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Home › Articles › Trouble Getting Pregnant › Infertility Insurance Coverage

Infertility Insurance Coverage

Basics Tips When You're Trying to Conceive

By Kim Seidel

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  • If I have fertility coverage for these procedures, what is my maximum fertility benefit?
  • Does my policy cover injectable medications? If yes, does my policy require prior authorization for injectable medications?
  • Do I need to use a specific laboratory?
  • Do I need a referral to visit my doctor (include your doctor's name here) for an initial consultation?

    • Be sure to indicate that you would appreciate a response as soon as possible, as you will be seeing your physician in the near future, Brian says.

    Steps for No Coverage

    Currently, only 15 states require insurance coverage for infertility treatment, and laws vary widely, Collura says. You can learn about which states offer coverage and what is included and excluded in each of these states at the RESOLVE Web site (www.RESOLVE.org).

    Step 1: Get as much information as possible.
    "If the answer is 'no coverage' from your insurance company, then push them for reasons why," Simmonds says. "In some states, this lack of benefits could be the measure of the quality of the plan purchased."

    Step 2: Keep talking.
    Again, communicate with your insurance company and your employer to discover ways you can work with this situation. A variety of programs are available to financially assist women with their infertility treatments.

    Step 3: Know the alternatives.
    "Many of the best practices in this country, such as RSC, participate within the IntegraMed national network of fertility practices," Brian says. "They offer the Shared Risk Refund Program, one of the best treatment financing programs. The Shared Risk Program maximizes the success of IVF while minimizing the risk and guarantees a refund if you don't take a baby home. Seventy-six percent of those who enrolled in the program have taken a baby home."


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