Insurance Coverage for IVF & Fertility
Before beginning fertility treatment at New England Fertility, we urge patients to check with their insurance company to confirm the coverage provided by their specific plan:
- GHI (out-of-network coverage)
- Harvard Pilgrim
We also are a Carrot-approved provider. If you receive Carrot fertility benefits through your employer, you may be eligible to reimbursement from Carrot for certain services you receive at our clinic.
Verification of Coverage & Billing
If New England Fertility has a contractual agreement with your insurance company, we will bill the carrier directly. If we do not have a contract with your carrier, but you can obtain written verification of coverage for the specific test or procedure, we will bill your carrier directly on your behalf. If you do not have coverage or if you prefer to submit your own claims, your account will be designated as self-pay, and we will not bill your insurance company and you will be responsible for all the fees. In some cases, self-pay patients may be asked to pre-pay for certain procedures such as IVF and egg donation.
Important Insurance Information
- Some insurers have a lifetime maximum for infertility treatment. We suggest you find out what this is before you start any infertility treatment.
- Preauthorization may not guarantee payment. Claims may be denied or partially covered following the procedure. Patients covered under such policies are responsible for the payment of the balance.
- The State of Connecticut mandates that insurers cover a maximum of four cycles of ovulation induction, three cycles of IUI, and two cycles of IVF.
Questions to Ask Your Insurance Company
- Is there a specific person who handles questions regarding infertility coverage? Request to see the insurance manual regarding infertility coverage.
- Is there a pre-existing condition limitation?
- What percentage of medical expenses is covered?
- Is there a co-payment for services or for medications? If so, what is it?
- What is the annual deductible?
- Is there a maximum out-of-pocket expense you can incur in a single year?
- Is there a need for preauthorization of services?
- What procedures should be followed when filing a claim?
- Is there a specific pharmacy that should be used to order the medications?
- Is there a time limit for infertility treatments or a specified number of IVF cycles allowed?