Understanding Your Insurance Plan for Fertility Treatments

Is your medical insurance plan confusing you? Well, you’re not alone.

Many patients approach fertility treatment with little to no knowledge of what coverage they have or how their medical plan works. To help you understand the billing process, patients should take a few basic steps before visiting to your fertility provider.

Step 1: Check your insurance benefits and eligibility

How can I find out if my insurance is accepted or not at Center for Reproductive Care?

Many insurance providers have portals online which allow patients to log in to check their benefits and eligibility. If your insurance provider doesn’t have online access, you can always call member services (the phone number is normally located on the back of your insurance card) to assist in explaining what service will and will not be covered at your future visits a Center for Reproductive Care.

Your provider’s office will also verify your benefits and eligibility. If certain services are not covered by your insurance provider and you choose to proceed with them, you will be required to make payment for services not paid by insurance.

Step 2: Determine the deductible for your insurance plan

How do my deductible, coinsurance, copay, and out-of-pocket maximum work together?

If your insurance plan has a deductible, you are responsible for 100% of your medical costs until your deductible is met. Your monthly premiums do not count towards your deductible, only what you pay on your medical bills.

Once you have reached your deductible, your insurance plan will begin to pay for some of the costs. The amount you pay is your co-insurance. Only after you reach you out-of-pocket maximum does insurance start paying at 100%.

Example: Jenni has a plan that has a $2,000 deductible, 20% co-insurance and a $3,000 out-of-pocket maximum.