Infertility Health Insurance

Health Insurance Benefits for Fertility Treatment

Many infertility diagnostic and treatment expenses are not covered by healthcare insurance. The cause of infertility and the treatment recommended can have a significant impact on how much a patient may have to pay out-of-pocket.

How FSMG Health Insurance Experts Help Our Patients

We believe in educating our patients from the very beginning of our relationship about the cost of their diagnosis and treatment options and the available insurance coverage. We want to ensure our patients have a clear picture of what they can expect from a financial standpoint.

Fertility Specialists Medical Group’s insurance experts are well versed in dealing with infertility treatment coverage. We have extensive experience with:

• Pre-certifications
• Authorizations
• Co-pays
• Deductibles
• Lifetime and cycle maximums
• Limitations (age, duration of infertility, diagnosis, etc)

This extensive background in infertility health insurance and experience enables us to educate our patients about what to expect financially, which we consider to be an important ethical aspect of infertility medicine. We do not want our patients surprised with hidden costs and fees.

Tips For Checking Infertility Health Insurance

Our insurance experts will work with you on every aspect of your coverage.

The following are some general guidelines on how you can best prepare to manage your insurance benefits.

• In advance of your visit, review the coverage provisions for your health insurance plan, often called a Summary Plan Description, and seek clarification from the insurer if you have any questions.
• Call your insurer and ask specifically what infertility treatments are covered and what is excluded in your policy.
• Always make notes of any conversation with your insurer, listing what was said, the agent’s name, and the date and time of the discussion.
• Make sure to find out about coverage of fertility medications; they may contribute to your maximum benefit or may be separate. Some plans do not cover infertility medications at all.
• See if the insurer will give you a letter of predetermination of infertility benefits.
• If in vitro fertilization (IVF) is covered in your plan, make sure to determine any restrictions, such as the number of cycles covered and age limits for coverage.
• Ask your human resources manager if you can buy a policy rider that includes IVF.
• If your insurance is through your employer, ask if they offer a policy that covers infertility treatment. More and more companies are doing this, often after an employee asks.

FSMG Medical Group Affiliations

OB/GYN referrals are typically required for you to use your benefits from a medical group affiliation (typically an HMO). Fertility Specialists Medical Group is affiliated with the following groups:

• Sharp Community Medical Group
• Sharp Rees-Stealy Medical Group
• Sharp Health Plan