Here are some important questions to ensure that you have the right coverage for treatment: Does my insurance cover diagnostic evaluation for infertility (lab work, ultrasound, etc.)? Do they cover physician, hospital, and lab charges? Is treatment for infertility such as IUI or IVF covered? What is my co-payment? Are injectable or oral medications covered
Typically, PPO insurance does not require pre-authorization for an initial consultation. If your insurance requires a pre-authorization to see a specialist, then you must get a referral from you OB/GYN to see a fertility specialist. Pre-authorizations may also be needed for any testing, ultrasounds, or blood work. Your assistance in coordinating authorizations is important in
Couples often find out that infertility diagnosis and certain treatments are covered by their insurance. However, IVF and others may be excluded. California is one of 13 states with an infertility mandate in place. This is a "soft" mandate, which gives employers the option to offer infertility benefits. Since it is not required, not many
Following your initial consultation, your physician will outline a treatment plan and the associated costs. Costs will vary depending on what type of treatment is recommended. Without health insurance there are additional rate plans available as well as several financing options. Contact our office for more details.
RSMC accepts both "in-network" and "out of network" insurance. We work with Aetna, Anthem Blue Cross, Blue Shield, Cigna, Healthnet, Tricare, and United Health Care. Prior to your consultation we will verify your insurance benefits and review detailed coverage information at your consultation. In cases where insurance is not accepted, our coordinators will arrange for
This depends whether or not infertility has been purchased as a benefit. Some insurance providers may cover a portion of treatment if it is a medical necessity. Benefits vary by insurance policy. We always encourage our patients to reach out to their provider for an explanation of coverage.