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IVF Health Insurance


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#1 Glenn56

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Posted 19 January 2017 - 01:01 AM

Hi. I'm a newbie here and I am from Alberta. I just want to ask from you guys which health insurance that me and my wifey should get that covers IVF. Thank you for your response in advance.

#2 HelenM

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Posted 19 January 2017 - 01:18 AM

Hi Glenn,
We have Alberta Blue cross through my husbands work. It does not cover ivf but has covered a lot of the meds for our two rounds.

TTC since Oct 2013

IVF  w/ ICSI #1 Jan 2016

-15 eggs retrieved, 12 mature, 7 fertilized. Transferred 2 day 3 embryos. Nothing to freeze.th_abfn.gif

IVF w/ICSI #2 May 2016

-24 eggs retrieved, 16 mature, 6 fertilized. Transferred 3 day 3 embryos. Nothing to freeze. th_abfn.gif

 

 


#3 Glenn56

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Posted 19 January 2017 - 01:30 AM

Hi helen. I truly appreciated your reply. We got the brochure yesterday from alberta blue cross but we are still deciding. I have DIN #s here, is there a way that I can check it against ABC drugs coverage?

#4 Hopingfor1

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Posted 19 January 2017 - 05:45 AM

Please check carefully before purchasing insurance for IVF drugs. If you have already started the process/have had testing, etc, it is likely that most insurers would consider it a pre-existing condition and not provide coverage.
  • Yearning, ilovemydogs, amp77 and 1 other like this

Me: 40  = High FSH (ranges from 8 - 15), Low AMH (2.7), Low AFC = DOR

DH: 43 = borderline sperm analysis

Started TTC#1 January 2010

 

2011 - 2012 - First fertility clinic, lots of testing, operative hysteroscopy to remove polyps, multiple unsuccessful IUIs, 1 IVF (150 Menopur/150 Gonal F) converted to IUI due to poor response

 

2012 - got second opinion and after AMH results came back, advised at 36 I had a less than 5% chance of conceiving via IVF.  Donor eggs strongly recommended but not yet ready for that (I should say - hubby not ready for that.  I was ready for donor eggs - I just wanted to be a Mom).  Decided clinic wasn't for us and back to clinic #1

 

2013 - IVF #1 (after 1st converted to IUI).  Estrogen Priming protocol - start Climara patch 7 days post ovulation and change every other day.  3 orgalutran injections beginning day after first Climara patch applied.  Start stims day 2 triggered on night 15 of stims = 3 eggs retrieved, 0 fertilized via ICSI = no transfer  (300 Gonal F/150 Menopur & Orgalutran)

 

2013 - Switch clinics

 

Office hysteroscopy = all clear

 

IVF #2 (37 years old) June 2013 - Estrace priming protocol.  4 mg estrace started 7 days post ovulation.  Start stims Day 3 (300 Gonal F/150 Menopur & Orgalutran)

Slow response as usual

Triggered on night 12 of stims (given the option to cancel as it looked like we'd get 3 eggs - knew we wouldn't do any better so continued).

ER:  6 eggs, but advised some were small and would be immature

Fert report:  5 of 6 eggs immature.  2 fertilized via ICSI (including one of the immature eggs)

ET:  Transferred our only 2 embryos - a 5 cell and an 8 cell

11dp3dt = BFP - HCG = 65

16dp3dt = HCG 1,305 (cautiously pregnant)

7 week ultrasound = 1 baby HB = 141

12 weeks ultrasound NT scan = NT = 1.7mm all looks good.  Combined with blood work risk is 1/1,400

Got Harmony blood test results back (done for peace of mind) - all clear and we're having a GIRL!

EDD = March 2014 (cautiously looking forward to that date)

However - baby had plans to arrive early. After PPROM and managing to cook the little one a bit longer, our bundle of joy arrived at 33 weeks.  After a 3 week NICU stay, she is finally home.  We are totally in love and forever thankful for our little miracle baby - Ashley Nicole.

