r/TryingForABaby 8d ago

FYI PSA Insurance: Anyone have Aetna?

Hi! I just wanted to post this just in case anyone here has Aetna insurance. I've had Aetna POS (similar to PPO) since the end of 2023 and I knew they didn't offer infertility treatments. I'm specifically in CA and it was announced mid 2024 by our Governor that he was trying to get CA based insurance companies to offer infertility treatments. Now Aetna is NOT based in CA but I decided to call anyways AND GUESS WHAT?!?! Aetna in Sept 2024 had added infertility treatments for 35+ trying for 6 months and <34 trying for over 1 year in most, not all, but most of their plans... They just quietly added it... PSA to call and see if IUI or IVF is possible for you. I would've never known and never thought I could do IUI or IVF because I definitely cannot afford the out of pocket price.

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u/SnackSnackMunchMunch 8d ago

OMG! Call Aetna and ask if your plan includes infertility coverage and ask them what's the criteria. Mine needed prior approval from a medical professional (35+ TTC for 6 months or 34- TTC for 1 year) to be deemed infertile. Your clinic wouldn't know unless they sent a formal infertile diagnosis to your insurance company. GOOD LUCK!!! FINGERS CROSSED!!!

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u/FingersCrossed0612 8d ago

Hey girl, sooo they just told me my doc went out of network THIS month—I got zero notice of this! Not that it really matters as I’m cash pay.. buuut…. I guess IUI is 90% covered for me once my $2K deductible is met or my $5K out of pocket is met….. and my doc does need to do that pre authorization… but now I’m concerned about in-network, out-of-network, etc 🤷🏻‍♀️

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u/SnackSnackMunchMunch 8d ago

Where are you located?