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.
Our Participating Insurance Partners
We proudly work with the following insurance companies:
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
Insurance terms can be difficult to understand. Some common terms you’ll hear as you gather your plan information include:
PPO plans (Preferred Provider Organization) typically do not require any referral but it is important to call the plan prior to any initial consultation/treatment to check with them regarding this issue.
HMO plans (Health Maintenance Organization) always require a pre-authorization from your Primary Care Physician (PCP) for a specialist visit.
EPO plans (Exclusive Provider Organization) can be either Managed Care or not. Please check with your plan to make sure any registration or pre-authorization/certification issues have been resolved prior to your initial consultation.
FSA (Flexible Spending Account) is also known as a health saving account. It essentially moves the full burden of costs to you, the patient. If you do not spend any money on health care, you get to save the money in a special tax-free account. If you do utilize any health care services, you pay for the cost yourself.
Co-payment is the amount due for an office visit (i.e. consult, follow-up visit, etc.). This fee is due at the time of service and is a predetermined amount set by your health plan.
Co-insurance is the percent of patient financial responsibility pre-specified by your health plan.
Deductible is the predetermined amount (or percentage) of expenses that must be paid.
If you aren’t covered for fertility care, UCSF Center for Reproductive Health will extend the cash-pay discount to any service not covered by insurance. Please note that the cash-pay discount cannot be applied to any copay, coinsurance, or deductible amount designated by your insurance carrier, but only to services denied as “non-covered.”
Fertility care costs depend on both your insurance plan and the extent of your treatment. For example, intrauterine insemination (IUI) is less expensive than IVF, but there’s no guarantee you’ll get pregnant on the first cycle. If you need multiple cycles, it will cost more. For a more in-depth breakdown, please schedule a complimentary consultation with one of our financial navigators.
Visit us in San Francisco
Academic standards. Pioneering research. Personalized care. Start your journey at the UCSF Center for Reproductive Health, located in Northern California's San Francisco Bay Area.
Academic standards. Pioneering research. Personalized care. Start your journey at the UCSF Center for Reproductive Health, located in Northern California's San Francisco Bay Area.