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Hello!

My wife and I are planning to use IUI to have our first child and we aren't quite sure what we should be telling the insurance company. Our insurance covers fertility treatments, but the definition of infertility is:

To be eligible for Benefits, the Covered Person must:
● have failed to achieve a Pregnancy after a year of regular, unprotected intercourse if the woman is under age 35, or after 6 months, if the woman is over age 35;
● be under age 44, if
female; and
● have infertility that is not related to voluntary sterilization or failed reversal of voluntary sterilization.

We are in California, and I believe a law passed recently saying insurers can't discriminate against queer couples. (http://www.nclrights.org/new-ca-law...erage-for-fertility-services-to-lgbt-parents/)

Can we just say we have been trying for a year? How strict are these rules? We have been trying, but as two women, we haven't had much success.... It would be great to hear from peoples' personal experiences. Our insurer is United Healthcare, in case that is relevant.

Thanks for your help. Sorry if this has been asked and answered, but I can't find it anywhere.
 

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Good question. I am curious about this as well. I am in Illinois, though.
 

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:w

I am in California and I have Kaiser. I did not have any trouble receiving treatment or getting coverage. My doctor referred me to the fertility department. It think they just automatically considered me to be infertile because I'm a lesbian. I never had to prove that I had tried in the past. I would check with your doctor. You can say you have tried unsuccessfully. Depending on what you do, you may be able to skip the doctor anyway. You can have sperm delivered to your house. You may need a doctor to sign off on it, but they don't need to be a fertility doctor. And you can have a midwife come to your house to do the IUI. Also, be sure to save all your receipts. Sperm, shipping, all medical bills you pay are tax deductible if you reach a certain amount.
 

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I'm in Illinois--the rules here are similar to California, I think, if I remember correctly. In our case (BCBSIL) I told them what we were up to and they required three dr-supervised IUI attempts before they would cover anything, and then it was covered the same as it would be for anyone else with my insurance. The catch is that your company can choose to refuse fertility treatments entirely, in which case you don't get any coverage at all beyond diagnostics, as far as I can tell. If your company pays for treatment they have to do it regardless of gender, but if they don't pay, they don't pay.
 

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I also have Kaiser insurance in CA. All of our claims have a diagnosis of male infertility. Its a big joke in our house but it was necessary for proper processing. We did try at home first but that never worked. We eventually had to do IVF and I'm now 14 weeks pregnant.
 

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Here in CA as well. I know this post was 3 years ago. Did Kaiser cover IVF or just IUl? What was the benefit amount, full or partial? My wife and I are hoping to carry each other's eggs. Thanks!!!

I also have Kaiser insurance in CA. All of our claims have a diagnosis of male infertility. Its a big joke in our house but it was necessary for proper processing. We did try at home first but that never worked. We eventually had to do IVF and I'm now 14 weeks pregnant.
 

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I have Kaiser. What they cover depends a lot on what plan you have. Some cover 50%, some cover 80% of fertility services but this may not include IVF. Mine covered 50% of just about everything except IVF. But since there is an IVF center nearby, I would have been able to have my local RE do the monitoring and order the drugs and I could have paid 50% of that. The actual procedure at the IVF center would not have been covered.
 
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