From day one as a new patient, we work with you to verify insurance coverage and explain the costs. We never want patients to be surprised. Fortunately, we have what most insurers require to offer coverage, and other ways to help if they don’t.
At CARE Fertility, we offer comprehensive coverage. Our doctors, clinic, facility, anesthesiologists, and labs are all in-network with nearly all insurance providers. For non-insurance patients, the cost of the anesthesiologist is bundled into the fee for related treatments so there are no separate surprise charges. Our Ambulatory Surgical Center has been fully accredited since we opened its doors in 1996, which means it is covered by most insurance policies.
We also participate with several Financial Support Resources and Medication Discount Programs.
How do you know if your insurance benefits include fertility coverage?
While CARE Fertility is contracted with most major insurance companies, each policy is different. Coverage is determined by the type of policy you have with your employer, not the insurance you use. If you are insured through your employer, your employer chooses your benefit coverage or policy type. Some policies cover only diagnostic testing, some policies cover nothing at all, and some policies cover testing and 100% of treatment.
Your insurance policy booklet is your best resource to help you and our staff understand your fertility benefits. Be certain to check both your medical procedure coverage and prescription coverage. Additionally, check the “exclusions” section of your policy manual to see if there are exclusions or limitations on infertility coverage. Limitations may include higher copayments for infertility treatment, prior authorization requirements, limits to the number of cycles, dollar limits on benefits, and annual or lifetime limits. If you do not have a policy booklet, contact your human resources manager at work or your insurance company to obtain one.
It sounds simple, but another way to determine your infertility benefits is to call the 800 number on your insurance card. Tell the representative that you would like to verify your benefits for infertility coverage. Please keep in mind that a verbal confirmation is not a guarantee of benefits, and it is still necessary for you to obtain this information in writing from your insurance company.
Insurance coverage isn’t always clear and straightforward. No one is more determined to make sure you get the coverage you’re entitled to than you and your partner. Read, ask lots of questions, and don’t hesitate to ask us for help.
Once you know what to look for and have gathered as much information as you can, share with us everything you have received in writing. We are happy to verify your benefits, and we have specialists who are experienced in helping you navigate the entire insurance process.
Even for patients fortunate enough to have fertility insurance coverage, there are still hidden costs to navigate — some of them quite expensive. Read our blog post to learn how to avoid these surprise fees.