Will my insurance cover IVF again if I terminated IVF pregnancy?

[Qwertyui]

Illinois
While doing IVF fertility treatment covered by my insurance I wasn't seeing a psychiatrist and wasn't prescrbed medications to control my mental issues because I was afraid those meds will negatively affect outcome of IVF treatment so I just was buttling them ony own. I got pregnant but now my mental health is completely out of control, I cannot take care even of myself, we have no one to help. We are facing a hard decision to terminate this pregnancy, to stabilize my mental health with meds and then to try IVF again staying on medications. Does my insurance company have a ground to refuse to cover IVF again if we terminate this pregnancy?

 

[Shadowbunny]

Illinois
While doing IVF fertility treatment covered by my insurance I wasn't seeing a psychiatrist and wasn't prescrbed medications to control my mental issues because I was afraid those meds will negatively affect outcome of IVF treatment so I just was buttling them ony own. I got pregnant but now my mental health is completely out of control, I cannot take care even of myself, we have no one to help. We are facing a hard decision to terminate this pregnancy, to stabilize my mental health with meds and then to try IVF again staying on medications. Does my insurance company have a ground to refuse to cover IVF again if we terminate this pregnancy?

This is not a legal issue, but one of contracts. So you'll have to read the policy and see what the limitations are.

 

[Qwertyui]

This is not a legal issue, but one of contracts. So you'll have to read the policy and see what the limitations are.

The limitations for infertility treatment don't mention the situation we are in, nothing close to the situation. Does that mean that my insurance doesn't have a ground to deny coverage of IVF after termination?

 

[Just Blue]

The limitations for infertility treatment don't mention the situation we are in, nothing close to the situation. Does that mean that my insurance doesn't have a ground to deny coverage of IVF after termination?

Thats not what Shadow said. She said this isn't a legal question. We are a legal site. Call the insurance company and ask them your questions.

 

[Taxing Matters]

This is not a legal issue, but one of contracts. So you'll have to read the policy and see what the limitations are.

Well, contracts present legal issues.

Does my insurance company have a ground to refuse to cover IVF again if we terminate this pregnancy?

The federal Affordable Care Act (ACA), also known as Obamacare, requires that all health insurance policies cover certain things, but IVF treatment is not one of them. However, some states do require that insurers cover IVF procedures. Illinois is one of those states. The information on what is required to be covered for IVF is summarized by the Illinois Department of Insurance here: IVF coverage. Note though that the requirement is only for group insurance, e.g. insurance through your employer, etc. If you have an individual insurance plan the state does not require the insurer to provide that coverage at all.

Look at your policy to see if it says anything about this, though my guess is that it doesn't specifically address this situation. You may want to call the Illinois Department of Insurance at the number given at the bottom of that page I linked to ask the question if you are covered by group insurance. It may be that the state's rules won't let the insurer refuse to offer it in your circumstance.

 

[Qwertyui]

Taxing Matters, thank you very much for your response!
I have an individual insurance plan from Health Insurance Marketplace. In the link you gave I read that in Illinois treatment of infertility is considered an essential benefit so it must be provided by individual plans sold on the Marketplace and shall include IVF. My insurance policy states that it covers IVF treatment (4 egg retrievals per calendar year) but you are right it doesn't specifically address my situation. I will try to call Office of Consumer Health Insurance and ask my question.
Thank you again for your help!

 

[xylene]

Consumer Advice: consider ECT. immediate, effective and safe during pregnancy.