 

 


#5 eyedoc

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Posted 19 January 2017 - 07:42 AM

Many insurance plans will not cover anything to do with IVF (some cover the drugs if you're lucky!). As pp mentioned it sounds like you know you need IVF, which would mean a pre-existing condition and will make you void for any coverage relating to IVF. It's just like - you can't go buy home insurance after your house has already burned down.
  • Yearning and Hopingfor1 like this

Me - 33, PCOS
DH - 38, Male factor

April 2012 - Started TTC #1
2013 - 2014 - Several medicated cycles and 3 IUI - all BFN

November/December 2014 - IVF #1
Transfer of 1 day 5 embryo, 3 embryos frozen - BFP th_abfp.gif
pPROM @ 35 weeks and our baby babygirl.gif made her early appearance on July 26, 2015

 

July 2015 - Phone consultation with clinic to look at doing a FET towards the end of the year

August 2015 - Natural BFP??  th_abfp.gif  We are in shock!  Ultrasound at clinic confirms I was already 9 weeks pregnant and had NO IDEA!

Due date for baby B #2 - March 27, 2017


#6 HelenM

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Posted 19 January 2017 - 10:02 AM

We had to call the insurance company and check on the DIN that we had been prescribed, one by one.
Unfortunately as the other posters have said, it's likely considered a pre-existing condition so check very carefully!
For us there is a lifetime maximum for fertility drugs I think it's like 10k which can go pretty fast.

TTC since Oct 2013

IVF  w/ ICSI #1 Jan 2016

-15 eggs retrieved, 12 mature, 7 fertilized. Transferred 2 day 3 embryos. Nothing to freeze.th_abfn.gif

IVF w/ICSI #2 May 2016

-24 eggs retrieved, 16 mature, 6 fertilized. Transferred 3 day 3 embryos. Nothing to freeze. th_abfn.gif

 

 


#7 s00n

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Posted 19 January 2017 - 12:59 PM

Are you self-employed? I work for the federal government and our plan (Sunlife) covered most of the listed drugs with very few exceptions. Employer plans may too.


Him- Potential SA issues Me- PCOS like crazy/anovulation/long cycles. Started TTC before 30. TTC/Secondary Infertility(2008-2015) - Adopted from public system in Ontario 2012. Freeze-All IVF after OHSS, and successful FET 2015 @ 36Yrs Old.

#8 Glenn56

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Posted 19 January 2017 - 02:51 PM

Thanks for all you answers. Although, our doctor suggested ivf procedure already, i am planning not to declare it to our prospect insurance? What do u think of it guys? I am working but not cover my company insurance since i do not a position yet. Same with my wife, she used to have before insurance but was cut after she resigned to her previous work. So we will just get our own insurance.

#9 Glenn56

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Posted 19 January 2017 - 02:54 PM

*prospect insurance.
*not cover by my company
*do not have a position

#10 amp77

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Posted 19 January 2017 - 04:11 PM

I wouldn't risk lying about pre-existing conditions.  Infertility may be a bit different but, for example, if you had some kind of pre-existing illness, and lied about it, and got hit by a car, and they subsequently discover this pre-existing condition, life insurance may not be paid out.  I am not sure what is considered insurance fraud, but I wouldn't take a chance.  It is really frustrating, and IVF is very expensive.  I hope you do find a solution that works in your situation.  Note that some drugs are used for other thigns, other than IVF, so they are covered, even if the plan doesn't cover IVF.  But you would have to know what drugs and if the plan covers them.


  • Yearning likes this

Age 39, DH 43 in Oct.

TTC on and off since 2007 before our second IVF, in 2014, brought us our beautiful son.

