1. Choose the Right Insurer for Your Family
The company you work for is required to offer “open enrollment” for the insurance plans that cover employees and their families. Open enrollment usually begins on Nov. 1 and ends on Dec. 15, so now is the time to review your employer’s plan offerings, ask questions, add family members, upgrade your plan or even change medical insurers.
The open enrollment period is usually the only chance to make changes each year (with few exceptions like changing jobs or getting married). Watch company webinars or attend on-site meetings with insurance providers and/or your Benefits Administrator. Ask questions about what the plans offer, obtain and read a copy yourself, and determine specifically what the plan covers for fertility treatments.
Insurance Plans Can Differ from State to State
Connecticut law requires most insurance companies to cover infertility diagnosis and treatment, including up to four cycles of ovulation induction, a maximum of three intrauterine insemination (IUI) cycles, and up to two in vitro fertilization (IVF) treatments. The Connecticut State Mandate requirements do not apply to employees in self-funded insured plans or to employees who work for certain religious groups.
New York requires private health insurance plans to cover the diagnosis and treatment of infertility for patients between the ages of 21 and 44 who have been covered under the policy for at least 12 months. However, several procedures, including IVF, are excluded.
Insurance providers who work with Reproductive Medicine Associates in Connecticut and New York.
Laws in 13 other states -- Arkansas, California, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, Ohio, Rhode Island, Texas, and West Virginia -- require insurance companies to cover or offer coverage for infertility diagnosis and treatment.
Some companies self-fund their insurance, which means they don’t have to follow state mandates on fertility coverage. You may be able to purchase a rider to the insurance policy that will pay for some or all fertility treatment expenses not covered in your plan, whether it is self-funded or not.