Maybe. To make sure, are you looking at the full price of the plan on healthcare.gov or a subsidized amount based on your income? If you are eligible for a plan through work you are inelligible for a subsidy. Also, keep in mind you can only get the plans during open enrollment at the start of each year unless you have a qualifying event.

Did you also check deductibles, out of pocket max, copays, and how it provides for pregnancy? Can you use the same doctors you do now? You can’t just jump back on your employers once you’re pregnant btw. $850 also seems kinda low for two people without subsidies. And open enrollment is closed too

A single cycle of IVF is going to cost you more than $10k. Between your consults and mom's testing with the RE, your testing, your sample collection + cryo and/or donor usage requirements, the amount of meds you need, the number of stim cycles you need, etc. The meds alone for one round of stim are $7k+, and that is just the horomone injections. After that there are considerations for costs associated with the lab work to create the embryos, the storage of any embryos that are created that you don't use in the first cycle, genetic testing on any viable 3 or 5 day embryos, prepping mom's body and the actual embryo transfer itself, and lastly anything that may come up in between.

Make sure the plan you choose will cover the PHARMACY part of IVF, that is a significant portion of the cost. The meds are not cheap. Also take into account deductibles and copays/OOP max if not explicitly covered under the ART benefit.

Also know that it might take more than a year so you might be with this secondary plan for longer than just a single year.

Source: IVF in 2019 we had our first consult in January and embryo transfer did not happen until September. Got lucky and only had to do just 1 cycle (18 eggs collected, 6 5-day embryos, only 1 was viable after genetic testing and grading which was implanted and successful). Total cost was close to $20k, including unexpected surgery for my wife to remove some polyps from her uterus before transfer.

Yep, I clicked through their menus and it told me I was ineligible for the subsidy, and that enrollment doesn't open up again until January. So just doing some due diligence right now.

Right, that's why I said

>I know I'd need to put the actual plans side-by-side to compare everything else.

Thanks. Honestly I get a bit confused about pharmacy coverage and how that gets intertwined with everything. My wife's plan through her job had a separate pharmacy administrator. My plan at my last company had a pharmacy-specific deductible, while my current plan does not. But maybe that's all irrelevant regarding IVF if infertility treatment isn't broadly covered regardless.

$850 sounds low for a couple - are you just putting your wife on marketplace insurance?

I put both of us in. The price shown didn't say "per person" so I assumed it was our total, but I guess it's possible it wasn't.

The way our plan worked for Pharmacy portion was just that the meds were not covered by the normal pharmacy benefit at all, the claim was denied, but then the cost was picked up by the fertility/ART benefit. My plan offered $7500 worth of lifetime coverage for prescription drugs as part of IVF and we blew past it in the first cycle (total cost was around $9k for meds, so $1.5k out of pocket for us). You just will want to make sure the infertility benefit will cover the pharmacy portion, if the pharmacy part of the plan itself isn't offering coverage for fertility medication.

yeah that is your total

you might want to check what it is as a family for when you have a kid

when they have a kid it would be a qualifying event and they can switch back to employer plans

well yeah - but it is worth seeing the cost for employer insurance v. marketplace plan for family, along with the networks

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