insurance/state mandated IF coverage/NYS politicians...

Sooooo...some of you might think I am crazy...and I may be, or it could be the hormones...but...I am going to start my own little campaign to get all infertility treatments mandated by NYS like it is in Massachusetts. I mean really, why the heck do we pay so damn much for insurance we can't get coverage for the things we need??? Insurances profit WAYYYYY too much in my opinion.

Recently, I read some ladies on here have no infertility coverage. I was just wondering if any of you have called your insurance companies, because according to this they are mandated to cover the diagnosis and treatment of infertility; unless I am reading this all wrong. I did read that if medications are approved by the FDA, insurances must provide coverage.

I still need to do A LOT more research and find out how and who to contact for this. I am hoping I can get a ton of women and their families to write letters to NYS government when the time comes.

As of September 1, 2002, NYS requires that private group health insurance plans issued or delivered in the state that provide coverage for hospital care or surgical and medical care must cover the diagnosis and treatment of infertility for patients between the ages of 21 and 44 who have been covered under the policy for at least 12 months. IVF is excluded.

Currently in Massacheusets, covered fertility treatments include artificial insemination (AI), in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT) , sperm, egg, or inseminated egg retrieval, intracytoplasmic sperm injection (ICSI) for male infertility, and zygote intrafallopian transfer (ZIFT). The Massachusetts infertility insurance mandate also specifies that insurance companies cannot impose limitations, restrictions, or exclusions on coverage for fertility treatment drugs that are different from those imposed on other prescription drugs.

http://www.fertilityauthority.com/costs/insurance-coverage/new-york-infertility-insurance-mandate

http://www.ncsl.org/research/health/insurance-coverage-for-infertility-laws.aspx

insurance/state mandated IF coverage/NYS politicians...

I called United Health Care Oxford last month and I don't have ANY infertility coverage. As far as medications, they are covering progesterone supps. I don't have any $ towards IVF or IUI's. I am in network only. It's very frustrating!!!! As they explained it, it is my Employers choice to opt out or not include IF benefits. I spoke to my plan administrator and she said it cost too much $ to add the coverage so they will not be adding it to the 2014 plan...shocking.

Re: insurance/state mandated IF coverage/NYS politicians...

I was lucky enough to get my last two cycles of meds donated but I read the same thing and want tho Terry to get my insurance to reimburse the meds I paid oop for.

Re: insurance/state mandated IF coverage/NYS politicians...

I've been back and forth with my insurance (Oxford) also calling other insurance companies AND have had my insurance agent on this for me - all dead ends. Like pp said, if your employer opted out of IF coverage there is nothing you can do. We purchase our own insurance through our business and I checked I to getting the additional IF rider and was told we have to have a contract of 50 or more ppl covered in our company to be eligible to even purchase the rider. So again, another dead end.

If you want to start some kind of campaign for NY to get on board, I am in. Tell me way to do and I'll do it.

After receiving that letter from Oxford stating IVF is still not covered but you can get 1 abortion per year fully covered, I have been enraged!!!

Re: insurance/state mandated IF coverage/NYS politicians...

I was just thinking about this. So frustrated with how little to no coverage there is around infertility. I'm in with whatever you want to do. Even if you want to all gather up and put our heads together (hey! next g2G might be a good time ;)), then count me in.

Re: insurance/state mandated IF coverage/NYS politicians...

Re: insurance/state mandated IF coverage/NYS politicians...

insurance/state mandated IF coverage/NYS politicians...

you have FM!

Re: insurance/state mandated IF coverage/NYS politicians...

I'm with you. My insurance doesn't pay either, and in my research I did come across this "Infertility Tax Credit - Family Act of 2013" bill and sent emails right from the website to legislators to support it. Basically it is a tax credit for 50% of infertility treatment oop costs up to $12k. It would be better if insurance covered it, but at least it's something....


http://www.resolve.org/get-involved/infertility-tax-credit.html

Re: insurance/state mandated IF coverage/NYS politicians...

I have coverage through DH, we have no coverage for IUI or IVF . Basically all they will cover is testing and any surgery to correct any abnormality . WTF not being able to get pregnant in 6 years I would consider an abnormality no? We have spent thousands of dollars and its so frustrating DH works for Local 3 great job , infertility coverage was on the table for a renewal in their contract but they voted it down. I'm in for taking a stand against ins companies.

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Re: insurance/state mandated IF coverage/NYS politicians...

