This section of our Web site will detail a process that will enable you to review and determine your infertility health insurance benefits. As part of the educational process, this section will also review other financial options for patients who do not have infertility coverage as well as current problems with existing infertility coverage and solutions to those problems.

Health insurance coverage is confusing, and worrying about insurance coverage adds to the stress of medical care. If you understand your coverage, you can alleviate some of that stress.

Your challenge is to become a better-informed health care consumer by exploring and understanding your current health insurance coverage. As a patient, you are your own best advocate and you should be highly motivated to understand your coverage. Being thoroughly acquainted with your policy will ensure that you maximize the benefits that are available to you.

Lack of adequate and consistent insurance coverage creates a potential barrier to diagnosis and treatment for many infertile couples. Many couples would like to pursue infertility procedures but simply cannot afford the expense. The coverage problem results from the way health insurance coverage defines medical necessity. Most health insurance policies will reimburse tests and procedures that they consider medically necessary to diagnose and treat an individual for sickness, illness, or disease. For example, most health insurance companies consider diabetes or hypertension illnesses and reimburse the costs for the diagnosis and treatment of these conditions. Infertility health insurance coverage varies widely across the United States, and many insurance carriers believe infertility treatment is elective or not medically necessary. A few health plans offer no infertility benefits, many offer diagnostic infertility benefits and limited treatment benefits, some offer specific dollar limits for both diagnosis and treatment, and only a few plans offer unlimited infertility diagnosis and treatment benefits.

Next: Types of Coverage