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IVF INSURANCE



States that mandate coverage for Infertility Treatment: 

ARKANSAS, HAWAII, ILLIONOIS, LOUISIANA, MARYLAND, MASSACHUSETTS, MONTANA, NEW JERSEY, NEW YORK, OHIO, RHODE ISLAND, WEST VIRGINIA

Medical insurance has gotten extremely complicated. The situation for infertility coverage is even worse. Patients may have coverage by the same insurance company, work at different places, and have plans that don't resemble each other because of different riders that their company has purchased. The situation is completely unfair. It doesn't make any difference why a couple has infertility. The cost of care is also not the issue. More expensive, more elective medical conditions are routinely covered while excluding infertility coverage. For example, the cost of hip replacement surgery would pay for three IVF cycles (the most expensive infertility therapy). Many infertility therapies are extremely inexpensive compared to medical care in other areas. The cost of infertility care is lowest in settings in which it is universally available. The cost of providing infertility insurance coverage in states that require it be part of regular insurance is similar to the cost of providing medical nutrition services.

All of the states surrounding Pennsylvania have passed some legislation that helps patients working in those states. Currently, the best situation for patients is in New Jersey. In 2001, New Jersey passed legislation requiring most large companies to provide infertility coverage for their employees. This includes payment for infertility medications and up to three cycles of IVF when less extensive appropriate therapies have failed.


Some of the major plans that we currently participate with are:

Insurance Information

Many health insurance companies have an online process that allows patients to verify if their insurance includes coverage for infertility services as well as through the customer service call centers. Please note that if you have an infertility benefit, you may still be required to obtain prior authorization before starting therapy, be aware that insurance plans written in New York State are mandated by law to provide coverage for infertility treatment, diagnosis, however IVF is excluded.

Below you will find links and telephone numbers to the major insurance companies:

Insurance Company Telephone Website
Aetna/USHC - HMO 800.624.0756 http://www.aetna.com/index.htm
Aetna PPO 800.223.6857 http://www.aetna.com/index.htm
Cigna Health Group 800.345.9458 http://www.cigna.com
First Health 630.241.7544 http://www.firsthealth.com/
Guardian 800.873.4542 http://www.glic.com
GHI 877.244.4466 http://www.ghi.org
One Health Plan 800.663.8081 http://www.greatwest.com/
Oxford 800.444.6222 http://www.oxhp.com
PHCS 800.873.4542 http://www.phcs.com/
POMCO 800.234.4393 http://www.pomcoplus.com/
PHS/Healthnet 800.848.4747 http://www.healthnet.com/
United Healthcare 800.705.1691 http://www.uhc.com

Aetna plans, Amerihealth, Capital Blue Cross, Cigna, Eastern Pennsylvania Health Network (EPHN), First Priority Health (FPH), Health America, Health Assurance, Health One, Keystone East (KHP East), Keystone Central (KHP Central), Cigna, Oxford Health Plans, Personal Choice, Physician's Care, United Healthcare, and US Healthcare.


Attention Professionals practicing in the field of Assisted Reproduction, take advantage of these unique opportunities to put your practice in front of the people who need to know.

Attention Reproductive Health professionals, we accept articles on Surrogacy Law and legal practice. We welcome all ideas.
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