Best Fertility Insurance

Quick Look: The Best Fertility Insurance

• UnitedHealthcare
• Cigna
• Aetna
• Wellcare
• Progyny

If you’re looking to take the plunge and start a family, fertility insurance can be a great investment to make. Whether you want to get some tests done to determine your chances of success or are struggling with infertility, it can sometimes be a major financial undertaking to undergo the treatments and diagnostics necessary to aid pregnancy. While most insurance providers offer fertility coverage, certain plans may offer better coverage for what you need than others.  

The Best Fertility Insurance

Whether one fertility insurance plan is better than another is dependent on what you are looking for and need. The state in which you live will also play a role in the insurance provider that’s best for your needs. Some insurance providers offer more extensive fertility coverage than others. The following are a few of the best healthcare providers that offer different coverage options for fertility treatments. 

UnitedHealthcare

UnitedHealthcare offers affordable coverage through a large network of healthcare providers. This provider offers coverage for all treatments that are required in the states that have fertility coverage requirements. The plan you choose, the state you’re in and the level of coverage you want will determine the cost of your coverage, as well as the deductibles and copays. UnitedHealthcare typically covers the costs of 80% of the fertility assistance you receive. It also makes managing your payments and care easy through its app.

Cigna

Cigna includes coverage for IVF in most of its plans, in addition to a number of other fertility treatments and diagnostics. Cigna offers group plans, individual and family plans as well as Medicare plans in 10 states. Cigna’s health insurance plans are also impressive because they provide coverage for an enhanced range of diagnostic treatments that you may need to determine fertility. Eligibility for fertility insurance coverage with Cigna will depend on the state you live in and the plan you choose.  

Aetna

Aetna is known for its large library of resources that can help you find an infertility treatment provider, learn more about treatments and determine your likelihood of accomplishing what you wish to achieve with treatments. Aetna’s plans vary in coverage; however, they exclude people over the age of 40 who are trying to get pregnant from fertility coverage. This healthcare provider only offers Medicaid, Medicare and employer-sponsored plans, which means that you have limited options for coverage if you’re shopping for an individual or family policy. 

Wellcare

Through Medicaid and Medicare, Wellcare offers government-sponsored coverage for basic and comprehensive fertility assistance. Wellcare offers fertility coverage to those between the ages of 21 and 44. While it offers many basic and comprehensive treatments and diagnostics, it does not cover IVF. However, Wellcare is one of only a few health insurance providers to offer coverage for artificial insemination treatments. Its plans are available in all 50 states, but coverage varies depending on the plan and the state. 

Progyny

Progyny offers benefit packages to employers to attract high-quality employees and retain the best talent possible. Its plans focus on offering coverage for treatments that are most effective first, rather than the lowest cost treatment. The provider allows your doctors and you to decide which course of action should be the first step in your fertility assistance. Progyny offers a customized fertility assistance experience for those employees that have access to it through their employers. 

What is Fertility Insurance?

Fertility insurance is a form of health insurance that offers coverage for treatments and diagnostics related to fertility. Fertility coverage helps parents that are having trouble carrying or conceiving a child and need to seek help through fertility treatments. This type of insurance is typically included in a basic health insurance policy and isn’t usually a separate policy. 

While many states require health insurance providers to offer coverage for fertility treatments, not all require and offer it. Some providers may offer more coverage than others, with only certain treatments being covered. Coverage for fertility diagnostics and treatments vary from insurer to insurer. If you live in a state where Affordable Care Act (ACA) compliant health insurance plan providers are not required to cover fertility treatments and diagnoses, you may be able to purchase a supplemental health insurance policy or policy rider to cover these situations. 

What Should Fertility Insurance Cover?

What should be covered by fertility insurance varies from state to state. A number of states require certain diagnostics and treatments to be covered; therefore, fertility insurance in those states should cover those treatments and diagnostics. However, if you’re located outside of those states, then the coverage will vary greatly. 

You’ll want to look out for certain things when choosing a health insurance policy. The following are a few features that your health insurance should cover that are important for fertility. If you’re shopping for a plan with an eye toward fertility insurance, be sure to ask about these services and coverages.  

Doctor’s visits: Most health insurance plans offer some sort of coverage for basic doctor’s visits. Whether a visit for a certain reason relating to fertility is covered may depend on the policy. It’s important to find a plan that offers coverage for all doctor’s visits, or at least a number of them to help ease that cost since fertility treatments and diagnostics require more frequent visits to the doctor’s office. You should also look for a policy with affordable copays for specialists. 

Diagnostics: The health insurance plan you choose should provide coverage for necessary diagnostic tests and exams. These tests may vary, but look for a plan that offers at least the following: semen analysis, hysteroscopies, testicular biopsy and endometrial biopsy. You’ll essentially want a plan that offers coverage for any and all tests and exams that you and your partner need to undergo in order to start treatment or determine fertility status. 

Treatments: Some insurance providers offer coverage for in vitro fertilization (IVF) treatments but not injections that are necessary for this treatment. Some plans cover both the treatments and the injections. Some plans cover only a certain number of attempts at treatments, and once you’ve reached that limit, then they stop coverage. Some plans don’t cover any treatments at all. 

Additional treatments and procedures that must be covered if you’re in a state that requires fertility coverage may include ovulation induction, artificial insemination, insemination procedures, intrauterine insemination and assisted reproductive technologies. When checking out coverage plans, men should look for plans that offer coverage for male infertility care and testicular treatments and surgeries. When looking for a health insurance plan, make sure that the insurer offers coverage for all treatments and everything that is necessary and accompanies the treatments.  

Who Should Purchase Fertility Coverage?

Anyone who is having trouble conceiving or carrying a baby to term and wishes to continue trying should purchase fertility coverage. Many people need fertility assistance, and anyone who needs assistance should get fertility coverage to avoid the financial burden that can come with the diagnostics and treatments associated with fertility assistance. If you’ve had a previous diagnosis that you believe will make it more difficult to conceive a child in the future, be sure to look for an insurance plan that offers comprehensive fertility coverage. 

Understanding Your Fertility Treatment Options

Choosing a health insurance policy while considering future fertility begins by understanding your state’s insurance requirements. Depending on where you live, your health insurance provider may be required to cover everything from fertility doctor’s visits to multiple rounds of IVF. In other states, you may receive no additional protections for fertility treatments. Understanding what insurers in your state are required to cover can help ensure that you’re choosing a plan with the highest level of benefits possible. 

Frequently Asked Questions