A common misperception about fertility care is that it is not covered by insurance, prohibitively expensive and out of the reach of those who cannot afford large out of pocket payments. As a result, couples needing fertility care often worry that they will need to use part or all of their life savings in order to pay for their care. Fortunately, this is not true. Many couples at GENESIS are insured for fertility treatments, including IVF. Here’s why:
Insurance companies generally have a preset reimbursement rate for procedures performed, which are described using common procedure terminology or CPT codes. The ways in which these rates are determined vary by insurance company. But once they are set the companies do not waiver from them; regardless of what specialty the doctor practices, what training or expertise are involved, or what the quality is of the service delivered. Just a few years ago, CPT codes did not even exist for many of the treatments used in reproductive medicine. Because insurance companies were unprepared to deal with this specialty, most services were “uncovered.” Patients had to pay for most of the treatments, even if their physician was a “participating provider” with their insurance company.
Thanks to the efforts of the American Society for Reproductive Medicine, CPT codes now exist for virtually every aspect of fertility care. Pressure from infertility advocacy groups such as RESOLVE have convinced most large insurers that covering fertility care is proper. In many states, New York included, nearly all insurance companies are required by law to cover the costs of fertility care. Still, most reproductive specialists have shied away from participating on the panels of insurance companies, leaving their patients to bear the costs of care. This minimizes their need to work with insurance companies and maximizes their reimbursement. On the other hand, it leaves most patients unable to afford fertility care.
At GENESIS, we believe in promoting access to care. That is why we have worked long and hard with insurance company executives to arrange fair reimbursement rates for our services. As a result, our physicians participate in most commercial insurance plans. That means most of our patients are therefore insured for their treatment. GENESIS is one of only five fertility practices in New York City that has been designated by the Empire Plan as a Center of Excellence. We’re also nationally recognized as a Clinical Center of Excellence for Reproductive Medicine by Contemporary Ob/Gyn, a well respected professional health care magazine for Obstetricians and Gynecologists. Our physicians have repeatedly received local and national acknowledgment for their expertise in Reproductive Medicine by well-known publications including New York Magazine, Castle Connolly and Good Housekeeping.
How can I afford fertility treatment at GENESIS?
Patients who require in vitro fertilization who are not insured may be able to take advantage of a number of programs to assist them with financing their care. Please note: although GENESIS has been one of seven centers in the New York State participating in the Fertility Demonstration Project, the grant is severely limited in the amount of patients actually able to participate in it.
We are proud to partner with several financing programs that specialize in fertility. Different programs provide patients with affordable treatment packages, financing programs, and/or convenient pharmacy plans. One program, ARC Fertility even offers a money-back refund program.
- Military Discount Program
- Carrot Fertility
- LIVESTRONG Fertility Assistance Program
- Compassionate Care Program
- ReUnite Assist and more!
Our billing department has a long experience in managing the different programs available. For more information to afford fertility treatment, please contact our billing office at firstname.lastname@example.org .
Original post Feb 3, 2015
Updated Jan 28, 2021
Updated Mar 30, 2022