Fertility insurance can help on your journey to conceive
Infertility is very stressful, so you don’t need the added worry of the cost of treatment. It‘s no surprise that infertility treatment can be expensive, and fertility insurance coverage is spotty at best. Our financial counselor will explore your benefits and give you all the information you need to make the best informed decision for your care. If you do not have insurance coverage it does not have to be the end of your journey to parenthood. Our goal is to do everything possible to assure that the expense of treatment does not become a factor in your decision. We do have options for patients without fertility insurance coverage that can make treatment more affordable, and hopefully reduce your stress.
When inquiring about the cost of a particular IVF program, the couple should ask for a written statement that covers all the charges that they will incur. We understand that couples should not be faced with distressing surprises at the end of the treatment cycle.
At Fertility Specialists of Texas, a financial counselor will meet with you to explain your insurance coverage and benefits. During the meeting, we will review the cost for the medical treatments that you may be considering and advise you of any responsibility for payment that you may have due to deductibles, co-insurance or co-payments.
If you do not have insurance coverage for fertility treatment, we will discuss our programs to help make it more affordable.
Our practice is pleased to offer flexible payment plans from Lending Club (formerly Springstone Patient Financing).
- No initial payment and no payment for 3-7 weeks
- Affordable Extended Plans with low fixed rates & low monthly payments
- No prepayment penalty
You can calculate potential monthly payment options. Or place an application in a few short minutes, and decisions are typically available in seconds. For more information, just ask our team or visit Lending Club.
In today’s world, health insurance is very complex and can add to the decisions you will have to make when selecting infertility treatment options.
At Fertility Specialists of Texas, our goal is to lessen some of that strain and help you work with your insurance carrier to make sure that you are reimbursed at the maximum amount that is available to you. We will review your specific benefits with you at your first visit so that you have an understanding of your insurance benefits and treatment options available to you. All insurance claims are filed electronically by our office. Please call our office with any questions. You can also email us using the contact form on the web site.
It is important for you as a patient you to be the best advocate for yourself by completely understanding your insurance policy. It is critical that you review your specific insurance policy and understand what will be paid by insurance and what will not be covered.
More facts about fertility insurance and financing
Make sure that you contact your insurance company and request a written pre-determination of your specific coverage. Do not handle this on the phone. You may get a customer service representative who will give you their interpretation of your policy and it may not be accurate.
A written verification of their intent to pay is much more effective than a verbal one if you have to challenge them.
Ensure that you establish a point of contact with a representative at the insurance company and it may improve any follow-ups that are required. Make sure to request written documentation for all phone conversations concerning coverage and insurance benefits.
Below are some critical questions to ask your insurance provider:
- What is the specific policy or procedures that I need to follow in order to get infertility treatment covered? For example, do I need separate referrals or authorization for each office visit, bloodwork or office procedures?
- Is there a dollar maximum associated with infertility treatment? If so what is that dollar amount?
- Is there a maximum lifetime amount for intrauterine insemination (IUI)?
- How many cycles of in vitro fertilization (IVF) are covered?
- Are fertility medications covered and if so, am I required to use a particular pharmacy?
- Referral – A form issued by a primary care physician or ob/gyn referring a patient to a specialist. If applicable, the patient obtains all referrals.
- Authorization – A number issued by an insurance company authorizing a specific procedure or medication. Depending on the insurance, the doctor or the patient, can obtain authorizations.
- Pre-certification – A number issued by insurance for a surgery or in office procedure.
- Pre-determination letter – A letter from an insurance quoting benefit coverage according to the specific patient policy.
We work with the following healthcare plans
- 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)
- TML Intergovernmental Employee Benefits Pool PPO
- Texas DirectCare, Inc (TDC)
- UHC (United Healthcare Center of Excellence) all plans
- Unicare Performance and Classic all plans
- USA ManagedCare Organization PPO
Contact us to learn more about fertility insurance and insurance benefits.