Living in mandated coverage state (IL) but insurance won't pay- need advice (dd ment)

[Karyn]

Hi,

I would like to see if anyone has had an experience like this. I live in IL which madates coverage for DE IVF. My dh just got a job at a company that is headquarted in CA- and they do not have such laws. So we are being told no IVF coverage is available through our insurance. I would like to know where to go from here. I have one dd via DE IVF (at the time everything was covered). Has anyone had a similar situation, living in a mandated coverage state, but insurance headquarted in another state and denied coverage? What did you do about it?

Other than insurance- has anyone found a way to get financial assistance (loans, grants, etc.) to help pay for treatment? Do all RE's have to allow this type of funding (for some reason I remember mine not being open to this)??

Thank you,
Karyn

[loveforanother]

My husband is based out of OHIO which is also mandated, IF was coverered 100% by the ins. co but since we moved to the great state of WISCONSIN which is not mandated--we get to pay 100% for IF!!! Nice huh??? Anyhow what I'm getting at is that when we were transfered here our ins changed -we had choice care and it went to blue cross/blue shield in Wisconsin-- Will you get a different provider since you are in ILL. now?

Other than that you will have to pay out of pocket-- get a loan, or low interest credit card!!-Good luck to you!!



Karen

[justkaren]

I don't know the answer, but you should have a state agency with a name something like "state insurance board" (that is what it is called in NY). They will know the answer. It is their job to know.
Best of luck. BTW- I would GUESS that even though the company is headquatered in Cal, if your hubby works in IL-at a regular office-not as an indepentent worker sort- they have to cover. But, that is just my guess. I would call the state and ask. I wish my insurance covered DE IVF. Honestly, it is only because IVF is covered and DE IVF is not that I haven't moved on to DE.
Karen

[Hopefull K]

I had the opposite situation. I live and work in CA (no coverage state), but my company was headquartered in NJ (mandated coverage state), so for a period of about 1 year, my IVF was covered, except for the meds, because it was a CA prescription plan. Then unfortunately my company moved its HQ to CA and again, I had nothing.

My understanding is that if a company is HQed in CA like in your case, and they have employees in IL they fall under the CA laws, basically wherever the policy originated (the address of the company's on the insurance policy document). However after a company has x (I think this may be 50) number of employees in a different state, they have to comply with that state's insurance requirements and have a local policy available for employees in that state.

Hope that makes some sense.

Good luck!

[Skidaddle]

Karyn -

Check out the Insurance & Advocacy Board here at Fertile Thoughts. There is some info. on Illinois law there.

Good luck!!

[Margaret W]

Karyn,

My employer is from IL and I had mandated coverage while my company had IL insurance. But, they just switched to coverage from another state (we are a multi-state company) and they therefore no longer offer coverage. So, I am in a similar situation, unfortunately, I don't know what can be done about it.

Wishing you luck,

-

[kara6820]

I also live in IL. This is just a suggestion and I really have no idea what your situation is. My DH insurance covers $0 of fertility. My job covers almost everything. My health insurance has more than doubled my salary in the past year because of the cost of IF treatments. Why not just get a job (temporarily) here in IL that does cover the IF? I am sure you would have to pay for day care for a while for dd but in the long run it woud save you so much money to have insurance that covers IF. Just an off the wall idea.

[DA]

Why is it that fertility treatment is not mandated in California? Isn't California supposed to be a liberal state, sympathetic to the needs of a diverse culture?