 

FET #1 -  Sept 2016

Day 1 - Sept. 9

Monitoring - Sept. 18-22

Lining Check - Sept. 22 (11.3 mm)

Transferred 5B-BB Sept. 25 - BFP!!!  HCG 890 @ 12dp5dt and Progesterone 95.
Midwife appointment Sept. 19 and first ultrasound Nov. 4
3 Frosties left

 

<a href="https://lilypie.com/"><img src="https://lbdf.lilypie.com/9GKrm4.png" width="400" height="80" border="0" alt="Lilypie Pregnancy tickers" /></a>

 

-------------------------------------------------------------------------------------------------------------------------------------

 

Seems like forever ago...

 

Age 37, DH 40.

TTC on and off since 2007

Unexplained Infertility

 

IVF #1 - April 2014 - BFN - no frosties

 

IVF #2 - July 2014 - BFP - 5B-AB and 4 frosties (5B-BB, 2x4B-BB and 3B-BB)

Apr. 13, 2015 - Daniel Erik was born at 5:05 am, weight 8 lbs, 13 oz, and 22" long.  He is perfect in every way.

 

 


#11 Glenn56

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Posted 19 January 2017 - 04:54 PM

Actually you are right. Not all meds needed for ivf are not really for ivf use only. I saw some are antibiotics and some for hormones. That is why I am surveying here in forum if what is the best insurance so far that cover some of ivf drugs. Nwei, your suggestion amp77 is really a big help and enlightenment. Thank you

#12 amp77

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Posted 19 January 2017 - 05:24 PM

Actually you are right. Not all meds needed for ivf are not really for ivf use only. I saw some are antibiotics and some for hormones. That is why I am surveying here in forum if what is the best insurance so far that cover some of ivf drugs. Nwei, your suggestion amp77 is really a big help and enlightenment. Thank you


Without knowing protocol, you won't know what medications you would need. There are many different drugs depending on diagnosis etc.
  • annatarz79 likes this

Age 39, DH 43 in Oct.

TTC on and off since 2007 before our second IVF, in 2014, brought us our beautiful son.

 

FET #1 -  Sept 2016

Day 1 - Sept. 9

Monitoring - Sept. 18-22

Lining Check - Sept. 22 (11.3 mm)

Transferred 5B-BB Sept. 25 - BFP!!!  HCG 890 @ 12dp5dt and Progesterone 95.
Midwife appointment Sept. 19 and first ultrasound Nov. 4
3 Frosties left

 

<a href="https://lilypie.com/"><img src="https://lbdf.lilypie.com/9GKrm4.png" width="400" height="80" border="0" alt="Lilypie Pregnancy tickers" /></a>

 

-------------------------------------------------------------------------------------------------------------------------------------

 

Seems like forever ago...

 

Age 37, DH 40.

TTC on and off since 2007

Unexplained Infertility

 

IVF #1 - April 2014 - BFN - no frosties

 

IVF #2 - July 2014 - BFP - 5B-AB and 4 frosties (5B-BB, 2x4B-BB and 3B-BB)

Apr. 13, 2015 - Daniel Erik was born at 5:05 am, weight 8 lbs, 13 oz, and 22" long.  He is perfect in every way.

 

 


#13 Hopingfor1

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Posted 19 January 2017 - 06:17 PM

Not disclosing it might sound like it would work, but it won't. It is unfortunate that fertility medications are so expensive and it causes additional stress. If you bought a policy, didn't disclose and then started claiming expensive fertility drugs, this would be a red flag and the insurer would look into this.

Combined my husband and I had an $18,000 lifetime limit on fertility drugs and after we used that we could still be reimbursed for things like estrace and prometrium because they had other uses. Those are the cheap ones, but at least it was something.

Also check drug prices from various pharmacies when you find out what you need - the prices can vary.

