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We have good fertility benefits but poor (expensive) healthcare. I’m pretty sure you need to be on our healthcare to use it.
We have a really good PwC fertility yammer page. Would recommend checking it out!
I had fertility treatments under PwC. It has been almost 8 years but the firm gave $25k towards fertility treatments while I was on the PwC plan.
Also, you may also want to talk to your doctor about trials and studies as the reduce the costs of treatment.
Good luck.
Is the 25k after you hit the deductible?
I have not but can confirm you must be under PwCs health plan to leverage the benefit. I do know someone who used it and they hey thought it was an excellent benefit.
Thank you!
Good luck! Our twins are college freshmen. 😎
Yes highly recommend using the pwc benefits, especially if your spouses plan as has now coverage. If you look up fertility on HQ you should find win fertility - http://managed.winfertility.com/pwc/ - they work with our insurance on your fertility benefits. I believe we have $30k in coverage + $25k in medication coverage. Keep in mind this will kick in after you hit your deductible. You also will need prior authorization for treatments which can take time so make sure your dr requests that. The WIN people were super helpful in walking me through the benefits and rules. Also worth nothing that this lifetime max covered like 1.5 cycles for me (prices depend on the clinic). I ended up needing to do 5 egg retrievals. I was lucky that my husbands company has more coverage and I was able to shift to his. Good luck !
Does your spouses plan have coverage? You can always max out your husbands coverage and then switch during open enrollment to take advantage of a new plan
Ahh, you should definitely look and quickly as open enrollment is closing in many places. Also recommend checking your state medical/ACA plan for coverage.
Good luck!
Keep in mind, there are costs that are not covered by insurance and will be 100% out of pocket. PwC gives 20k towards meds. For my first retrieval meds were 17k billed to insurance (very basic standard protocol). If I were to buy those same meds in cash from Freedom fertility, it would be 5k. I ended up paying 3.5k for meds only (deductible was not met), but it was billed 17k to the insurance. So basically 20k of the benefit covers only 1 retrieval cycle. You have to use Freedom Fertility pharmacy. Then there are meds not covered by insurance. Progesterone is one of them. You would think this is something basic and should be covered. Then there is a medical part of the cycle - ultrasounds, actual retrieval etc. Sounds like it’s all covered by PwC, but it is not. My first retrieval cost me just under 10k out of pocket (using PwC benefit). And I didn’t use any fancy clinics where they have fees just to be a client of that clinic. Do your homework, ask the clinic to run the estimate out of pocket.
Had this experience as well with EY coverage. The number of things that either aren’t covered or are out of pocket keeps creeping up. Still a great benefit just significantly more expensive than I had originally expected when I heard it was “covered”.