blue cross blue shield

Discussion in 'Insurance' started by happyfeet, Jun 17, 2007.


    happyfeet New Member

    I have insurance through my husband with BCBS over texas.... They DO cover fertility treatments such as IVF, perscriptions etc., 100% 10 dollar co-pay for fertility specialist up to $25,000 a lifetime.. like for instance i picked up my perscription for metformin, clomiphene,atenelol, and loritab and the cost all togather was like 6 dollars...So I'm gonna have to give BCBS a thumbs up for recognizing us who need a little help... $25,000 can go quick so we have to be sparingly about it but if it takes that much or more to conceive it just wasnt meant to be

    Poppycorn95 New Member

    You're VERY lucky!! Blue Cross doesn't cover ANYTHING fertility-wise at my husband's work... Well... it only cost us $10 for the Progesterone in Oil...but everything else was out of pocket.

    sarah16 New Member

    BCBS actually cancelled our IF coverage and didn't tell us until after one of my coworkers had gone through a IVF. Some meds are covered and we have co-pays for the doc visits. Nothing else is covered.

    jt1214 New Member

    I have BCBS through a direct pay program it costs me about $293 per month with no script coverage. They covered everything except for the scripts. I had to wait six months before I could use the Insurance card. After 4 IUI's w/clomid and Injectables, 1 Cancelled IVF cycle due to OHSS and my last FET cycle I am happy to say that I am :preg: and it cost us a total of about $7000 that is a big difference compared to what it could have cost us out of pockets. So needless to say I am very Happy with BCBS of Massachusetts. I am glad that Mass is an Infertility Mandated state. :cheer:

    happyfeet New Member

    yes, I guess every bcbs is different my husband has very good benifits through his company he pays a total of 262 a month and that is script, hospital stays, dental, vision, so far i havent found anything it dosent cover except the first year we couldnt use insurance on bridges or crowns in dental, however we didnt need it..thank god...but i asked about the ivf incase it comes to that and it covers all fertility procedures up to 25,000 a lifetime so i love bcbs

    jenjean New Member

    my husband has blue cross blue sheild of texas as well but the company he works for only covers the testing not the treatment. you are very lucky. my husband and i had to decide how far to take this and we both agreed after 3 iui's we will start adotion proceedings. i really hope the iui works.

    jencat215 New Member

    My insurance only pays diagnostics, not treatments. You are lucky. I am very glad you seem to be having a better day today. SOunds like you are a victim of the Clomid Crazies, like my husband likes to say to me!

    babydance143 New Member

    I have BCBS of ILLONOIS. I agree so far I have only paid co-pays of $15. But I was told that if I had to have further treatment done, that I would be covered!! I was relieved to hear that..

    Angel0226 New Member

    Yes, Blue Cross Blue Shield insurance definetely varies from state to state... and within each state as well. We have BCBS and pay the premium out of pocket each month. We pay approximately $600 per month, so I would hope they pay well. We have no infertility coverage left at this point. We were given $15,000 lifetime maximum and of course, you ladies all know how fast that goes. After our failed IUI's and diagnostic testing that was coded as infertility, we had to pay for most of our first IVF out of pocket as well as all of the second one.

    I wish the coverage from these insurance companies was a little more even across the board. I still can't believe that infertility is seen as just that, not a disease, but just a condition that they can cover if they want. I was soooo mad a few weeks back when I was watching a news program and they were talking about video game addicts. They were trying to say that it was a disease and make sure that insurance coverage was mandated for it. I got sooo mad, I ended up just shutting the t.v. off.

    heatherdawn New Member

    Blue Cross of California

    My husband has Blue Cross of California that only covers diagnosics and $1500 twards injectable drugs if you use their chosen super expensive general pharmacy (which of course we did) who always sends the meds late without enough needles and then doubts you when you call to get the rest of your needles. :grr:

    Then we couldn't do the IUI because I hyperstimulated so all the drugs were waisted anyway. So it's out of pocket and IVF from here on out.

    moolissa New Member

    I can't speak for BCBS, but I work for another large insurance company and know that in the states that don't have mandated coverage the Infertility benefits are offered as a rider, meaning that the employer chooses whether or not they want to purchase the coverage and at what level. In other words, it's up the employer whether or not you have the Infertility benefit.