Me: 40  = High FSH (ranges from 8 - 15), Low AMH (2.7), Low AFC = DOR

DH: 43 = borderline sperm analysis

Started TTC#1 January 2010

 

2011 - 2012 - First fertility clinic, lots of testing, operative hysteroscopy to remove polyps, multiple unsuccessful IUIs, 1 IVF (150 Menopur/150 Gonal F) converted to IUI due to poor response

 

2012 - got second opinion and after AMH results came back, advised at 36 I had a less than 5% chance of conceiving via IVF.  Donor eggs strongly recommended but not yet ready for that (I should say - hubby not ready for that.  I was ready for donor eggs - I just wanted to be a Mom).  Decided clinic wasn't for us and back to clinic #1

 

2013 - IVF #1 (after 1st converted to IUI).  Estrogen Priming protocol - start Climara patch 7 days post ovulation and change every other day.  3 orgalutran injections beginning day after first Climara patch applied.  Start stims day 2 triggered on night 15 of stims = 3 eggs retrieved, 0 fertilized via ICSI = no transfer  (300 Gonal F/150 Menopur & Orgalutran)

 

2013 - Switch clinics

 

Office hysteroscopy = all clear

 

IVF #2 (37 years old) June 2013 - Estrace priming protocol.  4 mg estrace started 7 days post ovulation.  Start stims Day 3 (300 Gonal F/150 Menopur & Orgalutran)

Slow response as usual

Triggered on night 12 of stims (given the option to cancel as it looked like we'd get 3 eggs - knew we wouldn't do any better so continued).

ER:  6 eggs, but advised some were small and would be immature

Fert report:  5 of 6 eggs immature.  2 fertilized via ICSI (including one of the immature eggs)

ET:  Transferred our only 2 embryos - a 5 cell and an 8 cell

11dp3dt = BFP - HCG = 65

16dp3dt = HCG 1,305 (cautiously pregnant)

7 week ultrasound = 1 baby HB = 141

12 weeks ultrasound NT scan = NT = 1.7mm all looks good.  Combined with blood work risk is 1/1,400

Got Harmony blood test results back (done for peace of mind) - all clear and we're having a GIRL!

EDD = March 2014 (cautiously looking forward to that date)

However - baby had plans to arrive early. After PPROM and managing to cook the little one a bit longer, our bundle of joy arrived at 33 weeks.  After a 3 week NICU stay, she is finally home.  We are totally in love and forever thankful for our little miracle baby - Ashley Nicole.

 

 


#14 Glenn56

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Posted 20 January 2017 - 12:38 AM

Thanks for the info. Aside from knowing the price of the drugs from different pharmacies or from online store and paying it by my own pocket (meaning we will not get an insurance anymore). Do u advise too to get an insurance then if we had our first IVF try and then we will just try our luck if they are going to refund it?

#15 amp77

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Posted 20 January 2017 - 09:21 AM

Thanks for the info. Aside from knowing the price of the drugs from different pharmacies or from online store and paying it by my own pocket (meaning we will not get an insurance anymore). Do u advise too to get an insurance then if we had our first IVF try and then we will just try our luck if they are going to refund it?

I think that is something to consider based on price of insurance.  Will the price of insurance vs. drug costs be worth it.  If it is only covering cheaper meds (antibiotics, birth control pills, and what is noted above by another poster), is it worth the premiums?  At the same time, insurance would cover you for other things outside IVF.  And if you are successful, then you can add your new baby as well.  I am fortunate to have insurance through work so I have not had to worry about this but I think it is important to have some additional coverage unless you are more organized than me and can budget for unexpected medical expenses.


Age 39, DH 43 in Oct.

TTC on and off since 2007 before our second IVF, in 2014, brought us our beautiful son.

 

FET #1 -  Sept 2016

Day 1 - Sept. 9

Monitoring - Sept. 18-22

Lining Check - Sept. 22 (11.3 mm)

Transferred 5B-BB Sept. 25 - BFP!!!  HCG 890 @ 12dp5dt and Progesterone 95.
Midwife appointment Sept. 19 and first ultrasound Nov. 4
3 Frosties left

 

<a href="https://lilypie.com/"><img src="https://lbdf.lilypie.com/9GKrm4.png" width="400" height="80" border="0" alt="Lilypie Pregnancy tickers" /></a>

 

-------------------------------------------------------------------------------------------------------------------------------------

 

Seems like forever ago...

