We are contracted with many insurance programs. Insurance coverage and reimbursement issues for the treatment of infertility are complex. There are many variables that come into play in determining how much support, if any, these companies will provide. If you are reluctant to pursue treatment because of financial concerns, determining your coverage in advance can help set your mind at ease. If you experience difficulty obtaining this information, please call 405-271-1616 to speak with a member of our team. In addition to the various insurances accepted, OU Physicians Reproductive Medicine has also partnered with IntegraMed to offer a shared risk alternative to help people become parents.
Determining your coverage
You should have received an information packet regarding your insurance plan when you first enrolled with your employer.
If you did not, you may request one from your employer. This packet should contain the details of your benefits. We recommend that you review and highlight the sections pertaining to infertility benefits so you may easily find and refer back to this information.
If you plan to pursue treatment, it is always a good idea to speak with your insurance company in advance. There is a customer service phone number on your insurance card. When speaking with a representative, it will best serve you to do the following:
- Document the day and time you called, as well as the name of the representative you spoke with.
- Ask what your benefits are specifically relating to infertility.
- Some examples of questions you might want to ask are:
- What is my coverage for testing and procedures?
- What is my copay?
- During which office visits will I be required to pay a copay?
- Is there a deductible?
- If I am responsible for a percentage of the cost, what is the percentage?
- Will my medications be covered?
- Does this plan require authorization prior to beginning treatment?
- Request the information that they have provided about your specific policy in writing, and also take your own notes.
If you plan to change your insurance or purchase insurance prior to treatment:
- Research your options well. If you have already decided that you would like to pursue treatment with OU Physicians Reproductive Medicine, check to see if any of the available options are in network with us. If you must choose a plan that we are not in network with, check to see if the provider offers out of network benefits.
- Determine if the plan has clauses regarding preexisting conditions or benefit exclusions.
- Inquire about a pharmacy benefit for medications.
- Ask about waiting periods or open enrollment periods.
- Check to see if the plan requires you to receive authorization prior to beginning testing or treatment for infertility.
If you currently have insurance, but you or your employer has decided to change plans, please take the following information into account:
- Different plans with the same provider may offer different benefits. Do not assume that because your provider is the same, your benefits will also remain the same.
- You may need to receive authorization to begin or continue treatment.
- The OU Physicians Reproductive Medicine staff will not be able to verify your benefits until the plan is actually in effect.
- You must inform the OU Physicians Reproductive Medicine staff if your plan changes.