IVF and Fertility Insurance Coverage
While Oma Fertility offers fertility treatment at a more accessible cost than the national average of $15,000 to $30,000, knowing which insurance companies and policies offer fertility coverage and how much they will cover is a primary concern for aspiring families.
Oma breaks down everything you need to know about fertility treatment and insurance coverage, and how it works at our fertility clinics.
How Oma works with your insurance provider
While Oma does not directly accept fertility insurance, we make every effort possible to help our families get the most out of their insurance benefits. Families pay Oma directly for their treatment and we courtesy bill your insurance provider to help you get reimbursed for as much as your policy will allow. It is important to note that Oma does not courtesy bill for medication.
What is Courtesy Billing?
A courtesy bill is a claim submitted by Oma to your insurance provider after you have self-paid for your treatment so your insurer can reimburse you directly.* Only applies to in-network insurance providers. Please check with clinic staff to see if your insurer is in-network with Oma.
Finding your state’s fertility coverage regulations:
Insurance coverage of fertility services varies state-by-state. If you currently have employer-sponsored insurance, the size of your employer will determine how much they are legally required to cover.
Many fertility treatments are not considered “medically necessary” by insurance companies, so they are not typically covered by private insurance plans or Medicaid programs.
A handful of states require coverage of fertility services for some fully-insured private plans, which are regulated by the state. You can check online to see what your state regulations are here.
How to choose fertility insurance if your current plan is not enough:
If you don’t have fertility insurance or feel your current fertility coverage is not adequate, you might want to consider other insurance plans available. Some key things to look for in a fertility insurance plan include:
- Treatments offered: Which fertility treatments and elements of treatment (medication for example) are included in the plan?
- Providers in-network: You’ll want to check whether Oma works with or is in-network with different insurers in order to maximize your benefits.
- Rounds covered: Is there a maximum number of IVF rounds the insurance policy or provider will cover?
- Co-pays, limits, and deductibles: Like any health insurance plan, you’ll want to understand each plan’s co-pays, maximum out-of-pocket limits and deductibles.
Which insurance companies provide fertility coverage?
Most health insurance companies offer fertility coverage either as part of their general benefits or as a supplemental policy option.
Does Oma Fertility offer additional financing options to supplement my insurance?
Yes, Oma is proud to partner with CapexMD to help families manage the cost of fertility treatments. You can read more about our financing options here.
How do I get IVF covered by insurance?
You’ll need to have either fertility insurance or fertility benefits as part of your existing health insurance plan. Or, if you have neither, but would like your IVF covered by insurance, you should shop around for fertility coverage before beginning your treatment. If you have any questions about your current coverage or other coverage options, contact your insurance provider directly.
How do I know if private insurance covers fertility services?
If you have any questions about what fertility benefits your current coverage includes you should contact your insurance provider directly.