Can I just say, to those of you who have infertility insurance coverage, that you are some very lucky gals?
Even though I work for the State of California, I stupidly decided to go with my husband's insurance and give up my fantastic insurance options through my job. I don't have the option to get it back until 2010 (unless I have a baby, of course). Let me just say that I have no idea what the infertility coverage through my work insurance options is, because I dropped my insurance way before I knew we were infertile. Still, I don't think it can be worse than my husband's options.
My husband is a co-owner of his business - he owns around 45%, the other major partner owns 45%, and then there is a third guy who has about 10% ownership. The reason why this matters is that any company expenses are paid halfway by us. Including the employer's share of the insurance premiums.
We're switching insurance right now. Our old insurance had a $2000 lifetime limit for infertility, and our clinic is out of network. I still haven't submitted our claims, so I don't know if it will cover anything we've done. I really need to do that soon.
Our new insurance ... sucks. If we do the HMO option, we get around a $1500 lifetime limit, BUT it doesn't cover IUI or IVF! (But it does cover GIFT?! Who makes this shit up?) Um ... really? WTF does it cover, then? Ultra-sounds and meds?
If we do either the PPO or HMO option, there is an "optional rider" my husband's company can purchase. It has a lifetime limit of around $1500 to $2000 (depending on the plan), and will cover 50% of costs for 6 unmedicated IUIs, 3 medicated IUIs, and I think one round of IVF (up to a maximum of $1500 to $2000, which is to say a fraction of what we'll have to pay). But premiums for the entire company for a year will easily cost MORE than the benefit for us. Considering that just about everyone in the company either already has kids or is a young single guy - we'd be paying the premium for everyone pretty much to cover only ourselves.
To make it worse, to get the optional rider, we'd be basically telling everyone in the company that we're infertile, AND underhandedly having the other partners pay for our (useless) infertility insurance. So it's not really an option.
So there you have it - basically, no coverage at all. Really, what's the point of even having infertility coverage in these plans? For appearances?
Does anyone know how to get involved in political reform? Isn't this kind of thing an absolute crime? Really - anyone out there in the state of California who knows how we can fix this? On the other hand, after the recent octuplet incident in our fair state, I'm guessing this would get shot down before it got off the ground.
Oh, and to add insult to injury - the insurance agent told us that our premiums were so high BECAUSE WE'RE OF CHILD-BEARING AGE. I didn't know whether to laugh or cry.