What Fertility Treatments Are Covered By Insurance?

In Illinois, many fertility treatments are covered by insurance thanks to a law that requires insurance to cover the treatment of infertility. People who have had trouble conceiving for over a year, or who have not responded to previous treatments for infertility, can have their fertility treatment covered under most insurance plans in the state of Illinois. Below, we will take a look at getting fertility covered by insurance, as well as the financing options that are available for managing remaining costs.

Treatment for Fertility Covered by Insurance

Under Illinois law, fertility treatment must be covered for patients who are determined to meet certain infertility criteria. Covered procedures include:

  • Diagnostic testing
  • Medication
  • Intrauterine insemination (IUI)
  • In vitro fertilization (IVF)
  • Embryo transfer
  • Prescription medication
  • Medical costs associated with donor eggs and sperm
  • Monitoring and follow-up appointments

Treatments Not Covered

Although most fertility treatments must be covered by insurance in Illinois, a number of fertility treatments are not covered, including:

  • Fertility treatments for patients who do not meet the fertility criteria
  • IVF before less intensive options have been exhausted
  • Sperm or egg cryopreservation
  • Surrogacy
  • Experimental treatments

In addition, the law does not apply to very small insurance groups. People whose insurance does not cover fertility treatment may consider purchasing supplementary fertility insurance.

Managing Remaining Costs

Insurance should cover the cost of fertility treatment in Illinois, but patients with a high deductible or a high copay may still face out of pocket costs that are higher than they can pay all at once. Some couples may have non-essential savings or investments they can dip into; others turn to financing to spread the cost of treatment over a number of payments over time.

Patient financing companies are the most common form of financing, and many doctors partner with a specific patient financing company to streamline the process for patients. Those who prefer to may turn to other financing options, such as health care credit cards, traditional credit cards, bank loans, or lines of credit. The best financing option depends on the couple’s preferences and their particular financial situation.

Dr. Randy Morris would be happy to meet with you about your infertility, and to help you get the treatment of fertility covered by insurance. To schedule your consultation today, please click below and enter your information or call IVF1 at (630) 357-6540.

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