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Insurance for Fertility Treatments

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Fertility care for same-sex couples can be a very stressful journey, so you shouldn’t have the additional anxiety about the cost of treatment. It comes as no surprise that infertility treatment can be costly, and insurance coverage may be available depending on your policy. Our financial counselors will work with you to discover all the benefits available to you and provide all the information you need to make the best decision for family building.

When gathering information regarding the cost of a particular IVF program, you should request a written statement from the fertility center that outlines all charges that you may incur. At Fertility Specialists of Texas, we believe it’s important that patients not be met with any financial surprises at the completion of a treatment cycle.

During your initial consultation with Fertility Specialists of Texas, you and your partner will meet with a financial counselor. We will review the cost for the fertility treatments you may be considering, as well as any deductibles, co-insurance or co-payments.

If you do not have insurance coverage for fertility treatment, we do have many options that can make treatment more affordable.

Insurance

Health insurance is very complex and can affect the decisions you will have to make when selecting infertility options.

At Fertility Specialists of Texas, our goal is to reduce this stress and help you work with your insurance carrier to ensure you are reimbursed at the maximum amount that is available to you. We file insurance claims electronically.

Things to do before your appointment

Because you are the patient you need to be your best advocate by thoroughly understanding your insurance policy. It is vital that you review your specific insurance policy and gain an understanding.

We always encourage our insured patients to verify that fertility treatments are covered. Make sure to contact your insurance company and ask for a written pre-determination of your specific coverage and any eligibility requirements that must be met in order to have that infertility treatment covered. Your insurance company representative can frequently answer questions over the telephone, but the information provided is not binding since it is not in writing.

Should you have to challenge them, a written verification of the insurance company’s intent to pay is much more useful than a verbal one.

Establish a point of contact with a representative at the insurance company; this may improve any follow-ups that are required. Request written documentation for all phone conversations concerning coverage.

Get answers to these important questions from your insurance provider:

  • What specific procedures am I required to follow to ensure my infertility treatments are covered? For example, will I need separate referrals or authorization for each office visit, office procedures or blood work?
  • Is there a maximum lifetime amount for Intrauterine Inseminations (IUI)?
  • Is there a dollar maximum related to infertility treatments? If so, what is that dollar amount?
  • Are fertility medications covered and if so, am I required to use a certain pharmacy?
  • How many cycles of In Vitro Fertilization (IVF) are covered?

We are affiliated with the following health care plans:

  • Optum Center of Excellence 3
  • Accountable PPO
  • Aetna all plans
  • Affiliated PPO
  • Associated Administrators Group (AAGI)
  • BCBS PPO
  • Beech St PPO
  • Cigna all plans
  • Direct Care America
  • Evolutions Health Care Systems
  • First Health Network
  • FOCUS Health Care Management
  • Galaxy Healthcare Network
  • Genesis Medical Savings Plan
  • Great West Healthcare all plans
  • Healthcare Partners of East Texas
  • Healthsmart all plans
  • Humana all plans
  • IMS PPO
  • Managed Care Strategies (MCS) PPO
  • Multiplan PPO
  • National ChoiceCare
  • NHA PPO
  • NPPN (National Preferred Provider Network)
  • NTHN all plans
  • One Health Plan
  • PHCS (Private Healthcare Systems) all plans
  • ppoNext PPO
  • ProNet PPO
  • Regional Healthcare Alliance PPO
  • Rockport Healthcare Group (RHG)
  • Texas True Choice PPO
  • Texas Integrated Health Network (TEXIHN)
  • Texas DirectCare, Inc (TDC)
  • TML Intergovernmental Employee Benefits Pool PPO
  • UHC (United Healthcare) all plans
  • Unicare Performance and Classic all plans
  • USA ManagedCare Organization PPO