June 12, 2014
On the recommendation of the Medical Benefits Advisory Committee, the university will expand its current coverage of infertility diagnosis, drug therapy and counseling to include in vitro fertilization.
The new coverage takes effect on Jan. 1, 2015, and applies to most U-M medical plans.
The expansion will provide IVF coverage for women through age 42 who have been diagnosed with infertility. Individuals contribute a co-insurance of 20 percent of the cost, and the remainder is covered by the plan up to a $20,000 lifetime maximum.
Everyone who is eligible for IVF will have access to a clinical provider in the U-M Health System, where procedures must take place. IVF services at non-UMHS providers will not be covered.
Rich Holcomb, senior director for benefits, said the expansion of coverage was recommended by U-M's Medical Benefits Advisory Committee, a group consisting of clinical practitioners from the U-M Health System and insurance and plan administration experts from U-M. The group periodically reviews plan designs and coverage levels based medical protocols and evidence of outcomes.
"The coverage of IVF is intended to help women and families with infertility options and reduce the financial burden on families by covering the IVF treatments most likely to be safe and effective," Holcomb said.
All of U-M's self-insured medical plans will add IVF coverage for 2015. Health Alliance Plan is not a self-insured plan and is excluded. Employees with HAP coverage who are candidates for IVF can change plans during the next Open Enrollment period for coverage of IVF in 2015.