If you're a teacher in the NYC schools (IF related)

and you have the GHI plan......

What was the cost of IVF? Were you able to have it before 12IUIs?

I'm just curious...

Re: If you're a teacher in the NYC schools (IF related)

Hey, I work for NYC schools but I don't have GHI. when I was looking into switching insurance GHI told me I.U.I's were unlimited and 3 IVF's per lifetime.. they pay 75%. They never mentioned I needed to have a certain amout of I.U.I's... what did you hear?

it is the same as my insurance (Vytra) but it seems that every time I call or the Dr's office people tell us different things.

Re: If you're a teacher in the NYC schools (IF related)

Yea, I keep hearing conflicting things! I heard 75% of 3 IVFs, but I heard conflicting info about the 12 IUI thing.

Re: If you're a teacher in the NYC schools (IF related)

I guess I can't help you too much because I obviously received a waiver for the IUIs. I don't know how difficult it is to get the waiver. Maybe you should email Margaret to ask? I found she had the clearest information when it came to IVF cost.

Re: If you're a teacher in the NYC schools (IF related)

I do know what the IVF cost would be through Dr. B with our insurance if you want to send me an FM with your email, I'll email you the info.

Re: If you're a teacher in the NYC schools (IF related)

My husband is a NYC teacher and we have GHI, I was able to get a waiver of the IUI requirement because of my age eventually. The first time we made the request after 1 failed IUI, they refused and said that I had to do 1 more IUI. I believe that the 12 IUI requirement is lowered to 6 if you are over 35 and I was told at my age that they would want 4 or 5 but I was able to do 2 and then get a waiver because of medical neccesity. If you have male factor IF or tubal issues, you will likely have an easier time getting an waiver.

At my center my co-pay is $1,200. You pay 25% of the contracted rate and not the rate that someone would pay out of pocket. For instance, the OOP cost at my center is over $13,000.

Just an FYI...they may not approve ICSI if you have no male factor issue so if that is something that you want to do, add the cost of ICSI into your costs. They also do not cover the cost of storage for your frozen embies.

Message edited 1/12/2011 8:37:52 PM.

Re: If you're a teacher in the NYC schools (IF related)

I'm a NYC teacher and have GHI. I also go to Dr. B.
We're covered for 75% of the cost of IVF, for up to 3 IVFs. We pay the other 25% which was $1,250. One IVF cycle is a fresh plus a frozen transfer, so it's kinda like 2 tries for the price of 1... as long as you have embryos to freeze.
I didn't have to do any IUIs beforehand, but we have male factor IF so I think that's why. I don't remember paying for ICSI. Oh, and we had to pay for the anesthesiologist ($500) because that was out-of-network.
At least I've gotten lots of reward points on my credit card from all this

Re: If you're a teacher in the NYC schools (IF related)

Posted by AllyCat

I'm a NYC teacher and have GHI. I also go to Dr. B.
We're covered for 75% of the cost of IVF, for up to 3 IVFs. We pay the other 25% which was $1,250. One IVF cycle is a fresh plus a frozen transfer, so it's kinda like 2 tries for the price of 1... as long as you have embryos to freeze.
I didn't have to do any IUIs beforehand, but we have male factor IF so I think that's why. I don't remember paying for ICSI. Oh, and we had to pay for the anesthesiologist ($500) because that was out-of-network.
At least I've gotten lots of reward points on my credit card from all this

Re: If you're a teacher in the NYC schools (IF related)

Thank you SO much everyone! This info has been very helpful, though hopefully I won't really need it!

Re: If you're a teacher in the NYC schools (IF related)

I hope this IUI is it for you and you do not need to go ahead with IVF

We have GHI city plan. I am about to start my 2nd IVF with a different RE. We have unexplained IF and from what GHI and the 2 RE offices have told me, unless you have a male factor, blocked tubes or possible uterine issues, they will not cover IVF unless you do 12 rounds of IUI first. I guess it can depend on age as well. After my 2nd IUI, my DH and I decided to go ahead with IVF even though it was not covered. I just couldn't see putting my body through 12 medicated rounds of IUI's, not to mention my doctors felt it would be unethical for them to do so. I finally realized, that fighting GHI and going through the IVF process was just too much for me to handle. They did pay for some minor things such s semen analysis during IVF process and the $1200 anethesia fee.

Good Luck to you!

Re: If you're a teacher in the NYC schools (IF related)

Posted by classc1

Posted by AllyCat

I'm a NYC teacher and have GHI. I also go to Dr. B.
We're covered for 75% of the cost of IVF, for up to 3 IVFs. We pay the other 25% which was $1,250. One IVF cycle is a fresh plus a frozen transfer, so it's kinda like 2 tries for the price of 1... as long as you have embryos to freeze.
I didn't have to do any IUIs beforehand, but we have male factor IF so I think that's why. I don't remember paying for ICSI. Oh, and we had to pay for the anesthesiologist ($500) because that was out-of-network.
At least I've gotten lots of reward points on my credit card from all this

They likely covered ICSI because you have male factor IF....I don't have male factor issues so they probably figured that I could get by with natural fertilization. BTW...can I ask you or anyone else that might know a question about their FET coverage? I had a frozen embie with my 1st IVF but will be doing my second IVF soon. If I decide to go back and do a FET for that one embie, will they still cover it even though I did a second IVF before the FET?

Re: If you're a teacher in the NYC schools (IF related)

Posted by AllyCat

Posted by classc1

Posted by AllyCat

I'm a NYC teacher and have GHI. I also go to Dr. B.
We're covered for 75% of the cost of IVF, for up to 3 IVFs. We pay the other 25% which was $1,250. One IVF cycle is a fresh plus a frozen transfer, so it's kinda like 2 tries for the price of 1... as long as you have embryos to freeze.
I didn't have to do any IUIs beforehand, but we have male factor IF so I think that's why. I don't remember paying for ICSI. Oh, and we had to pay for the anesthesiologist ($500) because that was out-of-network.
At least I've gotten lots of reward points on my credit card from all this

They likely covered ICSI because you have male factor IF....I don't have male factor issues so they probably figured that I could get by with natural fertilization. BTW...can I ask you or anyone else that might know a question about their FET coverage? I had a frozen embie with my 1st IVF but will be doing my second IVF soon. If I decide to go back and do a FET for that one embie, will they still cover it even though I did a second IVF before the FET?

I think it's still covered, because they told me we get 6 tries --3 fresh and 3 frozen. I didn't have any embies to freeze so I'm not 100% sure...