Message edited 11/8/2013 6:05:02 PM.

Re: insurance/state mandated IF coverage/NYS politicians...

Re: insurance/state mandated IF coverage/NYS politicians...

I've done some research on this as well. The only thing I've found is that NYS is a state that mandates insurance companies to provide infertility testing to all men and women- but there are loopholes. If your health insurance is through your employer, and the policy is is self insured (which most are), then they do not have to follow the state guild lines. If they are fully insured, then they MUST provide you with fertility testing.

Also, if your employer is located out of state (let's say you work for a branch of a corporate company based out of state), then they do not have to cover any testing.

Also, if your company is based in another state, and that state offers any other type of fertility treatment (like IUIs), but you do not live in that state, then you can not reap that benefit.

I did so much research through the resolve website trying to find out if anything was covered since we pay out of pocket for everything, but we were shit out of luck. Hopefully the testing part can help out some women on here though.

insurance/state mandated IF coverage/NYS politicians...

This continues to boggle my mind. I am sooo fortunate for my coverage it embarrasses me. I will join any campaign and dedicate myself to it 100%. It's just not right.

Re: insurance/state mandated IF coverage/NYS politicians...

okay I will fully support this idea. But its a long shot. look at resolve.org it shows which states have mandates to cover ivf. most of this was political motiviated if you ask me. they have been pushing for a national coverage for a long time.
Most insurance companies will cover tests as diagnostics. drugs like progesterone,femara and letrozole will be covered because they are used for different things not just infertility but not clomid.
I did a lot of research since I was all oop and even my ultrasound were not covered. I was also lucky coz I got some donated meds.

insurance/state mandated IF coverage/NYS politicians...

Trust me, I totally know it's a long shot. I could absolutely be setting myself up for another disappointment. But, nothing changes until we try and make a change. I've been looking into steps to make it happen all day. I have to research and gather facts about all of the states IF mandates especially the best ones. I will need a ton of IF statistics, especially NYS stats. While I am researching I have to write up and start a petition. I will use an online petition as well as carry a printed petition everywhere I go . After I have my facts and petition I will make an appointment to meet with our state assembly person and HOPE we can get somewhere . I'm going to share the petition in every IF forum, Facebook, maybe I can get my RE to leave a petition at the front desk, I will send it to news outlets...wherever I can. That's where we are going to need the most help, the petition. I don't know if anyone wants to pick a state and research their IF mandates? I am determined. So many of us are at the mercy of our insurances. If they will pay for abortions, Viagra, narcotics...so many things, why not help women like us bring children into loving, stable, happy homes. We pay sooooooo much into our insurances, would be nice if they were mandates to give back a little!

Maybe nothing will happen...but what if something DOES happen. It's worth a shot. An hey, if nothing else, it will keep me so busy I won't have time to snack all day LOL

Message edited 11/8/2013 8:26:29 PM.

Re: insurance/state mandated IF coverage/NYS politicians...

I would love to help. Please FM me with a state.

insurance/state mandated IF coverage/NYS politicians...

Definitely share the petition with us when it's ready !! Could this be done through change.org ? This needs to happen

insurance/state mandated IF coverage/NYS politicians...

I would definitely be in support of this and sign a petition! I think it's horrible that IVF is not covered.

Re: insurance/state mandated IF coverage/NYS politicians...

I couldn't agree more....Let me know what we can do ....

insurance/state mandated IF coverage/NYS politicians...

count me in. If I didnt have coverage thru work I wouldnt have been pregnant now. Or ever. As insurance was running out (my ins covers 10,000 lifetime IVF including one live and one FET cycle) I knew that next step if it doesnt work would be OOP and we are a one income family. This is not something ppl shld be thinking abt when trying to bring children into the world.
What boggles my mind is that infertility not considered a medical condition. Would they refuse a heart patient's coverage? no. how is this different? and reading Phyllis's post abt the abortion coverage enraged me to no end. How is that a medical condition to be covered??? I am all for woman's right to choose, but common! Having ins company cover for it and not for actual real medical issue is ridiculous (when its not medically necessary that is but an unwanted pregnancy).

You are absolutely right this will be a huge long shot, but something has to be at least attempted to be done. Let me know where to sign and I will also work in getting a petition out to co-workers and family members (esp that close friend and SIL are all IVF patients).

Message edited 11/9/2013 11:48:51 AM.

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