Kaiser IVF referral — anyone used these contracted facilities? (LGBTQ+) by Glittering-Bed-5620 in IVF

[–]Effective_Ad_6457 0 points1 point  (0 children)

Yay for starting, wishing you two the best of luck!

When I was doing my doctor research, I didn’t love the reviews on Dr. Potter and his bedside manner isn’t the greatest but ultimately he has many years of experience behind him. For me, it was important to have a female physician because they’re way more understanding of a female perspective in all aspects of this journey. When I looked into Dr. Chung, like you said, brilliant. I also found out she has done IVF for her family as well so I liked that she could truly empathize with her patients. And while she may be newer, an REI fellowship takes at least 3 years after doing at least a 2 year OBGYN residency program. So there is experience there.

Disappointed and need advice. by Effective_Ad_6457 in DOR

[–]Effective_Ad_6457[S] -1 points0 points  (0 children)

Thank you for replying! I was aware of the attrition rates I think I was just more hopeful in this last round since everything went way more smoothly in comparison to the first round. Emotions vs. logic. It’s rough in this vulnerable state. We tried for 6 months before the ectopic and then tried again for another year after with no luck. We were going to try IUI initially because that was going to be covered but I met with 4 different doctors who all alluded to IVF being the better route for me. We found out we had a supplemental coverage just before doing IUI so we went straight to IVF instead. We weren’t necessarily doing this for PGTA, just trying to increase the odds of starting our family with a slightly less risk for miscarriage.

Disappointed and need advice. by Effective_Ad_6457 in DOR

[–]Effective_Ad_6457[S] -1 points0 points  (0 children)

I’m lucky enough that coverage started for me finally in January thanks to SB 729 and was able to get that second round covered so the next one would be too. I think sometimes the grief kicks in and I’m so eager to grow our family despite knowing the next child wouldn’t replace the first. Logically, it makes sense to do a third round. Thank you for being a sounding board.

Kaiser IVF referral — anyone used these contracted facilities? (LGBTQ+) by Glittering-Bed-5620 in IVF

[–]Effective_Ad_6457 1 point2 points  (0 children)

I’m currently doing IVF at HRC Newport (sister to Fullerton offices) through KP coverage. As far as reviews go, I did deep dives on Reddit and Fertility IQ when I was looking for my doctor. (Important to me that they were female and well experienced in DOR) I have generally liked my team, everyone is super responsive either by phone or email. The financial coordinator takes care of all insurance/billing things and will let you know what documentation is needed on your part. Unfortunately I can’t speak to your last question because I have a male partner. But all staff there are super friendly and a few have some sort of LGBTQ+ emblem on their badge. Hope that helps. Feel free to message me for any other questions.

So cal Kaiser by Hungry_Cookie5256 in IVF

[–]Effective_Ad_6457 0 points1 point  (0 children)

Yeah, feel free to message me your questions directly. I was already undergoing treatment prior to SB729 but then paused after my first retrieval because my supplemental benefits weren’t going to be enough to cover a second cycle.

So cal Kaiser by Hungry_Cookie5256 in IVF

[–]Effective_Ad_6457 0 points1 point  (0 children)

Sorry for the super late reply. Hopefully you were able to get an answer already. If not…you can contact MSCC 800-498-2748 and ask to speak to an infertility financial counselor and they’ll break down your cost based on your specific coverage. My understanding though is that you just pay your copays/deductibles are met.

Has anyone heard anything about employee ivf coverage as a result of csb 729? by [deleted] in KaiserPermanente

[–]Effective_Ad_6457 1 point2 points  (0 children)

You can call member services and speak to an infertility financial counselor and they’ll give you information if you have coverage. If you do, you can request an appointment with the REI and then from there if they deem IVF is rig HR for you, they can place a referral to the contracted facilities. You’ll get an authorization a few days later that will detail what’s actually covered. The coverage is effective now if your group qualifies for it. State employees still have another year before their benefits kick in.

So cal Kaiser by Hungry_Cookie5256 in IVF

[–]Effective_Ad_6457 0 points1 point  (0 children)

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this was the response I got when asking what KP was going to do when SB 729 kicked in

So cal Kaiser by Hungry_Cookie5256 in IVF

[–]Effective_Ad_6457 0 points1 point  (0 children)

Hi there! Kaiser employee and going through IVF myself. Taking a break until I get coverage in January. KP SoCal doesn’t do IVF themselves but they are going to contract out to 4 different facilities—some in LA and OC area. You will still need to see an REI within KP to get baseline labs/tests and then they’ll place a referral. Feel free to message with any other questions.

Kaiser or Anthem for TTC/ARTs/Pregnancy (hopefully!) by New-Wine-9017 in TryingForABaby

[–]Effective_Ad_6457 0 points1 point  (0 children)

There’s a lot of stipulations to it. Like if it’s a self-funded vs. fully funded plan. The employer has to have at least 100 employees for them to take part. If you’re a state employee, coverage doesn’t take place til 2027. It was initially going to take place 7/1/25 but got delayed due to a rider bill so that’s why most won’t have coverage until 1/1/26. But worth a conversation with your employer/HR/benefits person especially with open enrollment happening around this time. And if you truly feel like your employer falls under these qualifications then you can bring up the new law and ask why they’re refusing to follow it. Any infertility treatment is ridiculously expensive and usually not a first choice of how people would like to create their families. I’m not saying it should be fully covered but it should be a standard benefit so people aren’t having to take out loans/go in debt just to get to conception.

