Ask your carrier if drugs are included in the benefit amount or if there is a separate benefit for drugs. Verify if there are certain criteria that need to be met before starting treatment. Often carriers require that one meet certain criteria such as providing a letter of medical necessity, verifying length of time attempting conception, or length of employment before the benefit is effective. There are many different types of health insurance and many variables within each type of plan. Most people are covered by group insurance through their employers.
Most employers offer a choice of several different plans to their employees.
Employees should investigate the benefits of each health plan being offered before selecting one. When an employer contracts with an insurance carrier for their employees, they negotiate or purchase policies that provide specifically requested benefits, such as infertility benefits. Procedure and diagnosis coding for infertility treatment can easily be mistaken for diagnostic testing when the billing is filed. Please remember that your insurance company may request access to your medical records and we are required to code according to the treatment you receive. Please do not request that we falsify claims or diagnoses codes for you to obtain benefits you do not have.