Infertility services
Your Trust group health policy, like most health insurance policies, provides extremely limited benefits for infertility. We limit insurance coverage for infertility to only:
- Diagnostic services performed exclusively to diagnose the cause or source of a couple’s infertility. (Note: Once a diagnosis has been rendered, no further diagnostic tests are covered except in those instances where additional diagnostic tests are reasonably expected to reveal another clinical cause for the infertility.)
- Surgical repair of a malfunctioning body part found to be the cause of infertility, in order to enable natural conception.
Noncovered infertility services
The following are examples of infertility services that are never covered by your Trust group health plan:
- Physician, hospital, or any other service directed at, or associated with, treating the cause of infertility, other than surgical repair.
- Diagnostic tests performed in connection with the treatment of infertility.
- Medications to stimulate the ovaries (e.g., Femara, Clomid, Clomiphene Citrate, Serophene, Pergonal, Pregnyl, Profasi, Repronex, and Menogon) or to treat low sperm count or motility, or those prescribed for the purpose of treating infertility (e.g., Lupron and Progesterone).
- Services or expenses connected with an alternative or artificial method of conception. Examples include, but are not limited to, in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), intracytoplasmic sperm injection (ICSI), intrauterine insemination (IUI), embryo transplantation, and artificial insemination (AI). Please note that sperm and embryo storage is also not covered by the policy.
- The reversal of a tubal ligation or a vasectomy and any services related to such procedures, including follow-up office visits and possible diagnostic testing.
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