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Monday, October 15, 2018
“How much does IVF cost?” is a common question. This can be difficult to answer, because the amount billed to you can vary greatly depending on the state you live in and the coverage offered by your employer or insurance. We make every effort at the Mass General Fertility Center to make care as affordable as possible.
Read on to better understand IVF costs at Mass General and insurance coverage for fertility services.
State law in Massachusetts requires that insurance cover infertility diagnosis and treatment. Coverage varies between companies, so it’s important to check with your insurance provider directly to learn about your exact coverage. That said, there are some limitations, but this generally means that the following procedures should be covered:
Note: MassHealth covers only the diagnosis and treatment of the underlying cause of infertility. There are no benefits for IUI or IVF services.
Within New England, coverage for IVF treatment is also mandated in Connecticut and Rhode Island. The Resolve New England site has more information about mandated coverage.
While basic coverage for IVF is mandated in Massachusetts, the exact benefits and coverage can vary greatly from policy to policy. Prior to your first visit, our office will contact your insurance company to verify that your policy has benefits to cover and treat infertility and to determine whether there are any limitations or restrictions.
However, our team can only access general information on your infertility benefits, deductibles and co-insurance amounts. We cannot access the specifics relevant to your plan. Because of this, you should contact your insurance company’s member services department to review your coverage specifics in detail.
Questions to ask about your IVF coverage:
*Deductible – The amount you must pay out-of-pocket before your insurance coverage will apply.*Co-insurance – The percentage your insurance will cover of your expenses. Example: if your co-insurance is 20%, you will pay 20% of the charges and your insurance company will pay 80%.
There are hundreds of insurance plans, and only a representative from your insurance company will be able to review all your specific coverage details with you. This will be important information to be aware of when scheduling ultrasounds, lab work and other diagnostic testing, as each individual service can incur its own fees.
In addition, if your partner’s insurance coverage is with a company different than yours, you will also need to confirm their benefits for diagnostic testing of infertility.
It is important to let your care team know right away if anything changes with your insurance coverage. It is likely a change in coverage will require new referrals and authorizations under your new insurance. You may also receive bills for services if your insurance information is not correct or not authorized.
The total cost for a cycle of IVF at Mass General is a combination of costs for the cycle itself, plus the necessary procedures and treatments that are needed to prepare for the cycle. At the Massachusetts General Hospital Fertility Center, we make every effort to make care as affordable as possible, and the exact cost for you will depend on the exact course of treatment recommended by your care team. The documents below outline the self-pay costs at Mass General for some of the most common appointments and procedures.
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