Many insurers now offer coverage for the various stages of infertility treatment — from examinations and tests, to medical procedures and drugs. In addition, more states are now requiring that insurers include infertility benefits in their policies.
Unfortunately, fertility coverage is not yet universal. So take some time to study your policy and find out if, and to what extent, you may be covered.
If you'd like assistance verifying your benefits, call Fertility LifeLines™ at 1-866-LETS-TRY (1-866-538-7879).
If you don’t have fertility coverage, you may be eligible for self-pay patient savings on every cycle of Gonal-f® with the GO Direct to Savings Card. Learn more.
Knowing exactly what your policy covers before you see a healthcare provider is a huge timesaver. Your coverage may dictate the kind of healthcare provider you see, the types of tests you have, the sequence of the testing and which treatments will be covered.
When possible, it's best to get a commitment for coverage prior to seeing a fertility healthcare provider. This is called "preauthorization" or "predetermination." To help you along the process, we've created sample preauthorization letters as guides for you.
If you have questions about what your policy covers, Fertility LifeLines™ can help you verify what insurance benefits you may have. Call Fertility LifeLines™ at 1-866-LETS-TRY (1-866-538-7879) and a Fertility LifeLines™ benefits specialist can help you to verify your insurance.
Read over both your medical coverage and your prescription coverage plans. Consider the following:
Unfortunately, fertility benefits aren't always clearly spelled out in policies. What's not written can be just as important as what is. In most policies, there's usually room for interpretation. If you'd like assistance verifying your benefits, call Fertility LifeLines™ at 1-866-LETS-TRY (1-866-538-7879).
If your claim has been denied, you may appeal. In fact, resubmissions are common. The key is to be prepared to address the issues that led to the denial. The more specific information you have, the better you'll be able to respond to your insurer's request. Learning how the medical industry codes treatments can also be helpful, since sometimes a denial can be attributed to a simple typo. A few digits can be the difference as to whether or not you're covered.
Being an advocate for your fertility coverage can get frustrating. At these times, it's important to remember your rights and goals. It can also be helpful to talk with your healthcare provider in advance about your coverage.
We care about savings patients money. If you are unable to obtain fertility coverage, you may be eligible for self-pay patient savings on every cycle of Gonal-f® with the GO Direct to Savings Card. Learn more.
If you'd like to help inform the community about the importance of fertility treatment issues, these sample letters can help you become an advocate for coverage. One is designed to support legislation that may be before your state legislator. The other two are written to help make employers more aware of the importance of adding a fertility benefit to their coverage — one you can customize to send to your employer yourself, and one that your healthcare provider can customize and forward on your behalf.
The letters can be downloaded and modified using Microsoft Word or any other text editing software. Once downloaded, insert information relevant to you wherever you (or your healthcare provider) see parentheses.
If you need assistance at any step of the way, feel free to call Fertility LifeLines™ at 1-866-LETS-TRY (1-866-538-7879). You may also wish to download a free booklet, Maximizing Your Insurance Coverage for Infertility.
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