    State mandated coverage only applies if it is a fully insured plan. If it is a self-insured plan (the employer funds the claims and the insurance company only administers the plan) then state mandates do not apply. The majority of the employers I see are self-insured.

    Hope this helps and I have not caused more confusion.

    mrsjanowski New Member

    I have the BCBS in PA (but i live in MI) and they cover exactly what you just stated for me too. Unfortunately all BCBS states do not have this type of coverage, but it would be nice if they did for everyone elses sake... =)

    HollyC New Member

    Moolissa - I am glad you told us that because after reading several posts I was beginning to wonder if the different employers is what determined your coverage.

    For example, I also live in Illinois, however, I am lucky to have great BCBS insurance. I pay nothing for my insurance, my school district pays all of our premiums. My insurance covers 100% infertility treatment up to $1mil lifetime (I hope I won't need IF treatment long enough to even get close to that amount!!!).

    However, our contract is done at the end of this school year and negotiations will start for the next contract and insurance is always a bargaining chip!! So who knows...we may not have this awesome insurance starting next school year and I need to take advantage of all I can right now!

    That also irritates me that people are trying to get "video game playing" diagnosed as a disease so that insurance companies will pay for treatment....come on!!! That's easy to fix - just through the %$#@ game system away!!!!

    My heart goes out to all of you who need to pay a lot of money out of pocket for treatment. My DH has some friends with IF and they had a choice eihter save $ and buy a house or one round of IVF because that is all the money they would be able to save. Well...they went with the IVF and thank god it worked and she is :preg: now, but wooo, talk about putting all your eggs in one basket!!

    Sending :babydust: :babydust: to all of you!!!

    SueBear New Member

    Interesting, I'll have to check this again. I've got BCBS of NE with my husband and from what he was saying, nothing regarding fertility is covered and he works with a University Hospital.

    I really can't say for sure until we get more into it and I have further information.

    babycowlover New Member

    what state do you live in wher BCBS does this, I realize you said it is BCBS of Texas but what state do you reside in? I am wondering because my husband had BCBS of Texas.....hmmmmm!

    babycowlover New Member

    Happyfeet-what state do you live in? I am wondering because my husband has BCBS of Texas but I live in Michigan. I am wondering if he may have better coverage than I realize......hummmmmm!

    sunshineshimmers New Member

    my state bcbs covers 70% of all my fertility costs....for instance my consult with the RE would have been 235.00 and I paid 40.00. The injectibles are 53.00/vial and I have 10 vials on hand.....and it only cost 120.00.... I am really thankful too!!

    SueBear New Member

    Something I meant to add onto this husband has BCBS of Nebraska so there's no confusion and we checked into it for fertility coverage. From what was said, they cover testing but the treatment they don't cover is what it's looking like. A major bummer.

    I did received something in the mail earlier today (Friday) that has updates of new co-pays and so forth so it may be worth making a phone call if it gets to the point that we might be looking at something of fertility treatments. No guarantees that things have changed there but I guess it wouldn't hurt asking. I'm just trying to focus on my dr's appt Tuesday as it's only a few days away. My nerves are already starting to dance a little. LOL!

    MrsBiff New Member

    i know that BCBS has different plans. I have the ONE that the fertility center in Memphis doesnt accept. And of course its from DH's work. I'm wondering if i could get another insurance just for this. I really want to go to this fertility place.

    Right now DH is looking into getting me vitamins.
    After that, we'll see where we go.

    MrsBiff New Member

    i know that BCBS has different plans. I have the ONE that the fertility center in Memphis doesnt accept. And of course its from DH's work. I'm wondering if i could get another insurance just for this. I really want to go to this fertility place.

    Right now DH is looking into getting me vitamins.
    After that, we'll see where we go.

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