Announcements & Features: in vitro fertilization (ivf) coverage

Questions and Answers on IVF Coverage

The University of Michigan will implement coverage for IVF under most U-M medical plans starting on Jan. 1, 2015. Currently, our plans cover infertility diagnosis, drug therapy and counseling. This is a benefit expansion for coverage of IVF.

What new coverage is being added?
U-M’s self-insured medical plans (excludes HAP) will start covering IVF treatments for women through age 42 who are diagnosed with infertility. A single embryo transfer is covered for women under age 35 and double embryo transfers are covered for women ages 35 through 42.

How much of the cost is covered?
Patients contribute 20 percent of the cost as co-insurance, and the remaining 80 percent is covered by the plan up to a $20,000 lifetime maximum. 

Where can I receive covered IVF treatment?
The U-M Health System must provide treatment in order for IVF services to be covered. UMHS clinicians are committed to evidence-based practice, and you’ll be able to access IVF treatment at UMHS whether you are enrolled in U-M Premier Care, BCBSM Community Blue PPO, BCBS Comprehensive Major Medical or GradCare.

Are all U-M’s medical plans adding IVF coverage?
All of U-M’s self-insured plans will add IVF coverage starting on Jan. 1, 2015. Health Alliance Plan (HAP) is not one of U-M’s self-insured plans and will not cover IVF. If you are currently enrolled in HAP and wish to be eligible for IVF coverage in the future, you should consider enrolling in another U-M plan during the next Open Enrollment cycle this fall for coverage in 2015. Blue Cross Blue Shield Community Blue PPO, U-M Premier Care, BCBS Comprehensive Major Medical and GradCare will offer IVF coverage.

Is IVF commonly covered by other plans?
No, IVF is not commonly covered by plans in the state of Michigan. Certain U.S. states mandate IVF coverage, but Michigan does not have such a mandate. Although many employer plans cover infertility diagnosis and select services like drug therapies, IVF is classified as an Advanced Reproductive Technology (ART), and coverage is not standard.

Where can more information be found?
Coverage doesn’t begin until 2015, so it’s too soon to contact U-M’s medical insurance plans for details. Complete information will be available during fall Open Enrollment.

See the article, Most U-M medical plans to cover in vitro fertilization, University Record, June 12 2014, for additional information.