What is covered? What is not? Is anything covered? These are usually the biggest question! The first thing to do is look at your Summary Plan Description. This is what you should get whenever you purchase an insurance plan, no matter whether you get it through a private insurer or through work, look at your plan description. If you are lucky and have an electronic file of your plan, in the search field, search for infertility.
Most insurance’s will not cover anything that is billed for the treatment of infertility but there are a few that will pay a certain amount, like $2,500, towards infertility. Insurances that do cover a portion of infertility will most likely have disclaimers that they won’t cover things like In vitro fertilization, GIFT and ZIFT procedures, surrogate pregnancy, sperm banking and reversal of voluntary sterilization. If you have questions about your insurance coverage don’t hesitate to give them a call and see what your coverage is.
Although insurance may not pay for infertility treatments, it is very likely that they will pay for the diagnosing of infertility. They will usually cover the doctor appointments, the blood tests, hormone testing, ultrasounds, and even possibly exploratory laparoscopic surgery. Usually doctors are really good about making sure that when insurance is being billed that they aren’t billing under infertility but under diagnostics. Just make sure to be in control of the situation and ask the doctor what is going on; don’t be afraid to ask!