Are you just beginning on the road to parenthood through fertility treatment? Perhaps you don’t have coverage for fertility treatment through your insurance, you have exhausted your benefits, or just found out your fertility specialist no longer participates with your insurance company.
Many larger fertility practices are making the move to stop accepting insurance companies’ payments for services due to lower compensation rates. At the same time, more insurance companies are structuring policy packages to include more fertility benefits.
“The situation lays the groundwork for patients to become frustrated or disenchanted, leading to higher dropoff rates and less couples realizing their dreams of becoming parents”, says Dr. Morgan, Director and Principle at Morgan Fertility and Reproductive Medicine. “It’s not good.”
Dr. Morgan adds that he has always participated with nearly all insurance companies in order to be able to help more patients become parents. He suggests that when looking for a fertility specialist, be sure to ask whether the practice participates with your insurance and also to ask if they have a financial specialist who will inform you about what your plan will cover prior to coming in.
“Most patients don’t know the specifics about their insurance policies”, says Dr. Morgan. “So, a long time ago we committed to employ a full time insurance specialist whose sole responsibility is to advocate on our patients’ behalf to the insurance companies. We have seen a higher percentage of couples successfully pursuing treatment simply by doing the footwork for them.”
Health insurance policies fall into one of these five groups:
No fertility coverage.
Diagnosis and Limited Treatment.
Partial or Full Medications Coverage.
If your insurance policy provides full infertility coverage, you are lucky! However, be sure to read the fine print and talk to your fertility doctor if egg freezing, preimplantation genetic diagnosis (PGD) or intracellular sperm injection (ICSI) are recommended, so you know in advance if your insurance covers those procedures.
When you’re ready to start building your family with fertility treatments, covering the cost is one of your major concerns. Your health insurance plays a role in financing fertility treatment, but how much it will cover varies greatly from state to state and policy to policy.
It is best to seek out a specialist who participates with all insurances and will verify your benefits prior to your initial visit so that you are clear about what will and will not be covered.