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 Posted: Tue Nov 03, 2009 11:29 am Post subject: Infertility - Does health insurance cover it??? |
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Is infertility covered under health insurance?
Is their any other infertility coverage?
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Whistle-in-the-air
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| Posted: Tue Nov 03, 2009 5:00 pm Post subject: |
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Some states require coverage for infertility treatments, others do not. As well, group contracts sometimes cover issues that individual policies don't. So, what state are you in and is this a group or individual policy that you're looking for coverage through?
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InsTeacher
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| Posted: Thu Nov 05, 2009 7:27 am Post subject: |
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I've recently applied for a new health policy and now I have this offer from my employer, which seems like a group coverage.
I'm yet to know the details of the coverage, but it says it will cover infertility too. I'm from FL and I don't have any pre-existing health condition.
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Whistle-in-the-air
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| Posted: Fri Nov 06, 2009 6:47 am Post subject: |
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| It's estimated that only about a quarter of our employer-backed health plans would cover for infertility. The benefits under such plans may also vary with each carrier. Some of the carriers would choose to cover specific drugs while others may simply demand a co-pay worth 50%. That's a good reason why many of us would choose to bear these expenses on our own. Roddick |
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roddick
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| Posted: Fri Nov 06, 2009 7:56 pm Post subject: |
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The following is copied in its entirety courtesy of http://www.fertilityproregistry.com
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States that mandate infertility coverage be provided
The states listed below have mandated that health insurance plans include coverage of all or some aspects of infertility services.
* Arkansas
* Hawaii
* Illinois
* Maryland
* Massachusetts
* Montana
* New Jersey
* New York
* Ohio
* Rhode Island
* West Virginia
Some of these mandates require that coverage be provided only by particular groups such as health maintenance organizations (HMOs). Many direct that certain medical conditions be met before coverage is provided. Some specifically mandate coverage for assisted reproductive technologies (ART), while others specifically limit or exclude it. A description of each state mandate is set forth by the American Society for Reproductive Medicine (ASRM).
States that mandate infertility coverage be offered
The three states listed below have mandated that insurance companies make available policies that cover infertility treatment. However the laws do not require that employers pay for such policies so that individuals may not find those policies available through their employers. The ASRM Web site noted above also summarizes these state mandates.
* California
* Connecticut
* Texas
States without mandates
The remaining 36 states do not have laws that require the provision or offer of infertility coverage. However several organizations are advocating the adoption of additional state infertility insurance mandates. Currently, campaigns to enact such mandates are particularly active in Florida, Maine and Pennsylvania. There also are ongoing efforts to strengthen the existing mandates in Connecticut and Texas. |
This should give a bit more info that could help the OP
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InsTeacher
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| Posted: Sat Nov 07, 2009 5:41 am Post subject: |
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| Thanks for bringing forth such an important topic of discussion. Infertility is something that can't be neglected. Infertility insurance coverage truly helps to finance the required treatments. Important areas like fertility tests, transfer of embryo and insemination (artificial) are covered under it. It has become mandatory across some states to provide infertility insurance. |
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steven
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| Posted: Mon Nov 09, 2009 10:18 am Post subject: |
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There are some carriers who wouldn't cover infertility stating that though it's a medical condition, it's certainly not life threatening. But in reality I'd come across a number of carriers who'd cover medical treatment for erectile dysfunction. Carriers would also try to establish the higher cost of covering infertility as an important factor for their argument.
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anonymous00
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JTInsure
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heidrek
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| Posted: Wed Nov 11, 2009 8:28 am Post subject: |
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it's good that some states require the coverage of fertility treatments and that some insurance companies offer coverage for the same. but only 11 states out of 50?
i just hope more states would start requiring that. fertility treatments are so expensive and there's no way average-income couples can afford it. it's as good (or as bad) as saying goodbye to their dreams of having kids. |
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choco
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heidrek
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trisela
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| Posted: Sat Nov 21, 2009 3:43 am Post subject: |
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Not quite sure what this means:
| Quote: | | You are more likely to get coverage if you have a group policy. I would recommend speaking to you insurance broker. |
Do you mean you recommend speaking with the agent about an individual policy?
The employee doesn't talk to the agent in a group plan. That's between the employer and the broker only. An employee has no input as to the coverage terms, provisions or anything else in a group plan. Many of the benefits are mandated by state law, and if optional coverages are available and desired, that's between the group sponsor and the agent/insurer. The employee is always free to speak with the employer about benefits, but cannot alter the terms of the coverage. It is what it is.
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