NJ has mandatory fertility coverage

[KimC]

I work for a company in CA, but is headquartered in NJ. Fortunately, my insurance is through NJ.

Here it is:

IVF - they pay 90% for four cycles. All injectibles are covered at my regular prescription co-pay. Total out of pocket, including a $400 deductible, is $990/month for the first month. Every subsequent month is $490 max.

Total out of pocket is $3000, after which, they pay 100%.

Thanks,

[hopeandpray]

I live in NY and would like to either:

1)work for a company that has coverage for IVF
2)get covered by a company in NJ
3)buy an independent policy that has ivf coverage

Can anyone help with either 1)names of companies that a social worker might apply to that has such coverage or 2) names of insurance carriers that will sell me a policy that covers ivf or 3) any other tips!

Thanks so much . I am desperate.

[Buggabugga]

Hi. We have Amerihealth HMO New Jersey, and we are covered 100% for unlimited IUIs and up to 4 IVF retrievals. No copays or deductibles. Any eggs frozen from the 4 IVf retrievals are also covered for FETs. This policy is through my DH, who is a cop in a municipality in NJ. We are pretty lucky, the only thing we've had to pay for is freezing. Perhaps your township could use a social worker?

[KimC]

The company I work for is a technology manufacturer, so we don't employ social workers - sorry.

The insurance is Horizon Blue Cross Blue Shield of New Jersey. I'm not sure whether or not they sell independent insurance policies.

I hope this helps .....

[Miriam]

I'm in NJ and my company is self insured with United Healthcare and they don't cover any IF. See UH covers but since my company is self insured, they do all the payout and only use UH to manage. So I pay out of pocket for everything. I do however get some $$ back on U/s and b/w but that's about it.

Miriam

[Jenniferm]

Do you know if it is manditory in NJ or provider specific? My Dh works for a hospital and we have coresource which is a third party provider. I went to their website and cannot find anything.

[MelissaS]

NJ does have mandatory insurance for IVF, but Different companies have different levels of coverages.
Blue Cross covers, but how good it is depends on the employer. I have Empire BCBS, which is a NY Plan but is good in NJ, because we live here. it pays 100% for up to 3 attempts, no annual limits or caps. . . at least for this year.

I heard that insurance through a state or government employers is great. No caps or maximum attempts. . . .

[MelissaS]

http://www.resolvenj.org/FBAIsLaw.html


Here is a link to information
relating to the NJ Mandate for infertility benefits. The insurance company has to provide benefits, but to what extent I'm not sure. I know that some insurance has caps and other "rules" to limit payout. . . so it depends a lot on your employer.

Philips lighting has good insurance 100% for 3 attempts

[Jenniferm]

My Dh works at Morristown Memorial Hospital, therefore we have "Coresource" insurance. They cover as many IVF attempts as you wish but not the medication. So a plus and a minus for them. Also, there are only 2 or so clinics covered but since there are none in my area that they "cover" I can go to any one and they consider it in network.

[beeslisab]

Hi I am one of those government employees and we do have a limit. 3 over life. But we are still covered so I'll take the three and be thankful. I am just starting my first IVF cycle and am very scared! I am currently going to Diamond Infertility in Millburn. Just love 'em to a while to warm up to them but I am very happy with them now.