The Advanced Fertility Blog

Are Fertility Medications Ever Covered by Insurance?

Fertility Medications

New York State is 1 of 15 states having laws on the books mandating some form of coverage for fertility treatment by insurance companies. However, providing coverage for medical services does not always translate into reimbursement for fertility medications that are a necessary component of infertility treatment.

Your insurance provider and employer have determined the amount of coverage you have for fertility medications under your policy.

At Advanced Fertility Services, we understand that the cost of fertility medications – in addition to the cost of fertility treatment procedures – increases the financial stress most patients undergo when they are trying to have a baby. Reality dictates that the cost of fertility medications will make up a substantial portion of the total necessary expense of your infertility treatment.

How to Determine Your Coverage for Fertility Medications

A careful and thorough review of the terms of your health insurance policy will determine whether the scope of your coverage for fertility treatments includes medications.

The terms of your health insurance policy may contain:

  • An exclusion of fertility treatments
  • Coverage for infertility diagnosis only
  • Coverage for infertility diagnosis plus limited treatment services
  • Complete coverage for infertility diagnosis and treatment
    • Including fertility medications
    • Limiting fertility medications
    • Excluding fertility medications

In the event that you are fortunate to have partial or full coverage for fertility medications under your health insurance policy, terms and conditions may specify that you must purchase your drugs:

  • Through selected pharmaceutical providers
  • Through your insurance carrier’s prescription drug plan

Insurance Accepted at Advanced Fertility Services

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Do not despair at the complexity of interpreting your health insurance policy’s language. Let the insurance experts at Advanced Fertility Services help you review and understand the extent of your fertility medication insurance coverage. At Advanced Fertility Services, we will make every effort to discover all available coverage that is available to you for the cost of fertility medications.

A Plethora of Accepted Insurance Carriers

Advanced Fertility Services is experienced in working with an abundance of insurance carriers, namely:

GHI                                   Horizon                                  Great West

Cigna                                 Empire B/C                            Magnacare

United Healthcare               Empire B/S                            Oxford Liberty

The Empire Plan                 HIP                                        Oxford Freedom

Anthem B/C                       Pomco                                    Hotel Trades

Insurance Combo Plan

The insurance experts at Advanced Fertility Services will help you process claims for all fertility medications that are potentially covered. In addition, the Advanced Fertility Insurance Combo Plan may be available to you for a medical service fee of $6,000!

  • All monitoring is billed to the patient’s insurance company
  • The patient is responsible for all office visit co-pays
  • Fertility Medications, Ancillary Procedures, and Anesthesiologist Fees are not included as part of the $6,000 Advanced Fertility Insurance Combo Plan fee

Financing Your Uncovered Fertility Medication Costs

Because fertility medication costs can constitute thousands of dollars per IVF cycle, Advanced Fertility Services can help you to compile the expected total cost of your prescribed treatment. You will then have the opportunity to arrange your IVF treatment financing through a preferred commercial lender via Enhance Patient Finance.

For more information on how you can prudently prepare to absorb the costs of fertility medications, contact Advanced Fertility Services by clicking below or calling 212.369.8700.