Before beginning any discussion about insurance coverage, it’s important to explain the status of fertility benefits in the various States in the Union. Required coverage of infertility varies greatly from State to State. Not every employer is required to cover fertility treatments; this benefit is delineated per state.
States that do require some benefit level for infertility treatments are called “mandated to cover” states. The list is short, and exact mandates vary from State to State.
• Arkansas
• Hawaii
• Illinois
• Maryland
• Massachusetts
• Montana
• New Jersey
• New York
• Ohio
• Rhode Island
• West Virginia
Others, called “mandated to offer” states, require infertility benefits to be offered for additional purchase.
• California
• Connecticut
• Texas
Seems pretty clear cut, right? Of course! Everything that involves Government and Insurance is uncomplicated!?! To make it even more complicated, large, national corporations oftentimes offer the same benefits company-wide, resulting in exceptions to the State’s directive. Consult your Human Resources office to find out which State’s laws govern your companies policies. For example, you may live in a state that mandates coverage, but work for a company that is not required by the federal government to meet the State’s benefit mandate, find out which State’s mandate they must follow. On the other hand, if you live in a state that does not require fertility coverage; you may still be covered through your employer. Speak with your HR department and find out exactly what rules your company follows.
In addition to these complications, many times your healthcare plan may cover some parts of your treatment even if you work in a state that does not mandate coverage. It is extremely important, therefore, that you contact your company’s Human Resources department and your healthcare plan provider to discuss in detail your benefits. Don’t delay speaking with your HR Dept. start getting educated about your options today.
125 c Plans and Infertility Options
Paying for any type of medical treatment can be separated into three basic options. • Healthcare plans usually offered by your employer or professional organization. • From your own savings or other private arrangement such as a bank loan. • Grants and other programs offered by some patient advocacy groups and clinics.
Infertility and Health Insurance – Where to Start?
Infertility has become more of a concern for more hopeful couples as revolutions in medicine find more ways to treat the varied types if infertility. As more couples demand coverage for infertility more health insurance plans are covering more aspects of infertility treatment. The challenge can be finding out what that coverage is and how to file the claim so as not to have the claim rejected. Whether your plan is a HMO, PPO, POS, or Blue Cross / Blue Shield the bottom line is the same.
Fertility Centers help Arrange Infertility Financing
When most couples find that their health insurance benefits will not cover infertility treatments they turn next to personal savings or, worse yet, retirement savings. However, many patient advocacy groups and clinics offer additional options for dealing with the increasing financial costs of infertility treatment by working one on one with individuals to find personal solutions. Infertility consulting companies also provide viable solutions to explaining options and offering comfort and security throughout the process.
