We look forward to a time when infertility patients receive the same insurance considerations as patients undergoing other serious medical treatment. At the Texas Center for Reproductive Health, we are acutely aware of the cost sensitivities involved with infertility treatments. Currently, the State of Texas does not mandate coverage for infertility treatments. It does, however, require that insurance companies offer infertility coverage as an option that employers may choose to include as part of their health plan benefits. Depending on the benefits your employer has selected, your infertility coverage will likely fall into one of the following categories:
- Plans that are limited to diagnostics and do not cover treatments. These plans may cover fertility testing, such as ultrasounds, hormone testing, and diagnostic surgeries, to determine the cause of infertility, but they do not offer coverage for the treatment or correction of those conditions, i.e., in vitro fertilization.
- Comprehensive plans typically cover diagnostics, select treatments, and many infertility drugs. Depending on the plan, there may be limits on the number of treatments and/or IVF cycles you can receive, along with annual and lifetime maximum dollar amounts of coverage.
- Plans with no fertility coverage leave the responsibility for infertility diagnostic and treatment costs to the patient. For our patients who find they must shoulder some portion, if not all, of these costs out of pocket, we will always do our best to select testing and treatment carefully to maximize treatment success and to minimize your possible costs.
We recommend that you speak with your health insurance company directly to determine your specific coverage, deductibles, limits, and maximums. Your plan may also require a physician referral.
Our team is happy to assist you with understanding your overall costs of treatment, applying the appropriate diagnosis and CPT codes to ensure that you receive the highest rate of reimbursement. At the end of the day we recommend that you select the center and physician with which you feel most comfortable and believe will give you the highest quality of care.