertility med coverage - which I obviously chose the expensive insurance coverage knowing we'd be doing IVF this year. I am wondering if I should get a consult with another fertility center to see if they will utilize my coverage better or if this is the norm? I love my doctor but obviously finances are a huge deciding factor in this. 
Please share your thoughts / experiences.

Answer

I’d contact my insurance. I’ve never really heard of a clinic being in network but the procedures they do being out of network. That’s kinda weird. The clinic might not want to bill those procedures to your insurance bc insurance might pay them too low. It’s technically a form of insurance fraud. If they’re in network, generally everything has to be billed through insurance especially if you have fertility coverage.

Answer

Switch somewhere where everything is in network. No brainer financially, though it might be more complicated otherwise!

Answer

I have bcbs with 750 ded and 4000oop. But the time we did the egg retrieval 4000oop was met. Granted there were a few other things not covered living freezing the embroyos and facility fee so that was additional 1500. By the time we did Fet I was covered at 100% just has to pay facility cost of 200.

Answer

Once we reached our deductible ($3,000-of which our employer covers $1500) everything was covered including meds for 2 rounds of IVF. 
I don’t think the clinic had anything to do with what was covered other than they accepted our insurance. Insurance dictated everything after that, based on what our employer opted in to cover.

Answer

Honestly, I'd switch clinics. Call your insurance company and see how your fertility out of pocket is set up. Mine kicks in AFTER my deductible has been paid and it only accounts for what we pay out of pocket. I just found this out today. But I'll put this into perspective: I've done a frozen transfer and traditional IVF. Those combined are close to 15k in charges. (I also had some out of pocket IUIs this year too) I have a 20k max for fertility. I've paid around 2500 (plus my 1500 deductible that doesnt apply to my max) so I still have 17k left for my maximum. This doesnt include meds. That being said, you want your out of pocket to be as small as possible! I'd you're paying extra because they won't bill to your insurance, you're only hurting yourself in the long run.

Answer

Call the new insurance company and ask. I had the same situation last spring, and called before I was active in my husbands. We have bcbs of ma, and everything was covered, I know this is rare but we are so grateful

Answer

For me, my insurance covers up to 70% of fertility treatments- does not cover meds. For our IVF cycle, we’re paying $8700 + meds (3-4K), and pgs testing (2K) bringing our totally to about 15K. Our frozen transfers after will cost us roughly 4K.

Answer

I think every insurance is different, but we paid about $500 total for all tests, medication, retrieval, and one FET.

Answer

Contact your insurance company for details of coverage. There are two portions that contribute to the ivf cycle. Ultrasound and lab will be billed as routine medical ( like your primary care/specialist obgyn). You will be responsible for copays and deductibles if you have one(this does not go towards your life time 25,000). Your fertility benefits may require a pre auth for your dr to move forward. With the anesthesia a lot of time is will be their party and will have to pay out of pocket but can submit to your insurance for reimbursement.