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:
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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:
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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.
Insurance for IVF
