Infertility and insurance in Hawaii

 There are some states, Hawaii being one of them, that recognizes infertility as a medical issue and insurance can cover some, or all, the costs related to treatment. I found this link very helpful in determining what, if any, coverage your state has Fertility Coverage by State. Here is my disclaimer now: what I am going to write was my experience at the time, PLEASE, PLEASE, PLEASE check with your insurance provider before seeking or starting treatment so there are no unexpected costs. I am not giving insurance or medical advice, I am simply telling my story. Ok, done. Now back to it. 

As you can imagine, laws and insurance coverage can change annually so you’ll always want to double check what your latest coverage is. By the way, all of this will be in layman's terms, because I am talking to friends and not writing a research paper. During my journey, each insurance carrier would cover one 'round' of IVF. I started with Kaiser through my employer and used the Kaiser physicians, more on the Kaiser IVF adventure to come. There are several options, factors and decisions to be made. One big one is whether we would be doing fresh or frozen embryo transfers (FET), what does this mean?. For our particular situation, we decided the best option was to do frozen embryo transfers. You can read about the factors and experience that went into that decision soon. It cost more money out of pocket up front but we felt it gave us more chances should it not work the first time. As it turns out we needed every chance we got so I am thankful we made that decision. 

I went through one egg retrieval surgery and thankfully we got 6 healthy embryos to reach day 5. That is a whole process in itself, stay tuned for embryo stats and more in depth info if you would like. With our insurance through Kaiser, we had one transfer to be successful. We did end up getting pregnant but since this story doesn’t end there you can imagine it did not go as hoped. Once I accepted what happened, I picked myself up and called Dr. Hou at Kaiser to see what our next step was. This is where I had to grieve a second time. In my ignorance, I believed that even though insurance wouldn’t pay for another transfer, that we could pay out of pocket and try again through Kaiser. Unfortunately that is not the case. Once you go through your one chance with them then you are done, there is no paying out of pocket for a second chance. I was referred to The Fertility Institute of Hawaii. I was devastated that after 2+ years I would have to start a new relationship with a new doctor but such was life. As it so happens, I was no longer going to have insurance through Kaiser and would be on HMAA.  So not only did I have to trust a new doctor, but I had to figure out what the process was for the fertility treatments with a new insurance provider, more specifics with HMAA to come.

With the new insurance we could do one more ‘treatment’ whether that was an egg retrieval or a transfer. We still had 5 embryos so we decided on another transfer. Our doctor sent us a bill for the transfer that would need to be paid in full prior to the procedure. I called them to see why they didn’t bill insurance. They assumed since egg retrievals are more costly than transfers, that we would want to use the insurance for an egg retrieval, and not for a 'less expensive' transfer. We had no plans to do another egg retrieval, if we didn’t have success with 6 embryos then we would we done. This second transfer obviously didn’t turn out as hoped (story of transfer #2 to come). We continued to have HMAA coverage but it would not be covering another transfer. I am assuming if my insurance had changed again that it would have covered another transfer, as I have been told that each individual insurance carrier offers one ‘go at it’ but we never switched insurances again. Please leave a comment below or reach out to me if you have so that we can learn from your experience.