Top six questions to ask about infertility services

Información clave

 

• Understand your insurance coverage. Not all infertility procedures or medications may be covered.
• Start your journey at your Ob/Gyn's office. Talk to your doctor about options that are more likely to be covered.
• Consider your options. If evaluation and treatment don’t lead to success, think about other options like surrogacy or adoption.

Infertility planning questions

Starting infertility evaluation and treatment can be overwhelming. There are many options and lots of things to consider. Ask these top six questions early on to make the process less daunting.

1. What does my insurance cover?

Insurance coverage varies widely for infertility services. It’s important to know what your plan covers and what it doesn’t. Maternity and newborn care is typically covered. But infertility services like in vitro fertilization (IVF) and intrauterine insemination (IUI) may not be.

Aetna® now offers IUI as a covered medical benefit for eligible plans to evaluate infertility, regardless of sexual orientation or partner status. Our updated coverage policy began nationwide on September 1, 2024 for many plans. It will become effective on a rolling basis for most plans on renewal. Learn more about understanding infertility and insurance coverage.

2. Where do I begin?

Start by talking with your Ob/Gyn. They will evaluate you. If­­ you need treatment, they may suggest starting with more basic services. Simpler treatments can also lower your costs.

3. How do I pick a specialist?

If the first infertility services don’t work, consult a board-certified reproductive endocrinologist. Your Ob/Gyn can recommend one. Make sure the specialist is in your plan’s network. Aetna offers a provider search directory and the Institutes of Excellence infertility network (PDF) to help you find quality care.

4. How does the Aetna IUI medical benefit work?

For people who have a reproductive partner, timed intercourse is the usual way to learn if there’s a problem with fertility. For people without a reproductive partner, such as LGBTQ+ or single people, IUI is used to find out if there is a concern with fertility. With this policy change, IUI to evaluate infertility status is now covered for all eligible plans.*

5. If IVF is needed, how many treatment cycles are covered?

Review your health plan to see if IVF is a covered benefit. Also check to see how many cycles or the dollar amount of services that your plan covers. Then talk to your doctor about the best way to plan your treatment cycles.

6. What about surrogacy or adoption?

If treatment doesn’t work, you may want to think about surrogacy or adoption. Check to see if your plan covers surrogacy services as described by your doctor. For adoption, find out if your employer reimburses for adoption expenses or other costs not covered under your plan. Remember that adoption and non-covered medical expenses may be able to be paid from a Health Savings Account (HSA). Learn about Aetna HSA options.

Bottom line: Knowing your infertility benefits and treatment options can help bring you one step closer to growing your family.