Massachusetts & Infertility question

Mass has a "Hard Mandate" which means that insurers are required to offer it...there are SOME loopholes though and it will depend on your plan, where your policy is written and if your policy is "Employer Funded". This question could be answered better by your provider...they could give you information on the specific procedures that are considered for coverageӔ provided you meet their guidelines. My policy is written in a Mandated state but the procedures they cover do not include IVF. I live in another Mandated state ֖ they do cover IVF provided you meet their guidelines for coverage. Most plans that are Employer FundedӔ in mandated states do not have to offer any coverage. So, my suggestion would be to contact your provider and find out what they cover under the Mandate and what the requirements are for you to be considered for coverage. Some have rather extensive requirements such as number of years trying, number of other procedures and/or treatments. Its best to get this in writing, so you can refer back to it. Some providers even have their Medical PoliciesӔ on their website which wont be specific to your policy and doesn֒t guarantee coverage, but it will at least give you an idea of what your carrier will expect before they are willing to cover at all (if its available on your policy.)

Hi- I live in Mass and can verify what Brandy said - there are at least 6 states that typically cover infertility treatments however it still depends on the company you work for. My company is self insured (that was the term the insurance company used - employer funded like Brandy mentioned) - Blue Cross is the provider but because they are self insured they only have to comply with federal law. They cover everything for diagnosing fertility issues and paying to fix specific problems related to fertility but they will not pay for you to get pregnant. Many plans here do cover IVF treatments. I also know that some plans here won't cover IVF if the woman smokes. So I pretty much am just reiterating all the Brandy said. On the flip side - I do have a family friend that moved back here so her IVF was covered and their first cycle ended up with a little cutie patootie! Best of luck- Karen

I just wanted to reiterate what Brandy and Karen have already said. Our plan did, in fact, cover everything (including IVF) if there was a specific problem related to your infertility. Otherwise, you were on your own. That was nearly 10 years ago, so things may have changed with this particular provider.

Hi,Our plans (we had two during our IVF years) both covered, but I think only because our infertility was secondary to my husband's Leukemia treatments (he is healthy now! YAY!). It depends on the office, and on which insurances they work with. One of the offices in MA actually would not work with one of the largest HMO's because of a personal problem between the office and the hmo, I don't really remember the details, but thought it was so awful to penanlize their patients! Anyway, I'm not sure if we can post names of places on here, so I won't, but I would very highly recommend the center we ended at. They are a nationwide center, best stats in the country. I could direct you to them, if you would like (not sure if they are in Ohio, but worth a shot?) They helped us identify our problems, there were more than anticipated, which helped us walk away from IVF when we were ready. Don't lose the faith, it works for plenty of people! This same office, also had a "refund" policy for people who paid out of pocket for their services. If the pregnancy did not result in a birth, they refunded your funds. Likewise, if the embryo transfer just did not take. There are options out there, good job asking around and doing your homework!!! :-) If you'd like any info from me, please don't hesitate to email me!