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Insurance & Financing

Most patients have some coverage for infertility treatment. Our financial counselors will work closely with you to ensure that you are making the most of your insurance coverage.
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We accept the following Healthcare Plans:

AETNA *HMO, POS, PPO
Blue Cross/Blue Shield of IllinoisPOS, PPO
Cigna — Great West HealthcareOut of Network Benefits Only
Coventry/First Health/Personal CareHMO, POS, PPO
HFNPPO
HumanaHMO, POS, PPO
MultiplanPPO
Private Health Care SystemsPOS, PPO
TriCareHMO, PPO
United Health Care/OptumHealthHMO, POS, PPO

Plans update and change routinely. Please contact Fertility Centers of Illinois to verify coverage prior to your scheduled appointment. Some insurance plans will require a referral from your primary care provider (for example an OB/GYN) before receiving treatment for infertility services. It is your responsibility as the patient to provide Fertility Centers of Illinois with a copy of the referral prior to your scheduled appointment.

* Are You an AETNA Insurance Member? As a member of Aetna insurance, you are required to complete certain pre-testing requirements and/or enroll in their fertility programs. Failure to complete these steps prior to your consultation could result in unpaid claims, therefore making certain costs your financial responsibility. View more information.

FAQ

Once you know your treatment plan, your financial counselor will provide you with information on the available financial options, estimated out-of-pocket expenses, prior authorization or deductible, and payment due date. Payment will be made in advance to the start of your treatment.

Illinois law requires insurance companies to provide coverage for diagnostic tests and treatment to those receiving insurance from an employer with more than 25 employees. As of January 1, 2022, the law is applicable for same-sex couples, women over 35, single persons, and those who cannot get pregnant naturally due to a medical reason.

However, there are exceptions. The law does not apply to individual policies, small group policies (fewer than 25 employees) or insurance policies outside of Illinois (i.e., it may not be covered if you live in Illinois but have insurance through an employer in another state).

You may be fully covered or only covered for a portion of your treatment. Some plans are ‘diagnostic only’ which means that they only cover testing that is done before starting fertility treatment. Your plan may or may not cover aspects of treatment such as medications, outside monitoring, cryopreservation of embryos or genetic testing.

HMO plans will always require a referral. For other plans, your financial coordinator will let you know if treatment requires a referral or prior authorization for services.

It is essential for you to verify if your medication is covered. To help you get started, we provide a list of questions to ask your insurance provider. Based upon your insurance plan, you may be required to use a specialty pharmacy, and/or obtain prior authorization. Once your treatment plan is known, someone on your clinical team can provide you with a list of medications, allowing you to confirm coverage with your insurance. Some specialty pharmacies offer coupons and discounts. Your financial coordinator will help you explore discount options.

Progyny, a leading fertility benefits company, has put together a guide to make it easy to talk to your employers about fertility benefits.

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