How to make sure your Obamacare policy covers infertility and IVF

Illinois law requires most employers to provide insurance coverage for infertility and IVF. There are exceptions, however. What can you do if your lame employer doesn’t provide insurance coverage for infertility or IVF? Dump that insurance and get IVF insurance coverage through the Illinois Healthcare Marketplace. This is the centralized website where Illinois residents can go to buy insurance policies from common insurance companies like Blue Cross and Cigna.

Here is a quick run down on how to make sure that the insurance policy you purchase will cover infertility and IVF

Step 1  – You will be asked to specify where you live and who you are trying to cover. The website will determine whether you are eligible to get assistance to pay for your premiums. Once you have that completed, you will be presented with a list of insurance policies that you can purchase. For example, if you are a 35 year old woman who lives in DuPage county, you can choose from 22 plans

 

Step 2 – On each policy, you will see a button to click labeled “Details”.  Click the details button

 

Step 3 – Next, click the link labeled “Summary of Benefits”

 

Step 4 – In the Summary of Benefits document, scroll down several pages. Near the end, there will be a section called Other Covered Services. Look there to see whether infertility is covered.

Look for a statement like this one in yellow. This is a great insurance policy to have for infertility or IVF

Look for this statement: “Infertility treatment (covered for 4 procedures per benefit period)” This means that this policy will cover all infertility diagnostic tests and treatments INCLUDING IVF. This type of policy will provide you with covereage for 4 IVF egg retrievals each year (including egg donor retrievals) AND as many frozen embryo transfers as you need.

A statement like this is less certain. Be cautious about a plan like this!

If you see only the words “Infertility Treatment”, then you need to be more cautious! This type of policy may have more limited infertility coverage and may NOT cover IVF. You will have to then look at an actual copy of the full policy to see what is covered.