IF coverage in Maryland

Cibele · 10-23-2006, 12:43 PM

Hi girls, I know here is not the right forum but I was hoping someone could help me

Does anyone here know about IF coverage in Maryland. I was offer a job there and I was told that it is a great state for people like me with IF issues like me. I read this on the internet but I am still not clear. Does INS in MD cover the diagnostic and treatment part for IF issues? Or it is only for IVF?

The Maryland law requires health and hospital insurance policies that provide pregnancy-related benefits to also cover the outpatient costs of in-vitro fertilization. Policies that must provide the coverage include those covering people who live and work in the state, regardless of whether the policy is issued inside or outside the state. HMO's must provide IVF benefits to the same extent as the benefits provided for other infertility services.

Patients need to meet the following conditions in order to get their IVF covered:

The patient's eggs must be fertilized with her spouse's sperm;
The patient is unable to get pregnant through less expensive covered treatments;
The IVF is performed at facilities that conform to standards set by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists.
The patient and his or her spouse must have at least a two-year history of infertility; OR their infertility must be associated with one or more of the following conditions:
Endometriosis;
Fetal exposure to diethylstilbestrol, also known as DES;
Blocked or surgically removed fallopian tubes; or
Abnormal male factors, including oligozoospermia.
Coverage may be limited to three in vitro fertilization attempts per live birth and a maximum lifetime benefit of $100,000.

Cibele · 10-23-2006, 05:36 PM

anyone?

**BC-Maura** · 10-23-2006, 05:45 PM

Hi Cibele: Sorry

... I wanted to research the law itself to see if I could find the answer for you...

Back soon

+++++++++++++++
Maura

**BC-Maura** · 10-23-2006, 06:15 PM

Hi Cibele: I am confused too... I couldn't find the law, but every site that summarizes it talks about IVF only. I suppose any labwork or tests might be covered under any standard policy providing coverage for such things, but as for consultations with OBs and REs and any other kind of ART, like IUI, I'm just not sure.

You could always call the MD Commissioner of Insurance and ask them directly! Or call an insurance company that issues policies in MD and see if they'll give you an answer.

If you find out, let me know so I can file it away.

Are you looking in Massachusetts at all? As I think we've mentioned before, we have great IF coverage here!

Best to you++++++++++++++
Maura

Cibele · 10-23-2006, 06:35 PM

cofusing, isn't it? I try to look it further

10-23-2006, 12:43 PM	#1 (permalink)
Cibele Registered User Join Date: Feb 2006 Location: Kansas Posts: 426	IF coverage in Maryland Hi girls, I know here is not the right forum but I was hoping someone could help me Does anyone here know about IF coverage in Maryland. I was offer a job there and I was told that it is a great state for people like me with IF issues like me. I read this on the internet but I am still not clear. Does INS in MD cover the diagnostic and treatment part for IF issues? Or it is only for IVF? The Maryland law requires health and hospital insurance policies that provide pregnancy-related benefits to also cover the outpatient costs of in-vitro fertilization. Policies that must provide the coverage include those covering people who live and work in the state, regardless of whether the policy is issued inside or outside the state. HMO's must provide IVF benefits to the same extent as the benefits provided for other infertility services. Patients need to meet the following conditions in order to get their IVF covered: The patient's eggs must be fertilized with her spouse's sperm; The patient is unable to get pregnant through less expensive covered treatments; The IVF is performed at facilities that conform to standards set by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists. The patient and his or her spouse must have at least a two-year history of infertility; OR their infertility must be associated with one or more of the following conditions: Endometriosis; Fetal exposure to diethylstilbestrol, also known as DES; Blocked or surgically removed fallopian tubes; or Abnormal male factors, including oligozoospermia. Coverage may be limited to three in vitro fertilization attempts per live birth and a maximum lifetime benefit of $100,000.

10-23-2006, 05:45 PM	#3 (permalink)
BC-Maura Board Coordinator Join Date: Jan 2002 Posts: 12,946	Hi Cibele: Sorry... I wanted to research the law itself to see if I could find the answer for you... Back soon+++++++++++++++ Maura

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10-23-2006, 05:36 PM	#2 (permalink)
Cibele Registered User Join Date: Feb 2006 Location: Kansas Posts: 426	anyone?

10-23-2006, 06:15 PM	#4 (permalink)
BC-Maura Board Coordinator Join Date: Jan 2002 Posts: 12,946	Hi Cibele: I am confused too... I couldn't find the law, but every site that summarizes it talks about IVF only. I suppose any labwork or tests might be covered under any standard policy providing coverage for such things, but as for consultations with OBs and REs and any other kind of ART, like IUI, I'm just not sure. You could always call the MD Commissioner of Insurance and ask them directly! Or call an insurance company that issues policies in MD and see if they'll give you an answer. If you find out, let me know so I can file it away. Are you looking in Massachusetts at all? As I think we've mentioned before, we have great IF coverage here! Best to you++++++++++++++ Maura

10-23-2006, 06:35 PM	#5 (permalink)
Cibele Registered User Join Date: Feb 2006 Location: Kansas Posts: 426	cofusing, isn't it? I try to look it further