How to Get Insurance to Cover Infertility Treatments?

Infertility can be stressful, and finding out your insurance does not cover the procedures will only add to your problems. Unfortunately, there are only some insurance companies that offer coverage for infertility. Most patients will need to consult with their insurance company make their case of infertility clear to get any portion of IVF covered. By choosing the most reliable companies, beneficial insurance plans, obtaining necessary referrals, and by fulfilling any testing requirements, you can increase your chances of getting IVF treatment covered by your insurer.

Choose the Right Insurance before Starting IVF

Compare available plans with and concerned financial benefit officer. Discuss the different health plans available for you and compare deductibles and lifetime facilities for infertility and IVF coverage to choose the best plan for you. If you want to open an insurance plan for your spouse, prepare a list of questions about IVF and infertility coverage that your spouse can ask their benefits specialist. Also, consult your doctor about your insurance options and your insurance advisor at doctor’s office, which plan will be best according to the fertility tests you need. Your doctor can provide a rough amount about the relative costs of different procedures under the different plans.

Don’t pick a plan for a lifetime infertility coverage but choose a plan with infertility benefits that covers most of your potential IVF costs. Pick a more comprehensive and flexible infertility coverage so that you are able to switch coverage for other life events.

Confirming Your Coverage

Confirm your coverage with your insurer to know your benefits. You can also prepare questions beforehand. Depending upon your infertility situation, you may have more specific questions regarding certain treatments and medications.
Most plans that require referrals state that you need to have an existing relationship with a primary care doctor who can connect you with an approved fertility specialist. After discussing your infertility history, your primary care doctor can determine the most appropriate specialist that is available for you. Ask your specialist to call your insurance after your first consultation to find out the coverage of any diagnostic testing that is required during your IVF procedure.
Your insurance provider can give your specialist’s a better idea of what is covered and what is not under your plan.

Appeal Your Need for IVF

Lastly, complete a full fertility assessment to rule out any treatable conditions inhibiting conception. Nearly all insurance providers will require diagnostic tests to illustrate your case of infertility before they consider covering IVF. You can ask your insurance company about the tests which are required as part of your fertility assessment. Perform all treatment options that your insurer requires before releasing IVF coverage. Some plans may require IUI or follicle-stimulating hormones, before providing any IVF coverage. Sometimes partial infertility coverage is also provided, so clarify with your insurer on these situations.

All documentation of prior tests and treatments should be submitted to your insurer. Get your entire list of medical reports from your specialist of all the tests and treatments you have completed during your fertility assessment. Send all the medical documents to your insurance company for their records, and follow up to make sure they understand your medical profile.
Your insurer may also require you to make some lifestyle changes for some advanced infertility treatment coverage. Even though your fertility assessment may show a need for such lifestyle chances in IVF to conceive, your insurance company can halt your approval if you do not meet other health criteria they require.

Ask your insurance company if there is any additional testing that needs to be done before they can approve you for IVF coverage. Depending on your health, your insurer may also ask for hormone studies or uterine imaging. Some insurers also ask for test reports in every 6 months for your IVF approval to remain in good standing.

Any denials for coverage must be directly informed to the company. You can also request your fertility specialist to write a letter on your behalf in support of your fertility treatment plan. Fill out any appeals and submit them to your insurer. Appeals can be a months-long process, so you must be patient.

Even if you are denied for IVF coverage, it does not mean you cannot pursue IVF. You can continue with your treatment plan, but you will be responsible for any expenses not covered by your insurer. If you decide to pursue IVF using your own funds, you may be able to get reimbursed for eligible expenses if your insurer later approves your appeal.

The doctors suggested by Elawoman are ideal referrals for infertility treatment insurance coverage as they provide full support to help you get complete cover for your treatments.

ELA Woman is the largest fastest growing Fertility and Reproductive healthcare facilitator, having partnerships with more than 1265 best Fertility Centres across India and South- East Asia.

H135, DDA Flats
Naraina Vihar, Delhi

This release was published on openPR.