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FEHB plans - HMO plans?

We currently have BCBS Federal Basic and are considering switching this open season.  We are trying to conceive and have recently hit the one year mark so looking ahead I'm trying to look at policies that may cover ART (IUI and IVF).  It looks like none of the PPO plans do, but many of the HMO plans do. 

Does anybody have experience with Aetna Open Access, Care First Blue Choice of MD, or Kaiser Foundation Health Plan.  I'm interested in their overall care/doctor access as well as ease of payment for any IF related procedures.

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PAIF/SAIF welcome
TTC #1 since 10/2010, Cycle #26
Diagnosis: Unexplained IF
IUI #1 (Cycle #24): Clomid, Gonal-F, trigger, 4M post-wash = BFN 11/9/12
IUI #2 (Cycle #25): same protocol, 10M post-wash = BFN 12/12/12
Break Cycle #26 = CD69 BFP
Beta #1 2/20/13 = 449, Beta #2 2/22/13 = 1012, Beta #3 2/25/13 = 2479
u/s 3/1/13 = gest sac and yolk sac
BabyFruit Ticker

Re: FEHB plans - HMO plans?

  • I've been a Kaiser member for 3 years now and I absolutely love it. I like that they have electronic medical records and that all of your doctors can see the same information. Also, you can schedule appointments online, email your doctor, see all of your lab results online, refill prescriptions online, etc. It's really convenient to have everything done electronially. The urgent care hours are also nice because they are open until 1am every night, all day every weekend, and on holidays. With a LO, we have had to use urgent care many times so this is a godsend. They also have nurse hotline that is open 24/7 which I have also called a number of times when DD had a fever or something and I wasn't sure if she should see a doctor or not.

    I don't know specifically what Kaiser covers with infertility but hopefully that information is in your documentation. Oh, and when I had a baby, my plan covered everything. The only thing I had to pay was a $10 co-pay for my pregnancy confirmation appointment. After that, all of my prenatal care and delivery was covered at 100% (however, check your plan because this may depend on your employer).

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  • I have had Care First Blue Choice of MD for 3 years and have no complaints (I've been with BC for as long as I can remember so I'm comfortable with them).  We are currently TTC as well so I do know that they cover infertility testing as well as IUIs (up to 6 per live birth).  They do not cover IVF.  

    A friend of mine who just started IVF for her second child has Kaiser and they do provide some coverage for IVF and the meds.  It's not completely covered but I believe it was almost 50% (don't quote me on that).   

    I might consider switching to Kaiser if (hopefully not) we would have to pursue IVF.  I really like my current doctors so I'm hesitant to switch unless it's absolutely necessary.  Everyone I know that has Kaiser really likes it though - for many of the reasons that vtkendra mentioned.     

     Hope this helps a little.  

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  • Thank you ladies.  I will definitely take some close looks at the CFBC and Kaiser plans.  I know my current doctors are covered by the Kaiser plan and I'm pretty sure the CFBC so that is good. 
    Image and video hosting by TinyPicImage and video hosting by TinyPic
    PAIF/SAIF welcome
    TTC #1 since 10/2010, Cycle #26
    Diagnosis: Unexplained IF
    IUI #1 (Cycle #24): Clomid, Gonal-F, trigger, 4M post-wash = BFN 11/9/12
    IUI #2 (Cycle #25): same protocol, 10M post-wash = BFN 12/12/12
    Break Cycle #26 = CD69 BFP
    Beta #1 2/20/13 = 449, Beta #2 2/22/13 = 1012, Beta #3 2/25/13 = 2479
    u/s 3/1/13 = gest sac and yolk sac
    BabyFruit Ticker
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