Fertility Finance and Insurance Information
Financing Overview:
We at WVFC are sensitive to the high costs associated with infertility treatment and the variability of insurance coverage from one carrier and plan to the next. Our treatment programs are designed to keep costs competitive and to help you maximize any insurance benefits you may have.
We understand that infertility treatment can be physically and emotionally stressful and that often times the financial component adds another level of stress. We are aware of this and try to minimize as much of the stress as possible by making our highly trained and qualified business office staff available to answer your questions and guide you through the financial process before, during and after treatment.
Free Financial Consult
All patients considering fertility treatment at WVFC are offered a free financial consultation. When you enter our program and a treatment plan has been selected, we work with you to provide a complete financial consult, insurance benefits check, and will help you determine the best financial alternatives for your treatment plan.
Payment
We offer assistance with understanding your insurance benefits and provide financial options to assist you in seeking treatment but do request payment for procedures and lab work at the time of service. For patients undergoing treatment, payment is due at the time of their baseline ultrasound appointment; before they start injectable medications.
For your convenience, we accept payment in the form of cash, check, credit cards (Master Card, Visa, American Express or Discover) and ARC financing plans.
Insurance Coverage
WVFC is contracted with most insurance companies and we are happy to submit claims on your behalf for covered services. However, since insurance coverage varies greatly from carrier to carrier and policy to policy, we strongly encourage you to call and get specific information in writing about your insurance coverage before you begin fertility treatment. Since most patients have no experience in dealing with their insurance carrier and infertility coverage does not usually fall under standard care guidelines, we have listed below standard questions that will help you when talking with your insurance company's member services representative. We strongly encourage you to obtain written confirmation of predetermination of benefits for your records. (Note: Your member service representative's number should be listed on your insurance card.)
Insurance Company Questions
1. Is the diagnostic evaluation for infertility covered (i.e. lab work, ultrasound, hysterosalpingogram, andrology services)? Does my insurance cover physician, hospital and lab charges?
2. Are infertility treatments such as artificial insemination or in-vitro fertilization (IVF) covered under my plan? Are the hospital, physician and lab charges covered for these procedures?
3. Is there a co-payment to an infertility specialist? How much?
(Note, this is usually provided by a sub-specialist and can be different from your regular co-payment amounts.)
4. What is my co-payment/deductible for infertility related hospital charges?
5. Are oral or injectable medications covered?
(e.g. Gonal-F, Follistim, Menopur, Repronex, Luveris, Ganarelix, Clomid, Lupron)
6. Does my insurance require use of a specific contracted pharmacy?
7. Am I required to use a specific contracted laboratory for insurance coverage?
Your involvement and assistance in coordination of authorizations, etc. is vital in the process when working with your insurance company. This protects you from the surprise of becoming financially responsible if they will not pay. You have more influence with your insurance provider than your physician or surgery center so be sure you have the appropriate authorizations before you begin any treatment plan. Insurance authorizations can take up to 6 weeks, so be careful not to rush into a treatment without an authorization number.
Payment and Refund Plans
WVFC is proud to be a member of the ARC network. As part of the Advanced Reproductive Care (ARC) group, we can offer you a variety of financing programs that assist you with payment plans and refund/guarantee programs for couples looking for the security of having money back if they do not deliver a baby following treatment.
We encourage you to find out more about ARC by visiting its website at www.arcfertility.com.
Last updated:
June 4, 2008
Reviewed by Dr. Vladimir Troche and his medical staff