Most U-M medical plans to cover in vitro fertilization

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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.

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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.

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Comments

  1. Jill B
    on June 12, 2014 at 7:32 am

    Well, this is disappointing.

    • Sarah Rubin
      on June 12, 2014 at 8:07 am

      May I ask what’s disappointing about this?

      • Jill B
        on June 20, 2014 at 7:47 am

        The world is overpopulated as it is. Try adoption if you must have children but can’t conceive or carry a child to term. And, I don’t want to foot the bill for your infertility treatments.

        • Lauren D
          on October 30, 2014 at 1:05 pm

          Wow. That is awfully judgemental and quite rude. I’d love to hear how much you’re actually paying – you, yourself – towards the coverage of IVF treatments for others.

        • candace oleniczak
          on October 17, 2016 at 9:04 pm

          U are an inconsiderate bitch.

  2. Lisa McCloskey
    on June 12, 2014 at 8:20 am

    It is about time. Too late for me, but so glad my co-workers will get this coverage!

  3. Desiree Gillett
    on June 12, 2014 at 8:22 am

    As someone who personally witnessed the struggle of UM employees trying to afford their infertility treatments, this make me proud. A huge step in the right direction.

  4. D J
    on June 12, 2014 at 8:30 am

    My guess as to why Jill B would find this disappointing:

    The average cost of an IVF cycle without meds is 8,158. (see resolve.org, national infertility association)
    So if I’m reading this correctly, the plan covers 2 tries total throughout the lifetime. (20,000)

    Anyone I’ve met and in my family who has used IVF has gone through 3 cycles or more to conceive.
    For a coworker at another institution I worked at, our plan covered all $50,000 of her IVF costs. She paid nothing but doctor’s copays and some minor costs for lab work for the entire process.

    So what I’m seeing here is that I can try twice my entire life, and pay up to $1,000 each time I try. As a person with infertility very common in my family, I find this discouraging also.

    • T A
      on June 12, 2014 at 9:35 am

      The article says that there’s a 20% co-pay, which means that $20K would cover 3 treatments. As with many things at the U over the past 10+ years, costs are pushed off onto staff, while raises are held to a sub-inflation rate.

    • Sarah R
      on June 12, 2014 at 9:36 am

      Hi DJ, yes…that’s what I’m hoping Jill B is disappointed about as well but there are actually many people who were very against UM passing this policy. As someone who just paid over $15,000 out of pocket for IVF, I am well aware of the costs involved and how $20,000 doesn’t look like much but it’s something!! I’m thrilled about this announcement and couldn’t be more happy for my fellow infertile friends, family, and coworkers who now have an opportunity to seek infertility treatments without it being a completely crushing financial blow. While this wasn’t the announcement we were all hoping for, it’s a step in the right direction, hopefully this will lead to higher caps in the future for people like you and all the other female UM employees.

      • Jill B.
        on June 20, 2014 at 7:53 am

        Nope. I just don’t want to foot the bill and I believe that the world is overpopulated as it is. Make adoption an option if you must have children but can’t. And frankly, I don’t understand why people want to bring children into this troubled world. (My 81 year old father agrees with me.)

        • Sim M
          on July 3, 2014 at 5:31 pm

          I am wondering what your 81 year old dad feels about treatment for dementia. Is it necessary? Why should we foot the bill for dementia patients? I mean as long as their heart and lungs are functioning, do they really need all the memories and other brain functions? To one person motherhood and pregnancy might be as important as memory. Think about it.

          • Jill B
            on July 7, 2014 at 7:29 am

            Treating dementia is a quality of life issue. Motherhood is not a quality of life issue.

          • Sim M
            on July 7, 2014 at 4:33 pm

            Maybe not to you, but not every mind works in the same way. I have seen people go into heavy depression dealing with infertility issues. You can’t judge everybody by the same standard.

