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Insurance Wholesaler's Survey 5.2012 Small Group AB 1672 Survey ****************************** HISTORICAL!
May 15, 2011
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| PacifiCare - United Health Care | Unfortunately, we don't cover IVF in Small Group.
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| Blue Cross - Anthem | $2,000 Lifetime Max Rx limitations - Specialty List procedures or $1,500 Max.
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| General Agent - Wholesaler | In vitro is covered, if at all, very limited by all carriers
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| Kaiser | The only plans that offer limited infertility services are our $5 and $15 co pay plans. I have taken a sample excerpt from our sample EOC for reference. Artificial Insemination is eligible for coverage but IVF is not.
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| Blue Shield | Infertility Benefits - Rider
This optional benefit covers infertility services, which include procedures consistent with established medical practices by licensed physicians and surgeons, such as:
- Medication
- Surgery
- Gamete Intrafallopian Transfer (GIFT)
- In Vitro Fertilization (IVF), Intracyctoplasmic Sperm Injection (ICSI), and Zygote Intrafallopian Transfer (ZIFT) are excluded
- The actual IVF act its self is not covered but other procedures that are involved are covered. There are so many moving parts to IVF that it can be very confusing.
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| Health Net | We don't cover that at all. We only cover treatment for infertility including medication and medical procedures.
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| Aetna | IVF is not covered on any of our California Small Group Plans. We do the underlying testing, for the causes. We have a limited benefit on some of our HMO/PPO Plans. It 50% of a lifetime maximum of benefit of $2,000 and doesn't cover any of the drugs.
Most carriers will test for the underlying causes ,but have limited benefits out side of the testing,
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Try doing an HSA Plan and writing off the expenses that are not covered?
(IRS Publication 502)
 
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Availability INFORMAL - NON Binding! Survey of Individual Plans on Infertility Coverage
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| Company | Coverage | Date |
| Kaiser | No further treatment | |
| Aetna | No further treatment | |
| Anthem | Might write if no attempts or treatment at fertility have been made in the last 2 years. Probably OK, if Post Menopausal, tubal ligation, hysterectomy
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| Blue Shield | Might write if no attempts or treatment at fertility have been made in the last 2 years. | 2010 |
| Health Net | No | |
| Golden Rule - PacifiCare | Unfortunately there are no plans for either company that would cover it. Sorry | 3 Mar 2008 |
| sd fertility.com/ | There are no individual plans that we know of that offers infertility benefits. The most common way a person gets insurance coverage is through their employer "group plan".
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| Even if we do find an Individual Carrier that covers Infertility - there may be a problem getting the policy issued in the first place for underwriting reasons and 2nd a waiting period for pre -x. Try completing a "Pre Application."
If all else fails, your employer might consider "self funding" the benefits with an HSA Plan (Health Savings Account) or HRA Plan (Health Reimbursement Account)
 
Coverage's
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(HMO SAVER - Group) covers 50% with no maximum on services, and up to $1,500.00 for drugs.
blue cross ca.com/
The PPO 30 has a $2,000.00 lifetime maximum on all covered services.
.blue cross ca.com/
CIGNA's Position Paper on Infertility
More from a search on CIGNA's website
Kaiser Small Group - Infertility Coverage
Note - No footnotes on these plans!
$15 Co Pay Disclosure Form
kp.org/
Conception by artificial means
Except for artificial insemination covered under "Infertility Services" in the "Benefits and Cost Sharing" section, all other Services related to conception by artificial means, such as ovum transplants, gamete intrafallopian transfer (GIFT), semen and eggs (and Services related to their procurement and storage), in vitro fertilization (IVF), and zygote intrafallopian transfer (ZIFT) are not covered.
Coverage for newborn thru surrogate pregnancy. New Life Agency.com/
               
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