Question for EY folks going through IVF: has anybody been able to get PGS (not PGD) reimbursed through Pathways? The BCBS insurance doesn’t cover it but wondering if we can still submit it for reimbursement. Want to get embryos tested before FET, we have a high number which we are hopeful about but doc doesn’t want to have each transfer be a crapshoot so trying to narrow down to the ones that are truly viable.

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When I asked, they said the biopsy part of the procedure would be covered but not the actual testing

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Thanks EY2, just confirmed with WIN that this is the case for me too. Biopsy fees covered. Now trying to figure out what the outside lab will want to charge!

I think I ran into the same thing. I believe I paid but I only had one to test. It was $675 (and normal and he’s currently teething 🥰)

I didn’t think the 675 was bad. This was through igenomix. I’ve heard some testers have a flat fee of thousands. It’s insane.

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18 embryos!!!!! That is wonderful!!! Wishing you all the best. I’ve seen some people test the top 10 highest graded, like 5AA. depending on the coverage if you have the grading that’s one way to decide

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Are you not working through WINFertility? That is who manages the separate $25K (now $50K) benefit. You have to go through them for all pre-authorizations in order for it to be covered. You do not work directly with BCBS UHC for the separate fertility benefit. I was pre-approved to do it, but we chose not to at the time (wish we had done it). We have one frozen embryo left and will likely have to do another egg retrieval (then we will do genetic testing of any viable embryos). Here is the number for WINFertility (I have had them on speed dial for years now as it took me that long to find an in-network IVF doctor in my area): 855-678-3256.

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Yes it’s in the updated pathways to parenthood FAQ

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My clinic filed a prior authorization for PGT-A testing and it was denied by United healthcare, so they billed me for it. I’m planning on filing an appeal. Just be prepared to pay for it out of pocket if you want to do it.

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Also EY, had to pay out of pocket. My experience was the first 5 or 6 embryos, I believe, we’re all the same price and then there was an incremental fee for each one after that.

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Update: total price for the igenomix portion of the fees was $3100 for 19 embryos. Base price of $1450 for the first 8, then $150 each for the remaining 11. This $3100 is all OOP. The fees charged by embryology lab for the biopsy procedures will go through BCBS / WIN and get covered that way. Pretty happy with this price point. Was expecting to pay closer to $6k based on other “per embryo” costs I’ve seen out there.

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