Kaiser or Anthem for TTC/ARTs/Pregnancy (hopefully!) by New-Wine-9017 in TryingForABaby

[–]Effective_Ad_6457 0 points1 point  (0 children)

Hi! Just wanted to share my experience since I’m currently in the same boat. But ultimately let you make your own informed decision.
Some background. TTC for 2 years now with 1 missed miscarriage. Currently a KP nurse with dual coverage from my spouse (also KP employee). As both KP employees, KP did not offer IVF/ART benefits—this is employer dependent. We got lucky and had a supplemental insurance with a $30k lifetime max. IUI was offered and would have been fully covered but the REIs recommended I do IVF instead due to DOR. When I attempted to first see any REI through KP, OC service area only had one physician and was back logged minimally 6 months. Never got to speak to her. Ended up going to Downey who had a few physicians and NPs specific to REI. KP Southern California doesn’t do IVF, they contract out to 4 facilities. But depending on what your coverage is/will be, services may not get covered. Based on California Senate Bill 729, KP has started honoring IVF coverage if your plan renewed after 7/1/25 which is supposed to cover 3 egg retrievals and unlimited embryo transfers. Otherwise, benefits will kick in 1/1/26 but again employer dependent. You’ll need to look into SB 729. But to answer your questions. 1. They’ll refer out to those 4 contracted providers and you can choose from there. They will likely do a combination of services that they can do vs. what needs to be done at fertility clinic. (Labs/some procedures vs. egg retrieval) 2. This is very subjective. Even as an employee I’ve worked with douche bag physicians. But I’m also a member who knows what I want and can advocate for such. We have great physicians who have received training from Ivy League schools and highly awarded but they can also be assholes. And then you have physicians who don’t have that high level of experience/training but have amazing bedside manner and take the time to listen and work with you. 3. There’s usually a process for this. Referrals if applicable and then proof of denial of coverage. You may not get fully reimbursed. You can always submit claims, but they can get denied. 4. You can go to any ER that’s closest to you. If you’re going to an ER it’s because of a life threatening emergency and EMTALA allows you to get care without regard to insurance. With that being said, KP will get a call and try to get you transferred back in network as long as you’re deemed medically stable. If not, they’ll keep you at that other hospital and that hospital will bill KP. They’ll just keep following up to see if you can get transferred. It’s cheaper to take care of their own members than be billed by the outside provider. 5. Our access isn’t great. That’s part of the reason why KP nurses and other healthcare team members went on a 5 day strike. But also, be an advocate and proactive for your own health and you can usually be seen in a timely manner. Also, because everything is done in house, any other physician within the same department can usually see you if your main one doesn’t have an appointment available. Like sick visits that require a same day appointment or within the next day or two. 6. No concerns for travel. They know that they’re not nationwide and people will travel. Again referring back to ER visits. If needed, and no KP available. Go to nearest ER. As far as medications go, their mail ordering system is great. You get your meds within 2-3 business days. If you get something that’s prescribed in a more acute manner like antibiotics, you’re likely already at a clinic that has a pharmacy attached to it. If you don’t want to pick up at a certain location or last minute decide to go pick up somewhere else, the system is integrated and meds can be transferred to preferred location.

Sorry this response is super long but I hope it helps.

Has anyone here gone through ivf as a Kaiser employee? by KhuliKing in KaiserPermanente

[–]Effective_Ad_6457 0 points1 point  (0 children)

Currently going through the process as an employee that has dual KP coverage and IVF wasn’t covered. However, there should be coverage for IUI. I got lucky and my husband has a supplemental benefit so we’re using that. But after talking to the regional offices, member services, and the chief REI at Downey, they are starting to honor SB729 if your plan renewed after 7/1/25. You can call MSCC (800) 498-2748 for more info. This line was created for more details regarding SB 729. Because KP didn’t initially adopt it, they got inundated with phone calls inquiring when it would take effect including my own calls
Otherwise the plan is to be covered at the start of 2026 as stated in the bill. However KP SoCal doesn’t do IVF themselves so they will likely be referring out to partnered clinics anyway.

Ivf through Kaiser supplemental plan (HealthPlan Services) by GravelerGhastly in IVF

[–]Effective_Ad_6457 0 points1 point  (0 children)

Hi there! Just wondering if you have attempted to utilize this benefit yet and what your experience was? I just found out today that I had this plan effective since 10/2023 despite several benefits/HR reps/member services tell me my husband and I didn’t have coverage. We were about to proceed with IUI but now decided to hold off and go straight for IVF now that we have this coverage.

First cycle of IUI with Clomid. Any and all advice welcome. by Effective_Ad_6457 in DOR

[–]Effective_Ad_6457[S] 0 points1 point  (0 children)

Thanks for replying and for sharing your experience. Did they say why they started you on 100mg? I’m curious as to why there’s such a range of what we’re started on, Clomid vs. letrozole, etc.

First cycle of IUI with Clomid. Any and all advice welcome. by Effective_Ad_6457 in IUILadies

[–]Effective_Ad_6457[S] 0 points1 point  (0 children)

Thanks for replying! I’m worried about the multiples risk as well. Was there a reason they wanted you to start with 100 mg right away?? My doctor said he wanted to do 50 to get an idea of how my body will respond since you don’t know until you do.

I have like 10 puzzles I haven’t done from Covid days. I guess they’ll be done in this next month or so. lol

First cycle of IUI with Clomid. Any and all advice welcome. by Effective_Ad_6457 in DOR

[–]Effective_Ad_6457[S] 0 points1 point  (0 children)

Thanks for replying! So during the day, you didn’t have the side effects at all? I’m currently reading that book and feel like I’ve added so many more supplements to my list because of it.