How to Get Insurance to Pay for Infertility Treatments

Infertility treatments can be very costly. Each in-vitro fertilization (IVF) cycle can run many thousands of dollars between the medications and doctor's procedures. Some insurance companies will pay for infertility treatments, but even the ones that do have a maximum lifetime dollar amount that is reached very quickly.

Things You'll Need

• Health insurance contract
• Log of any telephone conversations
• Copies of prescriptions
• Copy of medical records detailing procedures done

Instructions

1. Get a copy of your employer's health insurance contract. This is different from the summary of benefits employees are usually given. Ask your supervisor specifically for the full contract.

2. Read the insurance contract thoroughly to see whether any infertility treatments are covered. Pay special attention to the language used in the document. If the wording does not say that a particular treatment is excluded, then you can reasonably argue that the insurance should pay for it.

3. Make sure that you qualify for the infertility benefits. Even states that are mandated to pay for certain infertility treatments can require you to try to conceive naturally for a period of time. You may also need to work at your current job for a number of years before qualifying for infertility benefits.

4. Call your insurance company for preauthorization before you have an infertility treatment performed. It is better to call even if you are told preauthorization is not needed, rather than have the procedure denied payment because you did not call.

5. Document every doctor's appointment and procedure you have had in relation to trying to have a baby. Keep a copy of prescriptions for clomid or other drugs you have taken. If your insurance company denies a request to pay for something, you will have a record of your medical history ready if you need to send out copies.

6. Ask your doctor to write letters to the insurance company if needed. Often a doctor's letter explaining why a procedure is necessary can be more powerful than a patient trying to appeal a denial herself.

Tips & Warnings

• In order to get a paper trail going when you are trying to get an infertility treatment covered, it's best to correspond with the insurance company in writing. Save all copies of letters you have written in case you need to use them again later for another procedure. If you choose to call the insurance company instead, be sure to get the full name of the person you speak to and document the date and time of the call, with clear notes about your conversation.