np20412 t1_je0j96v wrote on March 28, 2023 at 3:21 PM

A single cycle of IVF is going to cost you more than $10k. Between your consults and mom's testing with the RE, your testing, your sample collection + cryo and/or donor usage requirements, the amount of meds you need, the number of stim cycles you need, etc. The meds alone for one round of stim are $7k+, and that is just the horomone injections. After that there are considerations for costs associated with the lab work to create the embryos, the storage of any embryos that are created that you don't use in the first cycle, genetic testing on any viable 3 or 5 day embryos, prepping mom's body and the actual embryo transfer itself, and lastly anything that may come up in between.

Make sure the plan you choose will cover the PHARMACY part of IVF, that is a significant portion of the cost. The meds are not cheap. Also take into account deductibles and copays/OOP max if not explicitly covered under the ART benefit.

Also know that it might take more than a year so you might be with this secondary plan for longer than just a single year.

Source: IVF in 2019 we had our first consult in January and embryo transfer did not happen until September. Got lucky and only had to do just 1 cycle (18 eggs collected, 6 5-day embryos, only 1 was viable after genetic testing and grading which was implanted and successful). Total cost was close to $20k, including unexpected surgery for my wife to remove some polyps from her uterus before transfer.

rvH3Ah8zFtRX OP t1_je0miey wrote on March 28, 2023 at 3:42 PM

Thanks. Honestly I get a bit confused about pharmacy coverage and how that gets intertwined with everything. My wife's plan through her job had a separate pharmacy administrator. My plan at my last company had a pharmacy-specific deductible, while my current plan does not. But maybe that's all irrelevant regarding IVF if infertility treatment isn't broadly covered regardless.

np20412 t1_je0onvh wrote on March 28, 2023 at 3:56 PM

The way our plan worked for Pharmacy portion was just that the meds were not covered by the normal pharmacy benefit at all, the claim was denied, but then the cost was picked up by the fertility/ART benefit. My plan offered $7500 worth of lifetime coverage for prescription drugs as part of IVF and we blew past it in the first cycle (total cost was around $9k for meds, so $1.5k out of pocket for us). You just will want to make sure the infertility benefit will cover the pharmacy portion, if the pharmacy part of the plan itself isn't offering coverage for fertility medication.