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Infertility Insurance Coverage

Basics Tips When You're Trying to Conceive

By Kim Seidel

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Basic Steps to Determine Coverage

If you currently have health insurance through your employer or your partner's employer, the first step is to find out whether or not infertility treatments are covered in your plan.

"A woman interested in learning about her insurance coverage should talk with her insurance agent or the benefits administrator, perhaps in the human resources department, at her place of work," says Scott Simmonds, an insurance expert based in Saco, Maine.

Step 1: Ask questions.
The basic question to ask is, "Do I have coverage for infertility treatments?" If the answer is "yes," find out specifically what that coverage includes, Simmonds says. Find out the limits of coverage, deductibles, co-pays and pre-qualification requirements that may be required by your clinic and hospital.

Step 2: Get answers in writing.
It's extremely important to obtain all of this information in writing, Simmonds says. He recommends that you ask the administrator/human resources person at your workplace to provide you with copies of the insurance plan document.

Step 3: Call the insurance company directly.
Simmonds also suggests calling the toll-free telephone number on the back of your insurance identification card. You may be able to get your benefits explained over the telephone. But again, be sure to obtain this explanation in writing, he says.

Dealing with Insurance Companies

"Take advantage of the tools that your insurance carrier has in place for you," says Andrea Grater, vice president of IBD Insurance Services in Raleigh, N.C. "Customer service departments can explain your basic coverage, and most carriers also offer great online tools that can help you understand your benefits." Once you understand your policy, talk to your physician's office to coordinate any services that won't be covered, Grater says.


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