Laws for infertiltiy insurance?

I just found out my insurance Aetna (through my husbands company) wont cover iui or ivf. Someone told us there were laws that companies had to offer infertility treatment. They will pay for me to do up to 4 cycles of clomid.


I am thinking of leaving my business (I am self employed) and getting another job. I have a bachelors in sociology, but I'd even work retail for good coverage for now. Does anyone know of companies who don't make you wait the 90 days for coverage?

Re: Laws for infertiltiy insurance?

Some states have mandated infertility coverage. However, with that said, there are loopholes.

I work for a HUGE international company - well known. Both carriers they offer provide coverage for infertility. Where I live it's a state mandate that companies with more than 50 employess have to provide coverage. The mandate states 4 lifetime IVF attempts and I think unlimited IUI's. I get 3 lifetime attempts and only 6 lifetime IUI's. When I called and challenged this quoting the state mandate, I was told that if the company self funds their insurance policies, they do NOT need to comply with the state mandate.

You might want to check with your insurance carrier (I have Aetna too). If you live in NY, I don't tihnk NY has an infertility mandate.

Re: Laws for infertiltiy insurance?

Re: Laws for infertiltiy insurance?

This is so aggravating. I am trying to research this, but it really looks like New York doesn't force these companies to provider infertility treatment. Any info any one had would be greatly appreciated.

Re: Laws for infertiltiy insurance?

Call your insurance company, they might at least cover meds and blood work. That will leave you with less out of pocket expenses.

Do you have more than 1 insurance choice at work?

We have 3, 2 cover IVF and IUIs. The only one that doesn't is the cheapest monthly option, the HMO. People here at work learned that the hard way and had to wait till Nov to change firms

Re: Laws for infertiltiy insurance?

When my DH started working for the county, he was given 5 or 6 insurance options...out of all these companies, the only one (and the cheapest one I might add) that gave IF coverage was United Healthcare (its the empire plan so I do not know if that has anything to do with it).

Re: Laws for infertiltiy insurance?

NC doesn't have a mandate either and it stinks! I am a teacher, so I have to take the plan they offer me...no choices!
My parents live in Massachusetts and want me to move there next summer (temporarily) so I can get full coverage.
Crazy!

Re: Laws for infertiltiy insurance?

It's really the company that funds the coverage. It's all self funded. My firm covers some..$15K for infertility and $15K for meds. Pretty good but I know I will end up out of pocket for this eventually.

My cousin's firm paid for her 4 cycles with meds!

Re: Laws for infertiltiy insurance?

My company in NYC only covers IUIs (unlimited), all the meds, blookwork, and sonos. But they don't cover IVF which I wish they did. However they cover the meds for IVF which is strange. But better than nothing. I guess.

Re: Laws for infertiltiy insurance?

Unfortunately even in states with "mandated coverage" - the employer doesn't have to offer it. I forget the exact reasons why, but we live in CA now and there's "mandated coverage" but we have 0 coverage for infertility treatments - no meds, bloodwork, IUI, IVF, diagnostic... nothing!

Re: Laws for infertiltiy insurance?

I think in NY its only mandatory that insurance companies offer IF treatment, BUT companies can save money by not buying that rider on their policy. And that of course is only mandatory offering if its 50 or more employees. So, small companies (like mine) don't even have a chance of getting IVF coverage. So, far I have only seen Oxford be really flexible in terms of covering all meds and all IUI's but not IVF. That is what we have. And I'm sure my premiums are higher than other plans because of it.