| Determining which infertility treatments your policy | | | | you have ever seen the following explanation (or one |
| covers can be tricky. On one hand, you want | | | | like it) from the insurer when it only partially |
| accurate information. On the other hand, you risk | | | | reimbursed you: "This charge has been declared over |
| alerting your insurer to the fact that you are about | | | | and above the customary fee charged by medical |
| to undergo infertility treatment. If you are covered | | | | professionals in your area". Finally, try to find out |
| by a group plan, you cannot be disenrolled for medical | | | | about deductibles and at what ceiling your coverage |
| reasons. But if you have individual coverage, there is | | | | changes. Many companies begin to offer a higher |
| always the possibility that the insurer will try to | | | | percentage of coverage when your co-payment |
| cancel your policy if it anticipates costly claims on the | | | | ceiling is reached. Also try to find out which drugs |
| horizon. There are ways, however, to make inquiries | | | | may be covered. Injectable fertility medications are all |
| about coverage without jeopardizing your policy. | | | | costly. Some insurers cover them, others do not. |
| The first step is to read your claims booklet carefully. | | | | Some policies have an annual dollar limit for |
| This booklet may contain statements like "the | | | | prescriptions. If you are lucky, your policy includes a |
| treatment of infertility is not provided through the | | | | liberal prescription plan that covers almost all |
| general policy, but may be part of a rider clause | | | | prescription medications (except birth-control pills), |
| negotiated by a specific group". Your personnel | | | | with a small co-pay by you. If your claim booklet fails |
| manager should be able to give you a copy of the | | | | to answer all your questions about covered |
| rider. Even though infertility treatment (particularly in | | | | medications, your pharmacist, who deals with |
| vitro procedures or even inseminations) may not be | | | | numerous insurance carriers every day, may be able |
| covered, try to find out if diagnostic blood tests and | | | | to answer some of your questions. |
| ultrasound procedures are, and, if so, how many are | | | | Another good source of information is a co-worker |
| covered. From the booklet you may be able to | | | | or friend who has had the same policy you do and |
| deduce which diagnoses are more likely than others | | | | has undergone infertility diagnosis and treatment. This |
| to be reimbursable. | | | | individual should be able to give you the "lowdown" |
| You also will want to know what percentage of | | | | on the insurer's payment record and can alert you to |
| treatment costs are typically covered by the policy. | | | | any land mines. Even if this person is only an |
| Sometimes, instead of paying a percentage of a | | | | acquaintance, remember that there is an allegiance of |
| medical bill, some companies offer a flat fee. They | | | | sorts among infertile people. Having suffered and |
| may, for example, pay up to $45 for any blood | | | | survived the experience, most are eager to help and |
| analysis, even if your analysis costs $100. Try to find | | | | comfort others in any way they can. |
| out what the general fee schedule is, particularly if | | | | |