 

Age 37, DH 40.

TTC on and off since 2007

Unexplained Infertility

 

IVF #1 - April 2014 - BFN - no frosties

 

IVF #2 - July 2014 - BFP - 5B-AB and 4 frosties (5B-BB, 2x4B-BB and 3B-BB)

Apr. 13, 2015 - Daniel Erik was born at 5:05 am, weight 8 lbs, 13 oz, and 22" long.  He is perfect in every way.

 

 


#16 snootypup

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Posted 31 January 2017 - 10:20 AM

I have GWL insurance through work and they cover a lifetime amount of $5000 for either meds or procedures but you have to pay the premium for 2 years. I'm lucky that my employers pay half my premium

#17 Hopingfor1

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Posted 31 January 2017 - 04:13 PM

Even with the same insurer, coverage varies based on what your employer selects. My policy through work is with GWL. All premiums are employer paid. It covered $6,000 lifetime maximum for fertility drugs (the other $12,000 we had was through my husband's policy).

My $6,000 was for drugs only, but I also had a healthcare spending account with about $1,000/year where I could recover some money for procedures or use it for drugs once our combined $18,000/lifetime limit had been used.

Me: 40  = High FSH (ranges from 8 - 15), Low AMH (2.7), Low AFC = DOR

DH: 43 = borderline sperm analysis

Started TTC#1 January 2010

 

2011 - 2012 - First fertility clinic, lots of testing, operative hysteroscopy to remove polyps, multiple unsuccessful IUIs, 1 IVF (150 Menopur/150 Gonal F) converted to IUI due to poor response

 

2012 - got second opinion and after AMH results came back, advised at 36 I had a less than 5% chance of conceiving via IVF.  Donor eggs strongly recommended but not yet ready for that (I should say - hubby not ready for that.  I was ready for donor eggs - I just wanted to be a Mom).  Decided clinic wasn't for us and back to clinic #1

 

2013 - IVF #1 (after 1st converted to IUI).  Estrogen Priming protocol - start Climara patch 7 days post ovulation and change every other day.  3 orgalutran injections beginning day after first Climara patch applied.  Start stims day 2 triggered on night 15 of stims = 3 eggs retrieved, 0 fertilized via ICSI = no transfer  (300 Gonal F/150 Menopur & Orgalutran)

 

2013 - Switch clinics

 

Office hysteroscopy = all clear

 

IVF #2 (37 years old) June 2013 - Estrace priming protocol.  4 mg estrace started 7 days post ovulation.  Start stims Day 3 (300 Gonal F/150 Menopur & Orgalutran)

Slow response as usual

Triggered on night 12 of stims (given the option to cancel as it looked like we'd get 3 eggs - knew we wouldn't do any better so continued).

ER:  6 eggs, but advised some were small and would be immature

Fert report:  5 of 6 eggs immature.  2 fertilized via ICSI (including one of the immature eggs)

ET:  Transferred our only 2 embryos - a 5 cell and an 8 cell

11dp3dt = BFP - HCG = 65

16dp3dt = HCG 1,305 (cautiously pregnant)

7 week ultrasound = 1 baby HB = 141

12 weeks ultrasound NT scan = NT = 1.7mm all looks good.  Combined with blood work risk is 1/1,400

Got Harmony blood test results back (done for peace of mind) - all clear and we're having a GIRL!

EDD = March 2014 (cautiously looking forward to that date)

However - baby had plans to arrive early. After PPROM and managing to cook the little one a bit longer, our bundle of joy arrived at 33 weeks.  After a 3 week NICU stay, she is finally home.  We are totally in love and forever thankful for our little miracle baby - Ashley Nicole.

