Insurance Coverage for Fertility Treatment
Fertility treatment is costly, and for many people, multiple cycles of treatment are needed before pregnancy is achieved. It's critical to understand insurance coverage so you can maximize your coverage and save out-of-pocket expenses whenever possible.
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Types
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There are three traditional types of infertility insurance plans. There are three categories of fertility insurance, according to Shared Journey, a fertility Web site. They are "Standard Health Insurance, Refund Programs, and Financing." Standard includes monthly premium costs for specific treatment. Refund and financing offer some money back with no pregnancy results.
Mandated Coverage
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Legislators in 15 states have approved infertility insurance coverage. Currently 15 states have legally mandated insurance coverage for infertility treatment. Definitions of infertility and the treatment that is covered vary among states. Consult your state insurance commissioner or insurance carrier to determine your state's coverage.
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Examine Policy
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Be familiar with your insurance policy so you obtain maximum coverage. Request a complete copy of your insurance plan. Review it carefully. Look for references to infertility in definitions and exclusions sections. Without specific references to exclusions, you should have some coverage. Directly contact your carrier for information.
Legal Experts
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Lawyers specializing in infertility clients can assist you in getting insurance coverage. Seek attorneys specializing in family building or reproductive law. They will examine your insurance policy and help determine your legal rights for insurance eligibility. People have successfully sued for coverage, arguing that infertility is a disability under the Americans with Disabilities Act.
Considerations
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Consulting clinic insurance specialists is a valuable source of information. Many fertility clinics have financial /insurance specialists on staff to help prospective parents understand insurance issues, facilitate filing claims and get the best possible coverage. Human resources (HR) staff are also a resource to help employees clarify company insurance benefits.
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References
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