          • candace oleniczak
            on October 17, 2016 at 9:09 pm

            Exactly. It is too bad Jills parents didnt suffer with infertility. Gave birth to an awful human being. Too bad. Many people do suffer from depression because of infertility, but i guess depression isnt a quality of life issue to people like Jill.

  5. Alicia Petrucci
    on June 12, 2014 at 8:55 am

    Way to go UofM! So happy to see these employees will have access to this essential and fair coverage.

  6. Julia Shapiro
    on June 12, 2014 at 9:15 am

    While the dollar figure of 20K is perhaps less than a third of what my son cost to create, it is 20K more than my insurance covered. Also, even the best coverage, such as that mandated by Massachusetts law, only covers women to age 40. I’m 36, and seriously considering getting a job the U of M just to have baby #2.

  7. Laurie Howland
    on June 12, 2014 at 9:26 am

    I do not feel this is something that medical insurance should pay for. Cost of insurance is high enough without adding this to everybody’s tab for the few who need it. I understand that it is an emotional situation for people who need it, but, for me, this doesn’t fall into the category of maintaining or managing one’s health.

    • T A
      on June 12, 2014 at 9:40 am

      Some people use a less-narrow definition of what constitutes health. Mental and emotional health is important to the physical well-being of a human, and also impacts one’s ability to be a productive member of the university community. This is a logical step, as well as a humane one.

      • Laurie Howland
        on June 12, 2014 at 9:51 am

        I agree that mental and emotional health are important, and I can see that infertility is traumatic for those who are faced with it, but we disagree that it belongs in covered health care. How many women who finally succeed in becoming pregnant face more problems and have more costs associated with their pregnancy? I’m guessing that the percentage is higher for those who have become pregnant using IVF. I realize that there is no guarantee that any pregnancy will be care free, it is an amazing process and is fraught with peril, but I am not eager to see my premiums go up to support this. Sorry.

        • B S
          on June 13, 2014 at 8:18 am

          You do not support it because it does not apply to you. How many children do you have? Enough said.

          • Jill B
            on June 20, 2014 at 8:43 am

            Some people don’t have children because they very responsibly realize that it’s not the lifestyle for them and they would NOT be good at it.

        • Fred Gholami
          on September 10, 2014 at 1:36 pm

          If we use your logic, then I don’t like paying for your heart surgery while you lead an unhealthy life style, or accidnets you cause on the road for driving reclessly, or smoking, or abusing drugs. By the way, why should the infertile familys foot the bill for your child delivery and related child care cost? They are not using that service! Where do we draw the line?

    • Jill B
      on June 20, 2014 at 7:40 am

      Laurie expresses exactly why I think this is disappointing.

      I don’t want to pay for your fertility treatments. Furthermore, the world is overpopulated as it is. Try adoption.

      • Sharon fair
        on August 13, 2014 at 12:13 pm

        You go try adoption. It’s probably that you just don’t want to have kids. I sure do. They are a miracle and for someone who can’t have them this should be covered by all insurance companies. I’m so sick of depression over this. It really sucks. And I’m sure we pay for coverage for something you don’t necessarily need.. just saying!!!!!!

      • Syacey P
        on July 11, 2015 at 2:46 pm

        Jill B, don’t you think us in fertile people have thought about adoption and I don’t know if you have done your research lady but adoption is three times as much as in vitro in a very long process some of us can’t afford to go that route and are able to have our own child but have to have it through this procedure don’t you think every woman derives the chance to conceive her own child? Also some of us have donated our eggs two other families who are in need of them for free in return to have this procedure so don’t act like we are freeloading to get a kid I’ve spent more money on fertility treatments and testing in appointments than you can ever imagine lady and I’m not quite sure what you have to do with any of it you don’t really make any sense in my opinion. We all pay taxes we all have money that goes to things that don’t regard us anyhow so what singles you out in this specific issue your dad is not my problem but I’m sure some of my money will go towards whatever he’s going through so how about you back off

  8. S F
    on June 12, 2014 at 12:49 pm

    I support this coverage but I do not understand why women are being restricted to UMHS providers for IVF. Why the restriction? Why not in-network and out-of-network options like most other medical treatments?

