Insurance Coverage
Before your first visit, our new-Patient patient coordinator will collect your insurance information so that we can perform a benefit check and confirm your insurance benefits. At your first appointment, we will meet with you to review and help you navigate the complicated world of insurance benefits. We are committed to making sure you take full advantage of your health insurance benefits.
Frequently Asked Questions
1. Will my health insurance pay for infertility treatment?
If you employer has purchased infertility as a benefit, it will be covered by your insurance. Those benefits vary per employer. Before your initial appointment, our office will contact your insurance to check your benefits.
2 If I do have infertility benefits, what is my responsibility?
Each insurance plan is different so it really just depends on your plan. Your responsibility could be anywhere from a $10 co-payment per visit to 50% of all treatment.
3. What insurance companies are you contracted with?
We are contracted with all the major companies in the area including Blue Cross Blue Shield, Cigna, Evergreen, Aetna, QHP, Tricare, United Healthcare and even some smaller insurance companies through a third party provider.
4. If I do not have any health insurance to cover infertility, what would be my cost?
That can also vary depending on what type of treatment you may need. We will go over all the costs of all possible treatments with you at the time of your initial appointment.
5. Am I responsible for obtaining a referral to be seen at your clinic?
It is your responsibility to obtain a referral for your initial consultation from either your PCP or OB/GYN. After your first visit, you will be responsible for having a current referral. We will also obtain any pre-authorizations for any procedures done on an outpatient or inpatient basis, either at the hospital or at our clinic. However, for your own benefit, we would like to suggest that you always make sure there is a referral in place or authorization is obtained before any procedure.
Questions to Ask Your Insurance Company
1. Does my insurance cover diagnostic evaluation for infertility (i.e., lab work, ultrasound, hysterosalpingogram, andrology services)? Does my insurance cover physician, hospital, and lab charges?
2. Does my insurance cover treatment for infertility such as artificial insemination or in vitro fertilization?
3. What is my co-payment to an infertility specialist? (Remember, this is usually provided by a sub-specialist and can be different from your regular co-payment amounts.)
4. What is my co-payment/deductible for infertility-related hospital charges?
5. Does my insurance cover oral or injectable medications (Clomid, Lupron)?
6. Does my insurance require use of a specific contracted pharmacy?
7. Does my insurance require use of a specific contracted laboratory?
When working with your insurance company, make sure you have the appropriate authorizations before you begin any treatment plan. You are their customer and have more influence with your insurance provider than your physician or surgery center does. Your involvement and assistance in coordinating authorizations, etc., are vital in order to protect you from the surprise of becoming financially responsible if they do not pay. Remember, insurance authorizations can take up to six weeks, so be careful when rushing into a treatment or procedure without that authorization number!
Learn more about our team:
Dr. Prakash J. Thiruppathi | CCREI Fertility Staff
Taking the First Steps:
Getting Started | Schedule a Visit | Patient Forms