 

 


#18 Glenn56

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Posted 14 March 2017 - 05:19 PM

How many months or years do I need to pay for my insurance before I can try to use it for my IVF meds? I am planning to try our IVF next year of February. I will be starting to pay my insurance this coming April. Thank you for your help.

#19 Hopingfor1

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Posted 14 March 2017 - 08:52 PM

How many months or years do I need to pay for my insurance before I can try to use it for my IVF meds? I am planning to try our IVF next year of February. I will be starting to pay my insurance this coming April. Thank you for your help.



The correct answer is that if your insurer excludes coverage based on it being a pre-existing condition, it doesn't matter how long you pay it, it would still be excluded.

If you are saying you failed to disclose a pre-existing condition that would exclude you and are hoping to put through the claims without them finding out, no one can answer that other than to say I hope that isn't your question.

If you have been honest with them, your insurer is the one to direct your question to and let you know when you are eligible to put through a claim.

I fully understand the financial strains fertility treatment puts on everyone who has to go through it. It isn't fair and I so wish I could have used the tens of thousands of dollars I spent on treatment in other ways. However, if it was an option to get additional insurance for coverage after knowing about our treatment requirements, most on this site would have done so.

We do know insurance companies are in the business of making money which is why they exclude things like this. They don't want to pay out thousands of dollars for fertility meds after collecting significantly less in premiums which is why they exclude it as a pre-existing condition when purchasing almost any private policy.
  • amp77 and csbd like this

Me: 40  = High FSH (ranges from 8 - 15), Low AMH (2.7), Low AFC = DOR

DH: 43 = borderline sperm analysis

Started TTC#1 January 2010

 

2011 - 2012 - First fertility clinic, lots of testing, operative hysteroscopy to remove polyps, multiple unsuccessful IUIs, 1 IVF (150 Menopur/150 Gonal F) converted to IUI due to poor response

 

2012 - got second opinion and after AMH results came back, advised at 36 I had a less than 5% chance of conceiving via IVF.  Donor eggs strongly recommended but not yet ready for that (I should say - hubby not ready for that.  I was ready for donor eggs - I just wanted to be a Mom).  Decided clinic wasn't for us and back to clinic #1

 

2013 - IVF #1 (after 1st converted to IUI).  Estrogen Priming protocol - start Climara patch 7 days post ovulation and change every other day.  3 orgalutran injections beginning day after first Climara patch applied.  Start stims day 2 triggered on night 15 of stims = 3 eggs retrieved, 0 fertilized via ICSI = no transfer  (300 Gonal F/150 Menopur & Orgalutran)

 

2013 - Switch clinics

 

Office hysteroscopy = all clear

 

IVF #2 (37 years old) June 2013 - Estrace priming protocol.  4 mg estrace started 7 days post ovulation.  Start stims Day 3 (300 Gonal F/150 Menopur & Orgalutran)

Slow response as usual

Triggered on night 12 of stims (given the option to cancel as it looked like we'd get 3 eggs - knew we wouldn't do any better so continued).

ER:  6 eggs, but advised some were small and would be immature

Fert report:  5 of 6 eggs immature.  2 fertilized via ICSI (including one of the immature eggs)

ET:  Transferred our only 2 embryos - a 5 cell and an 8 cell

11dp3dt = BFP - HCG = 65

16dp3dt = HCG 1,305 (cautiously pregnant)

7 week ultrasound = 1 baby HB = 141

12 weeks ultrasound NT scan = NT = 1.7mm all looks good.  Combined with blood work risk is 1/1,400

Got Harmony blood test results back (done for peace of mind) - all clear and we're having a GIRL!

EDD = March 2014 (cautiously looking forward to that date)

However - baby had plans to arrive early. After PPROM and managing to cook the little one a bit longer, our bundle of joy arrived at 33 weeks.  After a 3 week NICU stay, she is finally home.  We are totally in love and forever thankful for our little miracle baby - Ashley Nicole.