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.
InsTeacher
8) 8)
Posted: Tue Dec 01, 2009 05:29 am Post Subject:
I just don't understand how to find out if the insurance do cover the infertility treatment. Because eventhough I live at one of the state that hv mandate to cover, but still, infertility treatments include in 'do not cover' or 'exclusion'... So, how to understand the insurance coverage?? I look likes find a dead end street now..Pls, help me.
Posted: Tue Dec 01, 2009 05:41 am Post Subject:
I just don't understand how to find out if the insurance do cover the infertility treatment. Because even though I live at one of the state that hv mandate to cover, but still, infertility treatments include in 'do not cover' or 'exclusion'
Not knowing what state it is, I can't really help. If you'll look carefully at the listing of states that I provided, there are a couple of different concepts at play here:
States that mandate infertility coverage be provided
is different from
States that mandate infertility coverage be offered
"Provided" means that the coverage must be in the plan by law; a plan cannot be sold without the coverage. "Offered" means that the coverage is likely available as an additional option to the plan but isn't required by law to be included.
As well, did you see this part?
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).
So, there's a lot more to it. Tell us what state you're in and we'll see what we can do to assist!
InsTeacher 8)
Posted: Tue Dec 01, 2009 05:56 am Post Subject:
Well, I live in MA with 'states that mandate to covered' and with regulation that every residents hv to hv health insurance. But with my current health plan, it still notice at ' do not cover'. So, which health plan do I should take since we enroll in health plan with commonwealth connector, and they determine by the family income?
I just don't get how lucky to live in a state that mandate to cover infertility treatments :(
Posted: Tue Dec 01, 2009 06:12 am Post Subject:
Megan, the Massachusetts state explains everything. Massachusetts, as you know, is a state that requires you be insured. The Commonwealth Care plan that you refer to is your state's pool of coverage for those who meet income and other guidelines and requirements.
Now it depends on what plan you have. Can you give me the specific name of your plan? Here's a link that might help you:
Posted: Thu Mar 25, 2010 04:06 am Post Subject: IVF treatment
massachusette.......by law they have to include IVF in your ins. plan or not???
Posted: Tue Jan 31, 2012 08:28 pm Post Subject: Any infertility tips?
My husband and I have been trying for about 18 months now and we still have no baby. I don't want to do IVF or anything like that. I'd like to stay natural if I can.
Does anyone one know how you can increase your fertility or chances of conceiving?
Posted: Wed Feb 01, 2012 03:24 pm Post Subject:
This is not really an insurance question. Try consulting a gynecologist. And best of luck.
Posted: Fri Feb 03, 2012 08:33 pm Post Subject:
Hello there,
In most cases there are medical problems that cause infertility and I wish health coverage did cover the expense. Sometimes it is unknown/unexplained infertility. I have first hand experience with infertility. I wanted to bring the costs down since I'm self-pay for the IVF cycles, and I learned that I am not insurable!!! (for an individual plan) because of preexisting medical condition (infertility). Worse off - My DH AND, GET THIS, my unborn children are ALSO not insurable for the next 5 years!!!!!!!! My unborn children are not insurable (in an individual plan) because mommy can't conceive, What? (crazy!) The insurance sales person said I could get another type of insurance, but it might be $1000-2000/month! AND - they don't cover infertility!!
Posted: Wed Nov 18, 2009 05:55 am Post Subject: insurance
thanks for such nice information....you can also look for International Travel Insurance
Posted: Sat Nov 21, 2009 03:43 am Post Subject:
Not quite sure what this means:
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.
InsTeacher
8) 8)
Posted: Tue Dec 01, 2009 05:29 am Post Subject:
I just don't understand how to find out if the insurance do cover the infertility treatment. Because eventhough I live at one of the state that hv mandate to cover, but still, infertility treatments include in 'do not cover' or 'exclusion'... So, how to understand the insurance coverage?? I look likes find a dead end street now..Pls, help me.
Posted: Tue Dec 01, 2009 05:41 am Post Subject:
I just don't understand how to find out if the insurance do cover the infertility treatment. Because even though I live at one of the state that hv mandate to cover, but still, infertility treatments include in 'do not cover' or 'exclusion'
Not knowing what state it is, I can't really help. If you'll look carefully at the listing of states that I provided, there are a couple of different concepts at play here:
States that mandate infertility coverage be provided
is different fromStates that mandate infertility coverage be offered
"Provided" means that the coverage must be in the plan by law; a plan cannot be sold without the coverage. "Offered" means that the coverage is likely available as an additional option to the plan but isn't required by law to be included.
As well, did you see this part?
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).
So, there's a lot more to it. Tell us what state you're in and we'll see what we can do to assist!
InsTeacher 8)
Posted: Tue Dec 01, 2009 05:56 am Post Subject:
Well, I live in MA with 'states that mandate to covered' and with regulation that every residents hv to hv health insurance. But with my current health plan, it still notice at ' do not cover'. So, which health plan do I should take since we enroll in health plan with commonwealth connector, and they determine by the family income?
I just don't get how lucky to live in a state that mandate to cover infertility treatments :(
Posted: Tue Dec 01, 2009 06:12 am Post Subject:
Megan, the Massachusetts state explains everything. Massachusetts, as you know, is a state that requires you be insured. The Commonwealth Care plan that you refer to is your state's pool of coverage for those who meet income and other guidelines and requirements.
Now it depends on what plan you have. Can you give me the specific name of your plan? Here's a link that might help you:
https://www.mahealthconnector.org/portal/site/connector/
Let us know and we'll see what we can do.
InsTeacher 8)
Posted: Thu Mar 25, 2010 04:06 am Post Subject: IVF treatment
massachusette.......by law they have to include IVF in your ins. plan or not???
Posted: Tue Jan 31, 2012 08:28 pm Post Subject: Any infertility tips?
My husband and I have been trying for about 18 months now and we still have no baby. I don't want to do IVF or anything like that. I'd like to stay natural if I can.
Does anyone one know how you can increase your fertility or chances of conceiving?
Posted: Wed Feb 01, 2012 03:24 pm Post Subject:
This is not really an insurance question. Try consulting a gynecologist. And best of luck.
Posted: Fri Feb 03, 2012 08:33 pm Post Subject:
Hello there,
In most cases there are medical problems that cause infertility and I wish health coverage did cover the expense. Sometimes it is unknown/unexplained infertility. I have first hand experience with infertility. I wanted to bring the costs down since I'm self-pay for the IVF cycles, and I learned that I am not insurable!!! (for an individual plan) because of preexisting medical condition (infertility). Worse off - My DH AND, GET THIS, my unborn children are ALSO not insurable for the next 5 years!!!!!!!! My unborn children are not insurable (in an individual plan) because mommy can't conceive, What? (crazy!) The insurance sales person said I could get another type of insurance, but it might be $1000-2000/month! AND - they don't cover infertility!!
Regards,
Delfina
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