How to Figure Out if You Have Fertility Benefits

Post image - How to Figure Out if You Have Fertility Benefits

If you’re considering pursuing fertility treatments like egg freezing or IVF, understanding the fertility-specific insurance benefits available to you through your employer can make a meaningful difference in how much you end up paying for treatment. 

How to figure out if you have fertility coverage 

Understanding your health insurance benefits is an important first step as you plan to move forward with fertility treatments like IVF or egg freezing. Insurance can be very complicated and so it’s helpful to know what questions to ask, how to understand your coverage, and learn more about your options.  

First things first, find out if you already have fertility specific coverage. It’s easy to assume that just because you have generous medical insurance benefits through your employer, that these health insurance benefits would also cover important treatments like IVF. Unfortunately, that is not the case. It’s important to know your fertility specific coverage (which is often through an entirely different insurance provider) and how to get your treatment covered by insurance. You can get more information by first requesting your “Summary of Benefits” to find out if your benefits already include either in vitro fertilization or egg freezing. This summary may also be referred to as a “Benefits Package” or “Explanation of Benefits.” If you work for a company that covers your insurance, your can connect with your HR department to get a copy of this. If you happen to be self-insured, feel free to reach out to your insurance provider directly. Reviewing these benefits can be complicated so it can be helpful to sit down with HR or your insurance provider directly. If you’re working with a fertility clinic already, they typically have a financial advisor that should be able to advise you. Coverage typically falls in one of the following categories:  

  1. No fertility coverage 
  1. Coverage for diagnostic testing only 
  1. Coverage for an infertility diagnosis, but doesn’t cover the treatment  
  1. Limited fertility coverage  
  1. Full coverage 

We encourage individuals to learn more about the specifics of their coverage early on in the process, even if you’re just in the consideration stage and have yet to choose a clinic. Understanding your coverage upfront helps set the stage for fewer surprises down the road and empowers you to ask questions. Whether you have full coverage or no existing fertility benefits, you always have options. Whether it’s applying for a grant, working with a financing partner, paying through your FSA or otherwise – these are the types of discussions your insurance partner, HR department or fertility clinic can support you with.   

Know you have fertility insurance benefits and want to learn more? Check out our resource, “Understanding your Fertility Insurance Benefits” to help guide your coverage conversations. This is a list of questions you can ask your insurance provider about your benefits.