Understanding Fertility Insurance Benefits
At IVFMD, we’re committed to making fertility treatments more accessible. Insurance significantly reduces the costs of fertility and IVF treatments. Here, you’ll find our accepted insurance providers and helpful guidance to understand your fertility insurance benefits.
Know Your Fertility Benefits
Major insurance providers such as Aetna, Blue Cross Blue Shield, Cigna, United Healthcare, and Tricare offer a wide spectrum of fertility benefits, including IVF treatment. However, coverage depends on your employer’s health plan choices or if you have privately purchased individual insurance.
Common fertility coverage levels:
- No infertility coverage: Rarely, some plans offer no coverage for infertility.
- Diagnostic testing only: Typically covers fertility testing such as sonograms, hormone testing, semen analysis, HSG, hysteroscopy, and laparoscopy.
- Diagnostic testing and limited treatment: Includes fertility testing and basic treatments like ovulation induction or intrauterine insemination (IUI). Medication coverage often includes Clomiphene, occasionally injectable medications.
- Comprehensive coverage: Covers fertility testing, IVF treatments, embryo freezing, and injectable medications. Usually has limits on IVF cycles, annual amounts, or lifetime caps.
Does insurance cover fertility testing?
Most providers offer at least diagnostic fertility testing. Coverage varies greatly depending on your specific insurance plan.
How much does IVF cost with insurance?
Costs for IVF with insurance vary widely based on your plan’s specific coverage. Confirm details directly with your insurer to get precise estimates.
Fertility Insurance Coverage in Texas
In Texas, insurance providers are required to offer infertility coverage, including IVF treatments. However, employers decide whether to include this coverage in employee health plans. Always confirm with your employer or insurance company for specific coverage details.
In-Network Insurance Providers at IVFMD
Want to know if you’re covered? Contact your insurance provider directly to confirm. (Please note: IVFMD does not accept Marketplace or HMO plans.)
Questions to Ask Your Employer About Fertility Benefits
Consult your employee benefits department with these questions:
- Are fertility treatments included in my current plan?
- Does another available plan offer better fertility coverage, and at what additional cost?
- When can I switch plans?
- If there’s a pre-existing condition clause, what’s the waiting period?
Questions to Ask Your Insurance Company
For detailed fertility insurance information, contact Member Services at your insurance provider or visit their website. Be ready with:
- Insured individual’s name
- Patient/employee ID or social security number
- Patient’s name and birth date
- Employer’s name
- Plan name and group number
Document the representative’s full name, contact number, and extension. Request written confirmation if possible. Key questions to ask:
- Is diagnostic testing covered?
- Are fertility treatments covered? Specifically:
- Intrauterine insemination (IUI)
- In vitro fertilization (IVF) and the number of allowed cycles
- Embryo freezing
- Frozen embryo transfer cycles
- Coverage of fertility medications (e.g., Clomiphene, Gonal-f, Follistim)
- Is there a lifetime or annual benefit maximum?
- Are medication costs included in lifetime maximum calculations?
Get Referrals and Authorizations
Your most current insurance card is required before you arrive at your appointment. Please remember that it is your responsibility to obtain the required referral and authorization prior to your appointment, if your plan requires you to do so. If you don’t have a referral or an authorization, your insurance will not reimburse your visit, and you will ultimately be responsible for the cost.
We will work closely with your insurance provider to ensure that you receive the benefits included in your policy. Our team will file claims and attempt to negotiate disputed claims on your behalf with your insurance carrier. However, you are ultimately responsible for payment of charges that are not resolved. In addition, expenses not covered by your insurance policy will be your responsibility. We’re always here to assist you with any questions and claims.
Page Updated: April 2025
No insurance? No problem!
Visit our Financing Options page for more ways to manage and reduce fertility treatment costs at IVFMD.