Mass. insurance questions! - Mothering Forums
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#1 of 6 Old 12-06-2012, 10:41 PM - Thread Starter
 
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Hey ladies! I have a few questions for you mamas living in Massachusetts. My partner and I are thinking about moving to Mass from Fl for a few reasons. Their infertility coverage being one of them. I know this is a broad questions, but does anyone have any information on how it works up there? Where to start looking into info or who to contact? All of the info I have found is outdated and coming from straight couples. (I only say that because sometimes infertility isn't considered infertility unless you're married to man) Anyway, I'm hoping there are a few of you out there that have experience with it. smile.gif


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#2 of 6 Old 12-10-2012, 04:34 AM
 
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It depends on your insurance and possibly age. Well known plans like Harvard Pilgrim and BCBS often cover infertility for queer parents after 12 documented inseminations. I'm not sure how they count it if you use known donor sperm bc they need a medical sign off that insem happened. You pay for those first 12. A few years ago it may have been that one company only required six but I think that's changed and/ or might only apply if you are over 35. But if you go for initial testing and they find that your tubes are blocked or something like that I think IVF gets covered right away. Once you've met the 12 or are close insurance often pays for a couple medicated IUIs and if those don't work then IVF. I was told by my RE that BCBS covers six tries of IVF as long as my hormones were in ranges that predicted IVF could work. I THINK that they said six tries per child. But this varies bc my friend has a different insurance and was told she had five tries total for her lifetime. Also they have an upper age range - maybe 42 ish? where they won't pay for it bc it's unlikely to work. Hope this helps.
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#3 of 6 Old 12-13-2012, 03:32 AM
 
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Call the insurance companies and ask.  I bought insurance in MA when we decided to go the ivf route.  I got the insurance for the month (or two?) when I actually needed coverage but had done everything ahead of time to be sure it would be approved.  I didn't need to wait 6 months because I already had health insurance and didn't have a gap. 

 

I was afraid to call and say "I have health insurance but I just need you to cover a full round of IVF for me and then I'll drop you.  Yes, I only want to pay $750 (or $500 or whatever it was) for the month while you give me way more in medical services.  And I want to get approval before I even give you a penny."  But they were great and it was very smooth. 

 

Good luck!


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#4 of 6 Old 12-13-2012, 03:40 PM - Thread Starter
 
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Do you live in mass? Or can you buy it while living in anothet state?

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#5 of 6 Old 12-14-2012, 07:16 AM
 
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We paid for the sperm and the clinic's actual insemination fee, but other services (like $900 worth of bloodwork) were covered. Also, after several months (but before meeting the minimum) we were able to argue that we had documented ovulation dysfunction and therefore got more coverage for subsequent cycles.

 

I do not know how much the law forces them to cover, so it would vary by insurer, of course.


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#6 of 6 Old 12-14-2012, 04:05 PM
 
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I think you can live anywhere.  I live in MA but have insurance in TX (where dp's company is).  Call and ask.  You'll end up talking medical stuff with a nurse but s/he'll know all the coverage issues as well.  I'm still surprised at how willing they were to work with me and to make it very easy for me.  I always felt like I was harassing them but she never let on I was annoying!

 

IF you are required to live in the state how long does it need to be for?  I'm sure there are plenty of people who would be willing to "rent" you their house and let you use the address to have bills, whatever sent to for the time you need to prove residency if you then just wanted to vacation here for a month for treatment. But it is a decent enough place to live!! 


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