It's no secret that infertility costs can be astronomical, but a little research and advanced planning can make the process a little easier. Understanding your policy and it's intricacies can help you anticipate the costs of your cycle and be more prepared for how the details need to be handled. Here are four questions you should ask your insurance company about infertility costs before starting treatment.
1. Do my medications need to be ordered through a special pharmacy?
Some policies mandate that only certain pharmacies can dispense your medications, especially injectables, for them to be covered. Find out if your policy has such a requirement so you can notify the doctor's office well in advance of your cycle start.
2. Do I need a prior authorization before my medications can be covered?
Many policies require that your doctor's office call in what's known as a prior authorization before they'll agree to cover your medication. The process is different for every company or policy, and can sometimes be quite involved. For that reason, you'll want to notify your office as soon as possible so they can get the process started. If it takes several weeks, you may miss a cycle while waiting to hear if your medication is covered. Having the phone number that your office needs to be call can be helpful as well.
3. Does my testing need to be sent to a specific lab?
When you start infertility treatment, you and your partner will likely need a lot of screening and testing done. Some policies will only cover the testing if the bloodwork is sent to a specific lab. Knowing that ahead of time and relaying that information to the appropriate staff will help ensure that you don't get a very high bill when the bloodwork is sent to the wrong lab.
4. What is covered and what isn't?
Again, each policy is different, but some may require that a certain number of insemination cycles be completed before you can move on IVF. Other times, IVF isn't covered at all. Knowing that ahead of time can help you and your doctor devise a treatment plan that both works for you and is affordable.
