Miracle Blog

Clearing Up the Confusion About Insurance Benefits for Fertility Treatments

Before undergoing fertility treatments, Dr. Hummel and Dr. Kettel recommend exploring your insurance benefits. There are three levels to the issue of insurance benefits for fertility treatment.

  1. Your State Law:
    Depending on where you live, your state might have enacted legislation requiring health insurance carriers to offer coverage. If you are one of the lucky ones, your health insurance benefit package will have coverage for infertility diagnosis and /or treatment. This is true for Arkansas, Hawaii, Illinois, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, and West Virginia. In the states of California, Louisiana, and Texas, insurance carriers are only required to offer coverage for infertility diagnosis and/or treatment. This means that it is up to each individual employer to purchase a rider that covers the benefits. All other states have no mandate concerning infertility insurance benefits. You can read more about your state’s mandate at www.resolve.org.
  2. Your Insurance Company:
    No two insurance policies are the same. Each one has its own list of coverages, exclusions and restrictions. You can start by getting a copy of your insurance contract and looking for infertility coverage and its exclusions, lifetime limits, and drug coverage.
  3. Your Employer:
    Ask the person in charge of medical insurance at work if infertility treatment such as IVF is a benefit on your health insurance plan. If not, find out if and when you could switch to a plan that has coverage. If you don’t have any luck, have your spouse or partner ask the same questions at their work and consider a family plan.

If you cannot find a plan that provides infertility coverage, have your employer consider adding it. Go to www.resolve.org to find a sample letter to make a case.

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