What You Need to Know About Insurance Coverage for Infertility Benefits

When we meet with couples, the most common concern is cost and the number one misconception is that fertility treatments are not going to be covered by insurance. The truth is, for about 90 percent of our patients, some portion of evaluations or procedures are covered by insurance. At the Arizona Center for Reproductive Endocrinology & Infertility, we work with you to best utilize your insurance and mitigate any costs.

Every couple is different—insurance benefits and causes of infertility can vary greatly. Because of this, there are three things you should know about insurance coverage and what fertility treatments will cost you.

1. We Determine Your Benefits & Try to Work Within Them

Before you come in for your first appointment, we have an idea of what your insurance will cover. When we set up your first visit over the phone, we’ll ask you a few questions about your insurance so we can have your benefits ready for you by the time you do come in. We want to let you know what to expect—whether there’s a specialist office copay, if you’ll be responsible for a portion of your deductible, or if you actually have infertility benefits. Regardless of benefits, we don’t want our patients to be in the dark about anything, and will make sure they have at least a ballpark figure of what they can expect the cost to be.

Coverage is always different. Some patients will just have their diagnosis and initial evaluation covered. For other patients, their insurance will cover diagnosis and treatments for the underlying medical causes of infertility, but not any procedures (such as IVFs or IUIs). When a patient does have infertility benefits, we’ll check to see if they need to enroll in a program and what their insurance covers specifically. Whatever a patient’s coverage is, we try our hardest to work within their benefits while including as many infertility benefits as possible.

2. We Start Treatment by Examining the Underlying Medical Causes

Because more of our patients have insurance coverage that will only cover the medical causes of infertility, we begin our treatments by identifying and correcting those possible causes. Many of our patients are surprised to learn that even if they don’t have specific fertility coverage, several of the underlying conditions and causes of infertility are medical conditions with evaluations and treatments that are actually covered by insurance. It’s often much simpler and more cost effective to correct the medical issues relating to infertility. For instance, a patient with irregular cycles will find it difficult to conceive; once that’s corrected, she can easily become pregnant and not need any further treatments.

We don’t just jump to an IVF procedure because that option is available. We make it a priority to really look for the medical causes behind your infertility so it can be covered by insurance. Our goal is to help you have a baby, and that can often be accomplished without the need for any actual fertility treatments or procedures.

3. We Do Everything Within Our Power to Mitigate All Other Costs

Sometimes we exhaust all insurance benefits and patients have to pay out of pocket. We never want the cost of treating infertility to prevent a couple from starting a family and having a baby. We keep our prices very reasonable and work with you to mitigate any outside costs, like medication or sperm and egg donations, when those are necessary. We also have discounted packages and in-house payment plans to make the costs of procedures less of a burden.

At the Arizona Center for Reproductive Endocrinology & Infertility, we want to help you realize your dream of having a family, regardless of your insurance coverage or costs. To learn more about what treatments and procedures may be covered by your insurance benefits, call us at 520-326-0001 or visit us online.