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In Conneticut, individual and group health insurers are mandated to cover medically-necessary infertility procedures. This includes ONLY IVF, IUI, embryo transfer, GIFT, and ZIFT, up to a specific lifetime maximum - which can be as low as TWO ATTEMPTS. Patients must meet specific criteria before qualifying for treatment. Employers with opposing religious beliefs may opt out of the mandate. You have several issues going on: Is it "medically necessary", or are you just trying to have a baby? Do you meet the specific criteria? Have you had this done before, under a different insurer, so maybe you've hit your lifetime maximum? Did your employer opt out of infertility treatment for religious purposes?? It's very possible that your coworker is being covered by her husband's policy with a different company - OR, that her issue is medically necessary, and yours is not. Again, maybe she meets the criteria, and you don't. You can always file a complaint in writing with the CT Insurance Department - but most likely, they are not "playing games" with you.

by mbrcatz

1 month ago

Asker's Rating: 

Check their websites.

by car253- 1 month ago

Why are you looking for answers about your medical coverage on yahoo? You know you are not going to get an accurate answer here. Call your health plan and ask them before you have any treatment. Chances are high that it is not covered. Your employer does not have to cover infertility treatment. The insurance company even told you that they don't pay. Even if you feel that it should be covered, they told you that it's not. The State of Connecticut passed a bill in 2005 which passed a breakthrough legislation that requires most insurance companies to cover infertility diagnosis and treatment. This change took place on October 1, 2005, and all women under the age of 40 are eligible. With this change, Connecticut health insurance covers: Up to 4 cycles of ovulation induction A maximum of 3 intrauterine insemination (IUI) cycles Up to 2 in vitro fertilization (IVF) cycles with a maximum of 2 embryos transferred per cycle This coverage is only available to individuals who have maintained coverage under their policy for at least 12 months. In addition, the law does not apply to employees in self-insured plans. Employers may also decline to cover this benefit if the diagnosis and treatment of infertility conflicts with the organization's religious or moral beliefs.

by Heather- 1 month ago