- Insurance FAQs - Our Payment Policy - Financial Options -
1. Will my health insurance pay for infertility treatment?
If you employer has purchased infertility as a benefit, it will be covered by insurance. Those benefits vary per employer. Before you initial appointment, your office will contact your insurance to check your benefits.
2 If I do have infertility benefits, what is my responsibility?
Each insurance plan is different so it really just depends on your plan. Your responsibility could be anywhere from $10 a visit to 50% of all treatment.
3. What insurance companies are you contracted with?
We are contracted with all the major companies in the area including Blue Cross Blue Shield, Cigna, Evergreen, Aetna, QHP, Tricare, United Healthcare and even some smaller insurance companies through a third party provider.
4. If I do not have any health insurance to cover infertility, what would be my cost?
That can also vary depending on what type of treatment you may need. We will go over all the costs of all possible treatments with you at the time of your initial appointment.
5. Am I responsible for obtaining a referral to be seen at your clinic?
It is your responsibility to obtain a referral for your initial consultation from either your PCP or OB/GYN. After your first visit, our office will be responsible for having a current referral. We will also obtain any pre-authorizations for any procedures done on an outpatient or inpatient basis, either at the hospital or at our clinic. However, for your own benefit, we would like to suggest that you always make sure there is a referral in place or authorization is obtained before any procedure.
We know that infertility treatment is a stressful, not only emotionally, but physically and financially as well. Unfortunately, many insurance plans do not cover infertility as a medical condition that requires treatment and we understand that your treatment decisions are often affected by financial concerns.
If you do have insurance coverage for infertility, we will be happy to file your claims with your insurance company and you would just be responsible for your portion. If your insurance company does not cover infertility treatment, our policy is to request payment at the time the services are rendered.
Infertility treatment is not only emotionally draining; it is also a very costly investment. We understand and sympathize with these concerns and try to alleviate as much stress as possible by providing information for patients considering fertility treatments. We will always strive to provide you with complete, open communication and an understanding of the financial aspects of your care.
Insurance Coverage and Benefits:
Insurance benefits vary widely and it is impossible for us to know every possible scenario of coverage each plan has. Because each plan was selected by you or your employer, it is important to call and know all your benefits before you begin treatment. To assist you with this process, below are a few standard questions with talking with a representative of our insurance company:
- Does my insurance plan cover diagnostic evaluation for infertility, such as lab work, ultrasounds, hysterosalpingogram, and semen analysis?
- Does my insurance plan cover infertility treatment, such as artificial insemination or In Vitro Fertilization?
- What is my co-payment to a Fertility Specialist?
- What is my deductible?
- Does my insurance cover oral or injectable medications such as Clomid, Follistim, Gonal-F and Repronex?
Remember, you are their customer and have more influence with your insurance provider than your physician. Your involvement and assistance in coordination of authorizations is a vital part of this process and to protect you from the surprise of becoming financially responsible for any services they do not cover. The more you know about your coverage, the easier it becomes to go forward with treatment.
There are a few options available if your insurance company will not cover infertility treatment or if you do not have insurance coverage. Some banks will allow you to take out a personal loan for these procedures. For more information regarding special banks which help with financing elective procedures, contact our office. We will be happy to assist you in any way.
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