18 replies to this topic

[Glenn56]

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.

[HelenM]

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.

[Glenn56]

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?

[Hopingfor1]

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.

[eyedoc]

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.

[HelenM]

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.

[s00n]

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.

[Glenn56]

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.

[Glenn56]

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

[amp77]

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.

[Glenn56]

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

[amp77]

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.

[Hopingfor1]

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.

[Glenn56]

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?

[amp77]

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.

[snootypup]

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

[Hopingfor1]

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.

[Glenn56]

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.

[Hopingfor1]

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.