Fertility Treatment Costs
The cost of fertility treatment can be better controlled when a fertility specialist is consulted early in the infertility evaluation. We are committed to helping couples afford the fertility treatments that they need. We do everything possible to control fertility treatment costs and the expenses of ART technologies.
The infertility specialists and staff at Dallas – Fort Worth Fertility Associates believe in offering the most cost effective evaluation and treatment for our patients, regardless of insurance coverage. Insurance coverage or the desire to control costs should not dictate the treatments administered. Unfortunately, not all insurance policies cover ART treatments like IVF. Coverage of fertility testing and treatments vary widely from policy to policy.
Fertility Insurance Verification
When a person calls to make a new patient appointment with a fertility specialist at Dallas – Fort Worth Fertility Associates, they will be asked to provide a copy of their insurance card so we may verify coverage prior to the visit. The purpose of this is to ensure our patients have coverage for diagnostic testing before any tests are ordered. Tests can be a significant portion of the overall cost of fertility treatment. The amount of coverage a couple has is dependent upon the terms of their insurance policy. Some policies completely exclude any type of fertility testing or fertility treatment, while others cover all costs including IVF. The cost of diagnostic fertility testing may be considerable if you are a self-pay patient. Fortunately, there are strategies that can be used to minimize some of these costs.
Although our staff will attempt to verify insurance coverage, patients have the ultimate responsibility of knowing the extent of their policy. We encourage our patients to independently verify that fertility treatment is covered. Sometimes our staff is provided with benefit information by an insurance company representative that differs from what the patient’s policy actually covers. We encourage all patients to obtain a copy of their insurance policy and contact their insurance company to determine their benefits for infertility and IVF. An insurance company representative can often answer questions over the telephone; however, the information provided is not binding.
Infertility Treatment Costs- Diagnostic Tests
Fortunately, many patients’ insurance policies cover diagnostic testing. This often includes office visits, blood testing, ultrasounds, x-rays and outpatient surgeries. Some policies specifically exclude infertility diagnostic testing. If so, our physicians and staff will try to minimize your out-of-pocket costs by ordering tests in a judicious fashion. Some insurance policies require all blood testing to be conducted at a specific laboratory.
Costs of Fertility and IVF Treatment
Some patients have insurance policies that cover fertility treatments such as artificial (or intrauterine) insemination (IUI) or IVF. Our office will try to obtain written confirmation of benefits before you actually undergo these procedures. We will file claims and attempt to negotiate disputed claims with the insurance carrier. However, patients are responsible for payment at the time of service.
Fertility Treatment Costs-Fertility Medications
Fertility medications are usually covered by your insurance, as long as your insurance policy also covers fertility treatments. Some policies require patients to use a specific pharmacy.
Some insurance policies place a cap on benefits, which is one reason a specialist should be consulted early in treatment. Sometimes these limits are annual; for example, $5,000 a year. Lifetime caps also exist. For example, some policies have a lifetime maximum of $20,000. Many patients cannot afford to waste fertility benefits on procedures that aren’t effective. One of our goals at Dallas-Ft. Worth Fertility Associates is to administer cost-effective treatment using the appropriate level of technology.
Infertility Treatment Cost Financing
When advanced procedures are required, such as in vitro fertilization or ICSI, we work with couples to determine the best payment options. We accept major credit cards for our patients’ convenience. Payment plans are available through Advanced Reproductive Care (ARC).
Dallas – Fort Worth Fertility Associates is contracted with many insurance companies through System Health Providers Inc. (Genesis), a network management company that negotiates contracts for several hundred physicians as a group in the Dallas-Ft. Worth metroplex. We also contract directly with some insurance companies.
A few of the insurance plans we are affiliated with are:
- Aetna (all plans) Health EZ
- Accountable PPO IMS PPO
- Blue Cross Blue Shield HMO*/POS*/PPO MultiPlan PPO
- Cigna HMO*/POS*/PPO Principal Edge PPO
- Coalition America PPO Private Healthcare Systems PPO
- EHN PPO United Healthcare (all plans)
- Galaxy PPO Unicare Performance PPO/Classic PPO
- Great West Healthcare PPO USA MCO
- Humana PPO Viant/Beech Street/ppoNext PPO
- Healthsmart PPO
Because these contractual agreements have varying expiration dates, you are encouraged to call the office to verify your specific managed care plan is contracted with us at the time of your appointment.
Some insurance plans are managed, meaning that some type of referral or authorization is required prior to office visits, testing or treatments. WHEN THIS IS THE CASE, IT IS THE PATIENT’S RESPONSIBILITY TO OBTAIN A REFERRAL FROM THE PRIMARY CARE PHYSICIAN PRIOR TO THE APPOINTMENT.
We look forward to helping couples have children, and strive to make sure they understand fertility treatment costs including ART therapies like IVF. This helps to reduce some of the stress associated with fertility treatments. Please contact our insurance coordinator to learn which therapies may be covered by your insurance provider.