Which Fertility Treatments are Covered by Insurance?

The financial commitment that is required to treat infertility can be daunting because coverage of treatment costs by insurance is limited for most people. At Kofinas Fertility Institute, an expert financial counselor is available to inform patients of all expected costs for recommended medical procedures as well as the extent of one’s potential insurance coverage.

Fertility Treatments Covered by Insurance

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Dr. George Kofinas has designed a vast array of financial plans to make his state-of-the-art facility available to all hopeful parents at an affordable cost.

If you are ready to undergo fertility treatment so that you can have a baby and start building your family, then it’s time to schedule a consultation with one of the financial counselors at Kofinas Fertility Institute.

The insurance experts at Kofinas understand your financial commitment is a major concern and they will help you arrange financing for your fertility treatment.

Insurance Coverage

Determining how much your health insurance will cover the cost of your fertility treatment depends upon the language of your specific policy and your home state’s insurance laws. Read on for some basic facts that may help you research which fertility treatments will be covered by your insurance.

The Affordable Care Act and Fertility Treatments

Before 2014, treatment for infertility was considered a pre-existing condition that was not covered by most insurance plans. With the passage of the Affordable Care Act (ACA), an insurance company cannot refuse to cover your treatment costs because of this preexisting condition.

  • Sort of good news – The ACA mandates that health insurance companies provide coverage for essential health benefits. However, infertility treatment is not one of the stated essential health benefits in the ACA.
  • Not such good news – If your insurance policy did not cover fertility treatments before 2014, it does not have to do so today.
  • Better news – Insurance companies cannot deny coverage for your treatment just because you are diagnosed as infertile.
  • The ultimate question – Does your diagnosis of infertility qualify as an essential health benefit under your insurance policy and within the purview of your state’s laws?

15 States Have Mandated Some Fertility Coverage

Out of 50 states, only 15 require insurance coverage for infertility treatment. New York is one of these states.

Even if your state does not require that insurance companies provide some level of coverage for the diagnosis and treatment of infertility, you may still be covered by your insurance policy.

  • This is because employer-provided insurance coverage levels are negotiated between insurance carriers and employers.
  • Employers today are fully aware of the family planning considerations American working women have to make when entering and staying in the workforce.
  • So, to maintain talented human resources, your employer may have negotiated infertility treatment as a benefit covered by your policy.

Thoroughly read and understand the particulars of your plan – especially the specifically covered benefits, exclusions, and restrictions.

The Spectrum of Insurance Coverage

The spectrum of health insurance policies make up five groups of coverage:

  • No fertility treatment coverage
  • Coverage for infertility diagnosis with no treatment
  • Coverage for infertility diagnosis with limited treatment
  • Full infertility insurance coverage
  • Coverage for medications

You are in luck if your insurance policy provides full fertility treatment coverage. Just make certain to read the fine print and review it with the expert financial counselors at Kofinas Fertility Institute. Some common elective procedures: egg freezing, preimplantation genetic diagnosis (PGD), and intracellular sperm injection (ICSI) may not be included – Our Fertility Insurance Policy.

Begin your financial planning for your new baby today by talking to a financial counselor at Kofinas Fertility Group.