Questions to Ask Your Insurance Provider | Fertility Out Loud

Questions to Ask Your Insurance Provider to Get the Answers You Need

The views and opinions expressed are those of the authors and should not be considered medical advice. Always consult your doctor, or a mental health professional, for the most appropriate treatment.

You’ve set a time to call your insurance company or meet with your employer’s benefits coordinator, and that’s an important first step. But getting all the information you need to decide the best way forward for you starts with asking the right questions— like these FAQs. 

1. Does my insurance policy cover tele-health appointments?

2. Does my health insurance plan cover fertility treatments?

3. If my plan doesn’t cover fertility treatments, are there other insurance coverage options that provide those benefits?

4. What are the specific procedures and treatments covered by my health plan?

5. What are the restrictions or limits to the benefits offered by my health plan?

6. Is there a deductible and/or out-of-pocket maximum l have to meet first?

7. Is there a maximum benefit amount?

8. Am I required to try certain treatments, like IUl, before proceeding to other options?

9. Do I need a referral from my doctor before insurance covers seeing a healthcare provider like a fertility specialist or undergoing fertility treatment?

10. Are there any cost-saving or financing programs that I am eligible for?

11. Are there specific pharmacies I need to work with for my insurance to cover prescription drugs associated with fertility treatments?

12. Do I need to get pre-authorized for treatment and/or medications?

13. Whom should I contact if I have questions or problems?

These insurance questions will hopefully get you the answers you need to understand what out-of-pocket expenses, copays and/or covered costs might be associated with your fertility journey, and bring you some peace of mind to help you move forward on your path to parenthood. Remember that you can always ask your insurance agent or HR rep to send over a written version of your benefits to review after the discussion. Fertility Out Loud also has additional resources to help you understand other aspects of coverage, both for fertility and generally, such as insurance premiums, coinsurance, exclusions and in-network vs out-of-network insurance costs. Lastly, a fertility coach on Fertility Outreach can help you navigate health insurance companies and employer benefits in order to better understand your insurance options and costs to cover fertility treatments.

Fertility Out Loud