Fertility Insurance Tips in Arizona | Boston IVF The Arizona Center
Search

Fertility Insurance Tips

Do you need insurance coverage for fertility treatment? You are not alone!

Most patients in Arizona lack insurance coverage. Why? Unfortunately, Arizona does not have a mandate for insurers to provide IVF benefits. It’s an issue our advocates continue to fight for every day!

However, it’s important to know there are still many opportunities to fund the treatment you need.

Below are some helpful tips on how to obtain benefits, via the great advocates at Fertility Within Reach, a non-profit who sole mission to help yourself and the infertility community gain access infertility treatment!

TIP #1: HOW TO GAIN BENEFITS VIA YOUR EMPLOYER

  • Educate your employer’s Human Resource Department about the affordability and benefits of offering IVF coverage.
  • Share an example of IVF coverage from another company
  • Utilize resources demonstrating benefits for fertility treatment costs less than 1% of insurance premium
  • Higher employee morale and loyalty
  • Change employers or take a leave of absence to work for an organization offering IVF benefits.
  • Before changing employers, check to see if you meet the medical guidelines to qualify for the insurance benefits

08TIP #2: HOW TO GAIN BENEFITS VIA YOUR INSURER

  • Submit a claim to the insurer. When denied, you can file an internal appeal
  • Contact your insurer stating you know your policy does not offer IVF benefits, but you would like them to make an exception. Convince them why this is in everyone’s best interest. This is also known as asking for a “predetermination of benefits”.
  • Take notes with any staff you speak with and ask all assurances from the insurer are provided in writing.
  • Send all documentation at the same time and include pertinent medical history, a letter of medical necessity, and research supporting your case.
  • When you submit your appeal to the insurer, include all important documentation and mail in a manner requiring a signature.

TIP #3: WHAT CAN I DO TO FUND TREATMENT?

Although it’s not a first choice, some patients choose fundraising as a way to offset the cost of treatment. Options explored include:

  • checkCrowd funding as an online outreach to raise funds
  • Flexible Spending Accounts through your employer are pre-taxed dollars to cover medical expenses
  • IRS heath care deductions are available for what you have spent in healthcare over 10% of your income

ARIZONA FERTILITY INSURANCE FAQ

I don’t think my employer will want the extra cost of providing IVF benefits. What am I suppose to say?

The key to communication with your employer is your approach and information.
Approach: It’s important to think of this as a way to help yourself, the employer and your co-workers. You are making a request for a win-win scenario.
Information: Your appeal for insurance coverage should consist of both a heart-warming story from a loyal employee and information showing a financial benefit to the organization. For example, research shows people with insurance coverage transfer fewer embryos; which reduces costs associated with high-risk pregnancies, premature labor, and NICU expenses.

SuccessRates2My insurer should provide benefits, but they said no. What can I do?

Upon receiving a denied claim, ask your insurance company for written information on how to appeal a decision on a claim. This type of appeal is known as an “internal appeal.” Make sure you can see the reason for denial as well as a date for when your appeal must be received by. If you have questions about the reason of denial, our financial staff will do our best to explain.

What happens if my insurance company denies my internal appeal?

If you believe you have been wrongfully denied, you still have options.

  • External appeals are filed when the internal appeal process is denied. If the external appeal is determined in your favor, your insurance company denial is overturned.
  • If you believe your insurance company (through a self-insured employer) has wrongfully denied you coverage, you can also file a complaint with Arizona’s Department of Labor.
  • To learn more about external appeals, please visit Healthcare.gov.

I don’t feel comfortable going to my employer or taking on my insurer. Are there any programs to make treatment more affordable?

There are several options to help fund fertility treatment at The Arizona Center. In addition to offering low cost IVF fertility cycles, we provide

  • Multiple Fertility Cycle discounts within a Shared Risk Program
  • Military Discount IVF Cycle
  • 50% off Select Fertility Medications
  • Financing Program

Is egg freezing covered by insurance?

Benefits associated with cryopreservation of eggs, sperm or embryos would be up to the employer and insurance policy. This tends not to be covered for “social” reasons (i.e. Your family building will be delayed for personal reasons, not medical). However, we are seeing more companies, with a desire to be competitive, offer this benefit. Some companies will provide coverage for preservation of eggs/sperm/embryo due to upcoming medical procedures, such as chemotherapy, which could render a patient infertile. You can learn more by contacting your insurer, submit for a predetermination of benefits, or discuss this healthcare option with your employer. Boston IVF, The Arizona Center has an extensive Egg/Sperm Freezing and Fertility Preservation program.

At Boston IVF, The Arizona Center we recognize out of pocket expense to treat infertility can be burdensome. This is why we offer the most affordable services and actively work with patients to help fund their care. For additional support, please contact our Financial Service Team at 480-559-0252.