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Affording Treatment

Accepted Insurance Plans

At ConceptionIVF, we work with numerous leading insurance providers to make fertility care more manageable for our patients.

Insurance coverage can differ greatly depending on your plan. This guide outlines the insurers we accept, explains what being “in-network” means, and provides guidance on confirming your specific benefits before starting treatment.

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Current Insurance Providers We Work With

We are partnered with many prominent insurance carriers and benefits administrators, including:
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Important Notes to Consider

Before reviewing your options, keep these points in mind. Always verify plan details with your insurance company and your dedicated ConceptionIVF Financial Coordinator.

  • Exclusions ConceptionIVF is not in-network with Medicaid, Medicare, Fidelis, or other government-supported programs.
  • Referrals HMO plans may require a referral from your primary care physician or OB-GYN before visiting our clinic.
  • Network Status Coverage depends on employer and plan; network participation may change. Our Financial Coordinators assist with verifying in-network status.
  • Prior Authorizations Some treatments or medications may require prior authorization and could fall under specialty pharmacy coverage.

At a Glance: Types of Insurance Plans

Understanding plan differences helps you maximize coverage. Confirm all details with your insurer.

Lower In-Network Costs
  • In-network coverage only
  • Lower copays with referral
  • Prior authorization often needed
  • No out-of-network benefits
Flexible Access
  • See specialists without referral
  • In and out-of-network coverage
  • Broad clinic and lab access
  • Higher costs out-of-network
Savings & Choice
  • In-network savings with referral
  • Some out-of-network coverage
  • Authorizations may be required
  • Unlimited specialist access

Understanding Your Coverage

Insurance benefits vary by individual plan. Keep these four key points in mind:

In-Network

Using ConceptionIVF in-network typically lowers your costs, but you’ll still need to meet deductibles, copays, and co-insurance.

Out-of-Network

Some coverage may be available, but out-of-pocket costs are usually higher. Prior authorization may be necessary.

Restrictions

Plans may limit cycles, set age caps, or have benefit maximums. Always verify before starting treatment.

Medications

Some plans cover fertility medications; others don’t. Confirm medication coverage in advance.

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Steps to Verify Your Coverage

Follow these steps to confirm your fertility benefits and avoid surprises:
Step 1
Network Status
Confirm ConceptionIVF and associated labs are in-network.
Step 2
Coverage Details
Ask about diagnostics, IUI, IVF, medications, and limits.
Step 3
Predetermination Letter
Request written confirmation of coverage.
Step 4
Coordinator Review
Share documentation with your Financial Coordinator for a clear cost estimate.

Before You Contact Your Insurance Get Organized First

Before calling your insurance provider, gather your plan details, member ID, and any past benefit summaries. This preparation ensures a smoother and more productive conversation.
What to Ask the Insurance Representative
Key Points to Confirm

Network Verification

Ask your insurance representative to confirm network status for both ConceptionIVF and any partner laboratories or facilities. Be sure to clarify:

  • Whether ConceptionIVF is in-network for consultations, diagnostic tests, and procedures
  • If partner labs, fertility pharmacies, and surgical centers are covered
  • What your out-of-network benefits include (if applicable)
  • Whether referrals are required for fertility specialists
  • If a new referral is needed for each stage of care
So you can focus on your treatment — knowing your fertility is protected.

Coverage Breakdown

Review each category carefully with your representative to avoid missing details. Ask what services are covered and which may need prior authorization:

  • Diagnostics & Testing: Consultations, ultrasounds, AMH tests, bloodwork, and semen analysis
  • Procedures: IUI, IVF, anesthesia, embryo culture, ICSI, embryo transfer, frozen embryo transfer, cryopreservation, and storage
  • Third-Party Services: Donor eggs, donor sperm, embryo donation, and gestational carrier (surrogacy) programs
  • Telehealth Services: Eligibility for virtual consultations or counseling sessions

If your insurer asks for procedure codes, your ConceptionIVF reference codes can be provided by your Financial Coordinator upon request.

Limits & Authorizations

Each plan has unique limitations and approval requirements. Be sure to ask for this information in writing :

  • Annual and lifetime limits for fertility cycles
  • Any age-related restrictions or dollar maximums
  • Medical necessity or diagnostic criteria
  • Prior authorization rules for treatments and medications
  • Referral policies from your primary care provider or OB-GYN
  • Waiting periods or employer-specific coverage delays

Medication Coverage

Fertility medication benefits often differ from medical procedure benefits. Confirm these details:

  • Whether fertility drugs fall under medical or pharmacy coverage
  • If a specialty pharmacy is required for fulfillment
  • Copay or coinsurance tiers for common medications
  • Prior authorization, refill limits, or shipping restrictions
  • Whether trigger shots and progesterone are included in coverage

Your Next Steps: Documentation & Appeals

Predetermination & Records

Request a predetermination letter outlining what is and isn’t covered. This step helps you avoid surprise expenses and supports any future appeals.

