UHC Insurance

[Fireflyxx]

Hi -

I live in New York and have an IVF rider with United Health Care. It is capped at $30K.

The question is - how do I find out how much of that is used up per cycle? Are prices paid by insurance companies lower for IVF than out of pocket costs?

They will be sending me an Out of Pocket Audit but it takes up to a month - that useless. I assume that will be an itemized listing of monies used. But I don't know if it's just all lumped in with my other medical crap.

I have put in a call to the insurance company but they are virtually useless. They couldn't even tell my how the meds were being accounted for. Did they come out of my $30K or are they being treated differently.

And I sent an email to the clinics UHC coordinator but she hasn't gotten back to me.

This is confusing. I would like to see whether I have enough for one or two more cycles.

If anyone has dealt with UHC in NY I would love to hear your comments.

Thanks!

[michie]

Hi,

I am in Georgia. I do not have UHC but I do have BCBS. I have done one fresh IVF and I know that my insaurance did not cover freezing my embryos. I basically paid my copay for each visit. Also your insaurance company neigotiates at a much lower rate than if you pay out of pocket so I would say that that 30K should cover at least 2 fresh attempts and 2 Frozen cycles. For example. My dr office charges 13K without insaurance and with my insaurance they were paid approx. $5K . Drugs ran about $4K . However I paid about $300 out of pocket. I have top of the line insaurance, and if you do too I would budget approx $2000 out of pocket for a fresh IVF drugs included. Also ask your RE office what your insaurance does not cover for a fresh cycle. Then ask them for an ivf protocal and figure out your copay total. Add that up and Im thinking that you will have an approx idea. Hope this helps.

[Fireflyxx]

michie -

I wish that they had negotiated prices - I've started seeing some of the claims now and it appears that they are getting a lot of money - not much under their published prices. They do each b/w and u/s separately. I'm going to have to see if my totals come to MORE than what they would charge out of pocket for a cycle.

Thanks for the info.

[ClaireMatt]

Hi Fireflyxx,
I know this thread is old, but I was wondering if UHC was covering your meds. After paying for two IVF cycles out of pocket, I finally have IVF coverage this year with UHC. Could you please let me know about the meds.?
Thanks! Good luck with your cycle.
Maria

[Fireflyxx]

Hi - Somehow the meds are covered under the prescription plan that we have and are not part of the IVF rider. I feel very, very, very lucky for this. You will have to check with your HR person and you can try UHC but they were pretty clueless.

Good luck!