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Old 05-01-2009, 04:39 PM   #1 (permalink)
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Default Need some guidance on selecting a Health Plan

My open enrollment isn't until Nov/Dec. But, I just came back from a consultation with my RE. We went over my next steps...IVF. My DH and I opted to do three more cycles of IUI. That brings us to September...and then we would relax until the new year, Jan 2010 and switch to a health plan who has a IVF benefit included. See, we don't have alot of money saved up and I know the plan that my company has with AETNA HMO covers 50% of IVF. However, they have a blurp stating this:

IVF is covered if you meet this criteria:

Your infertility is associated with endometriosis,
exposure in-utero to diethylstilbestrol (DES),
blockage of, or surgical removal of, one or both
fallopian tubes, or abnormal male factors, including
oligospermia contributing to the infertility, and
• You have been unable to attain a successful
pregnancy through a less costly treatment that is
covered by the Plan.

Well, I was diagnosed with PCOS as all of you have and I just don't understand whether or not I would qualify for the IVF benefit through AETNA...in fact all of the plans that my company use and that those plans have IVF coverage all have the same blurp as above. If someone could shed some light or help interpret the above statement...that would be so very helpful and appreciated.

Thank you! ebe44
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