  • Ask for the letter via email or postal mail before treatment starts
  • Record the representative’s name, date of the call, and reference number
  • Save all correspondence, benefit summaries, and coverage documents
  • Share these with your ConceptionIVF Financial Coordinator for accurate cost estimates
If Coverage Is Denied or Unclear

A denial can be frustrating — but it doesn’t have to be the end of your journey. Take these steps:

  • Request the policy criteria used for the denial decision
  • Ask for the appeal process and submission deadlines
  • Obtain all necessary forms and documentation listsContact your Financial Coordinator at ConceptionIVF for help with appeals and next steps

Common Insurance Terms

Familiarize yourself with these terms to navigate your insurance confidently:

  • Referral – Authorization from your primary doctor or OB-GYN to see a specialist.
  • Prior Authorization – Insurance confirmation that a service or medication is medically necessary.
  • Precertification – Similar to prior authorization, often for complex procedures or hospital admissions.
  • Predetermination Letter – Written estimate from your insurer confirming coverage for a service.
  • Deductible – The amount you pay out-of-pocket before insurance begins coverage.
  • Premium – Monthly insurance payment, separate from deductibles, copays, or co-insurance.

Affording Fertility Treatment

Fertility care can be costly, but there are strategies to make it manageable. Our guide offers tips on financing, budgeting, maximizing insurance, and applying for grants.

Fill out the form to receive your FREE financial planning guide for fertility treatment:

Fertility Insurance FAQs

Find answers to common questions about insurance coverage, state mandates, and affordable fertility care at ConceptionIVF.

Does insurance cover IVF at ConceptionIVF?
Coverage for IVF depends on your specific insurance plan and provider. Some plans include full or partial fertility benefits, while others may only cover diagnostic testing or medications. Our Financial Coordinators can review your policy, verify in-network status, and provide a clear cost estimate before you begin treatment.
If your plan does not include fertility coverage, ConceptionIVF offers flexible financing options, discounted treatment packages, and guidance on applying for IVF grants. We’ll also help you explore alternative routes like Health Savings Accounts (HSA) or employer reimbursement programs to reduce out-of-pocket costs.

Each insurance company uses specific procedure codes (CPT codes) to process claims. The most common include:

  • IUI: 58322, 58323, 89260, 89261, S4042
  • IVF: 58970, 58974
    Your Financial Coordinator will confirm the appropriate codes based on your treatment plan and insurer’s requirements before claims are submitted.
There are several organizations and nonprofit programs that provide grants or scholarships to help individuals and couples afford fertility treatment. ConceptionIVF’s financial team can connect you with trusted national and regional resources offering IVF or medication assistance programs.
Yes. Several U.S. states have laws requiring certain insurance providers to offer or cover infertility treatments. These mandates differ by state and employer size. Our Financial Coordinators can help determine whether your policy is subject to these requirements and how they apply to your coverage.

To minimize expenses:

  • Choose in-network providers whenever possible.
  • Confirm all required referrals and authorizations before treatment.
  • Use Flexible Spending Accounts (FSA) or HSAs for medical expenses.
  • Review your plan’s annual maximums and medication tiers to plan ahead.

Discuss package pricing and payment plans with our financial team.

When speaking with your insurance provider, consider asking:

  • Is ConceptionIVF in-network for consultations, diagnostics, and procedures?
  • Are fertility medications covered under medical or pharmacy benefits?
  • Are referrals or prior authorizations required?
  • What are my deductible and copay responsibilities?
  • What limits apply to fertility treatments or medications?

Document each conversation for future reference, including the representative’s name, date, and call reference number.

In-network means ConceptionIVF has a contract with your insurer to provide services at negotiated, lower rates—resulting in reduced out-of-pocket costs.
Out-of-network services may still be covered but often come with higher copays, deductibles, or limited reimbursement. Our team helps verify which services fall under each category before you begin treatment.

Covered services are the medical procedures or treatments your insurance company agrees to pay for under your plan. For fertility care, these may include consultations, diagnostic testing, ultrasounds, IUI, IVF, or medications—depending on your policy. Always confirm coverage in writing before starting a new treatment cycle.

Advocating for coverage starts with understanding your benefits and communicating directly with your employer or insurer. You can:

  • Ask your employer to include fertility benefits in next year’s plan renewal.
  • Share educational resources about infertility and treatment success rates.
  • Join advocacy groups or patient organizations supporting fertility coverage legislation.
  • Keep detailed records of communication with your insurer for appeals.

Next Steps: Personalized Planning

Start with a consultation with one of our reproductive endocrinologists. Afterward, a dedicated Financial Coordinator will:

  • Verify your benefits
  • Confirm in-network status for clinic and labs
  • Handle prior authorization requests
  • Provide a detailed, personalized cost estimate
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You’ll find everything you need here: a full spectrum of services, our award-winning laboratory, and heartfelt support for your mind and body.

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