  9. S F
    on June 12, 2014 at 1:00 pm

    Do UM plans currently cover infertility diagnosis, drug therapy and counseling???

  10. S F
    on June 12, 2014 at 1:00 pm

    Do UM plans currently cover infertility diagnosis, drug therapy and counseling???

  11. K A
    on June 12, 2014 at 1:23 pm

    I don’t suppose it’s reasonable to expect U of M to help defray the costs of adoption for couples who would prefer that method of starting a family?

    • Jill B
      on June 20, 2014 at 7:41 am

      Excellent idea.

  12. S F
    on June 12, 2014 at 3:11 pm

    KA, that’s a really great point. And this is tied to TA’s point about broadening the definition of health. One treatment for infertility is IVF. Another is adoption.

  13. S J
    on June 13, 2014 at 8:24 am

    I agree that it’s not fair to the majority of employees who’s premium will go up when they won’t benefit from this. I truely feel bad for those of you who need IVF, but why do I have to pay for it?

    • M A
      on June 13, 2014 at 8:27 am

      Agreed. It should be an option to add for the people who need it. More fair that way.

      • B S
        on June 13, 2014 at 8:36 am

        And do you think that it should be an option to add cancer treatment coverage only for those that need it?

        • M A
          on June 18, 2014 at 9:17 am

          I think we can all agree that infertility and cancer are 2 quite different things.

    • Jill B
      on June 20, 2014 at 7:42 am

      Exactly. I agree.

    • F G
      on September 15, 2014 at 5:03 pm

      I ask you this. Why do non fertile employees have to pay for your child bearing costs including pre-natal, child delivery, and after birth child health care cost?

  14. B S
    on June 13, 2014 at 8:31 am

    I think this is amazing news! As someone who was just recently diagnosed with unexplained infertility, I realize that it could be a long and expensive road ahead. This coverage will help defray some of the costs and will allow more women the ability to achieve their dream of becoming a Mother.

    • Jill B
      on June 20, 2014 at 7:43 am

      Adoption can also allow you the dream of becoming a “Mother”.

      • s f
        on August 13, 2014 at 12:20 pm

        It’s definitely not the same as having one yourself.. when you adopt you can’t experience the morning sickness the kicking inside you, the labor and birth and the joy you feel knowing you created that life

      • Autumn Araujo-Rodrigu
        on January 23, 2017 at 1:18 am

        I really hope you got fired Jill B. Wouldn’t that have been sweet justice ❤

  15. love rose
    on June 13, 2014 at 10:52 pm

    I am very happy about this I believe this a great start and a help as well as a blessing to those who need it, I belive that can change things and he has. God Bless all and to many many new babies to come for many families

  16. Katie Smith
    on July 14, 2014 at 11:55 pm

    Its funny how people are so upset about having to “split the bill” with people who need infertility treatment. But unbeknownst to them, sex reassignment surgery is covered by Medicare. Your TAX DOLLARS are being used toward mutilating people’s genitals. So please, if you do not have something positive to say about young families who want to start their own, keep it to yourself.

    • R P
      on August 21, 2014 at 4:47 pm

      I was reading through all of the comments….thank you for this one. This gives hope to those of us who are having “unexplained” infertility issues and defintely put a smile on my face. We all pay for something at some point in time that doesn’t apply to us so give it a break! Such is life!!

  17. Jennifer D’Agostino
    on September 2, 2014 at 5:12 pm

    Those of you who don’t support IVF coverage have no clue what it is like to endure the emotional turmoil of not being able to have your own child. Adoption can cost $25,000 or more, and is not easy. As person who has spent over $70,000 for fertility treatments, and have had 5 miscarriages, I applaud this coverage.

  18. rhonda bradley
    on November 9, 2016 at 10:56 am

    We’re looking at adding infertility coverage to our plan but we’re considering exclusing AI and IUI. Does UofM include these procedures in your coverage?

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