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Fertility Insurance Coverage

Some insurance plans offer significant fertility care coverage, while others provide little to none at all. It all depends on your provider and specific plan. At the UCSF Center for Reproductive Health, we aim to help prospective parents navigate the sometimes complicated insurance process so they can start treatment and grow their dream families as soon as possible.

Does insurance cover IVF and other infertility treatments?

There’s no simple answer to this question. To determine your coverage, you must speak with your insurance provider and employer. They’ll be able to tell you exactly what type of fertility care coverage you have. Our financial navigators can then walk you through our pricing as well as additional financing options. We are dedicated to being transparent and answering all of your questions honestly, so you never have to worry about hidden fees or other unexpected costs.

Talking to Your Insurance Provider or Employer about Fertility Care Coverage

To determine your fertility care coverage, your first call should be to your health plan’s member services department. You can also speak with your employee benefits office within the HR department. Your HR representative should be able to walk you through your options. 

Information You Need

You’ll need some information to get the answers you need regarding fertility care coverage. This information includes: 

  • Name of the insured person
  • Insurance plan name
  • Employee/Patient ID number or SSN
  • Group number
  • Employer name 
  • Patient’s name and DOB

Questions for Your Insurance Provider

  • What are the specific infertility benefits included in my plan?
  • Will I have to meet a deductible before coverage begins? If so, how much?
  • What is my level or percentage of coverage once my deductible has been satisfied?
  • Is there a maximum payment or cycle cap on infertility treatment or specific procedures?
  • Are my infertility medications covered? If so, is the medication benefit separate from my infertility dollar or cycle maximum?
  • Are there any exclusions or restrictions on my policy?
  • Is there an age limit?
  • Are there any criteria that must be met before I can access my benefits?
  • Am I required to have been trying to conceive naturally before being able to access my infertility benefits?
  • Is there an IUI requirement before proceeding with IVF?
  • Are there any required lab tests that I must complete before accessing my infertility benefits? If so, how often must I complete these labs?
  • Which blood draw labs/pharmacies are contracted with my insurance carrier?

Questions for Your Employer

  • Does my current health plan cover infertility treatments?
  • If my current plan does not cover infertility treatment, is there another plan available that provides benefits? If so, what is the cost difference between the two plans? How and when can I change plans?
  • Is there any required waiting period before I can start infertility treatment for pre-existing conditions?

Fertility Insurance & IVF Coverage FAQs