Question
What is the name of your state? Illinois
The Illinois state law mandates Insurance coverage for Infertility treatment. It states
What is Covered?
Illinois requires group insurance and HMO plans to cover the diagnosis and treatment of infertility the same as all other conditions. For example, they may not apply any unique co-payments or deductibles for infertility coverage. Benefits shall include, but not be limited to:
testing
prescription drugs
artificial insemination
invitro fertilization (IVF)
gamete intrafallopian tube transfer (GIFT)
intracytoplasmic sperm injection
However my insurnace carrier UHC states that they have a $5K limit on this coverage. The $5k is such a paltry amount and it exhausts even before we complete infertility testing - Is this legal ? Who should we talk to ? Can an attorney handle this ? Or should we take this up with state insurance regulatory authority ?
Any advice you folks give will be appreciated.
Answer
Yes, it is legal. The law says they have to cover infertility treatment. It doesn't say they have to provide unlimited benefits.
I'm quite sure this is not the only area in which your insurer has an upper cap.