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 must create an account (or log into your existing account.

Step 2. You will be asked to specify where you live. Make sure you select Illinois. Then start your application.

Step 3. You will be asked to answer a bunch of questions like your address, income, social security number and who in your family you want to have coverage. The most important person to get covered is the person who is trying to get pregnant. If your income is low enough, you might qualify for discounts on the monthly premiums.

Step 4.   Once you have that completed, you will be presented with a list of insurance policies that you can purchase. You can choose to filter plans by things like deductibles and premiums.

Step 5 – For each policy, you will see information to help you decide on the right plan for you.

You can see what the deductible and out of pocket maximum will be

To make sure that this plan allows you to come to IVF1,  click the “Add you Medical Providers” link and Add Randy Morris M.D.

You can also make sure that your fertility medications will be covered by using the “Add Your Prescription Drugs” link

Step 6 – Next, click the link labeled “Plan Details”

Step 7 – Scroll to the bottom of the page to where is says “Other Services” Click the down arrow on the right to open that section.

Look for the line marked “Infertility Treatment” It will tell you whether this plan covers infertility treatment and the in network and out of network costs.

To make sure that IVF is covered, click the link below Infertility Treatment called “View Limits and Exclusions”. If this plan covers IVF, you should see this in the popup window

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 coverage for 4 IVF egg retrievals each year (including egg donor retrievals) AND as many frozen embryo transfers as you need.

If you see only the words “Limitations vary based on the procedures performed”, then BEWARE! 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.