Kaiser Or United Healthcare? - Mothering Forums
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#1 of 8 Old 05-18-2010, 10:26 PM - Thread Starter
 
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I have to have IVF to conceive.I live in Southern California.I just changed jobs.The new company only offers Kaiser HMO & United Healthcare PPO.Preliminary web research shows that Kaiser may not be the way to go.The websites don't say anything.I know I can't get IVF covered,but what is best for related procedures?Anyone have any knowledge in this area? Your input would be greatly appreciated.
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#2 of 8 Old 05-18-2010, 10:53 PM
 
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What is your state law around mandated IVF coverage? I thought CA was a mandated coverage state...no?

I was wondering this same thing a year ago, and found out that you have to really, really, really read the contract/policy/manual thing carefully. Someone from HR if you work somewhere with an HR department SHOULD be able to help you.

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#3 of 8 Old 05-18-2010, 10:59 PM
 
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I have United Healthcare, and some plans through UHC actually do have infertility coverage. I am covered up to $50,000 at "centers of excellence". I would ask about this, I'm not sure if the PPO has this option, I honestly don't know what I have!

Good luck,
Kate
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#4 of 8 Old 05-18-2010, 11:10 PM
 
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We have United Healthcare PPO and while you're right they don't cover infertility treatments themselves, it's been our experience that they pay all of the testing leading up to it - we've been going through extensive tests as of late. The fact that they pay the claims is especially interesting since my RE's office has IVF in the name. The Dr. does try to bill it differently so idk if that has an affect on coverage. I was on UH's site the other day and did notice that they have a special pharmacy program where they might reimburse for injectibles (?), but it might be an opt-in thing. And I haven't rocked that boat yet since we're still trying to get other things covered right now. hth?

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#5 of 8 Old 05-19-2010, 01:40 AM - Thread Starter
 
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California is a manditory state for everything except IVF.

I want to aks HR,but don't want them to think "she just started here & she's already tryin' to get pregnant".I'll either have to wait until June when enrollment is open to me or get up the nerve to ask.
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#6 of 8 Old 05-19-2010, 09:05 PM
 
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We have UHC and actually have fertility treatments, covering 80%, and $5K max on IVF treatments. I'd just tell HR that you're looking to the future and need to know about IVF. And if your company follows HR rules, then she can't ask you too many questions, based on her opinion. DP's company is great, but VERY HR cautious.

Good luck.

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#7 of 8 Old 05-19-2010, 09:32 PM
 
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Hi (i'm lurking from "New Posts")

I had Infertility issues and Kaiser and live in SoCal (ended up not needing IVF but started down the road) and while they DON'T cover IVF, this is what they described.

All the tests were covered, some of the drugs were covered and they helped you find the $$$ drugs cheaper (and legally) on-line, the monitoring was covered, and the actual IVF was done by the SAME doctor BUT at a different clinic not affiliated with Kaiser. In this case, he used another doctor's clinic only one day a week and he charged SUBSTANTIALLY less than I recall others charging.

It would be a inconvinience as they needed to get you "ready" for the IVF on the exact day they worked at the other clinic...

This was 5 years ago and at Bellflower so YMMV... but I hope it helps!

FWIW, before I even spoke to the RE, I had to take a "fertility class" which was stupid, but short
Good luck!
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#8 of 8 Old 05-19-2010, 10:25 PM
 
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Quote:
Originally Posted by Goodness View Post
California is a manditory state for everything except IVF.

I want to aks HR,but don't want them to think "she just started here & she's already tryin' to get pregnant".I'll either have to wait until June when enrollment is open to me or get up the nerve to ask.
So what if they do think that? It's your right. And it's going to affect which insurance you choose.

I would be very, very cautious with the Kaiser one-day-a-week plan mentioned above, I didn't know which day my IVF would be until the clinic called and said "Trigger tonight, egg retrieval the day after tomorrow." That was on a Sunday, my ER was on Tuesday, and that is just how it is. Going in, I knew my ER would be somewhere around that week, but no way to time it that far in advance to the day w/o compromising your care.

If it were possible, do you think the best (if not most) IVF clinics would be open and doing ERs 365 days per year? (All three fertility clinics I've been to could schedule things 365 days per year.)

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