Fertility Insurance

Our dedicated financial team members serve as invaluable guides through the complexities of fertility insurance. Each member collaborates directly with you, offering clarity and assistance across all facets of coverage. They act as staunch advocates with insurance providers, maximizing your fertility coverage and reimbursement options. Additionally, they offer insights and directions on available financial packages that complement your treatments.

Most importantly, our team is readily accessible by phone or email to address any inquiries you may have before, during, or after your treatment journey with our fertility center.

NOT ALL PLANS ARE ALIKE
A common misperception is that all insurance plans are alike.

All insurance companies have multiple plans that they sell to employers. These different plans have very different benefits. For example, one plan might require the patient to select a doctor from a limited pool while another does not impose that limit. One plan may have a lifetime cap on fertility related services while another does not.

If you have your health insurance provided through your job, you will be able to obtain vital, useful information about your specific plan directly from your insurance company or employee benefits office. Of course, a Boston IVF financial counselor will assist you with any questions you may have regarding the benefits to which you are entitled under your insurance plan.

REFERRALS
Many insurance companies require you to get an insurance referral or authorization from your primary care doctor for visits with any other doctor. Some insurers will not pay for visits unless the referral paperwork is in place at the time of your visit.

TIMING
Once your physician has put into place a treatment plan, the nurses and financial counselor will make sure all the clinical information is in place to be able to submit for insurance pre-approval. Each insurance company have vastly different guidelines, pre-requisite testing and treatments that must be done prior to submitting for approval.  Most of the insurance companies also have up to 15 business days to make a determination on the approval. Since this is the case for most insurances, it can take between 2 to 4 weeks to obtain an insurance approval once you have seen your physician for a follow up appointment.

If you do not meet criteria for coverage under your insurance carrier’s guidelines, we can also appeal for the approval based on medical necessity.

DIAGNOSTIC TESTING
After your initial visit to Boston IVF, your doctor may request that you have one or more tests performed. Commonly, each visit to Boston IVF for office visits or testing requires an insurance referral. The form that you faxed to your primary care doctor prior to your initial visit asks for 6 referrals. If your primary care doctor issues these referrals, then they will be used, one at a time, throughout your diagnostic testing. The administrative assistant of your Boston IVF doctor will keep track of these referrals and can tell you how many remain.

OFFICE CONSULTATIONS
As with all appointments during the testing phase, each appointment often requires an insurance referral from your primary care physician.

IVF CYCLE AUTHORIZATION
Once your treatment cycle has been authorized, you may proceed with treatment as directed by your Boston IVF doctor. Some insurance companies issue approval one cycle at a time while others authorize several cycles at once. You must speak with our financial counselors to determine the specific details of your cycle authorization prior to starting treatment. This will help avoid unnecessary delays in your treatment and minimize your risk of incurring out of pocket expenses.

THAW CYCLE IVF 
A common question is whether insurance companies count thaw cycles as equivalent to fresh IVF cycles. The answer is that each insurance company handles it differently. You must speak with our financial counselors to determine how your insurance company authorizes thaw cycles.

DONOR EGG IVF
Some of the cost of donor egg IVF may be covered by your insurance policy. However, insurance company authorization for donor egg coverage may restrict your donor to having blood tests or ultrasounds at Boston IVF-approved sites. Some donors live a considerable distance away. You may be responsible for the costs of blood tests and ultrasounds performed outside of Boston IVF. You must speak with our financial counselors to determine how these outside costs can be minimized.

IF COVERAGE IS DENIED
What happens if your insurance company denies your request for coverage? Every insurance company has an appeal board that considers the merits of individual cases that have been denied. Your Boston IVF doctor will gladly write a letter on your behalf supporting your treatment plan. If coverage for a service is denied you have the right to proceed with the treatment plan agreed to by your Boston IVF doctor at your own expense. In such cases it is necessary to arrange for payment of services with our financial counselors prior to starting therapy.

CHANGING INSURANCE PLANS
If you change insurance plans during your time as a patient at Boston IVF it is critical that you notify our financial counselors immediately. Sometimes a change in insurance policies will delay initiation of treatment. Fortunately, you can minimize and often avoid these delays entirely by giving a copy of your insurance card (both sides) to our financial counselors and your Boston IVF doctor's secretary. If you know in advance that your insurance plan will change on a specific date, notify us immediately. This will often allow us to plan for the transition and help avoid delays in your diagnostic testing and treatment.