Your Coverage and Payment Options at a Glance
Here is a quick overview of the insurance, benefit, and payment options available through Brown Fertility. Continue below for more information about coverage, verification, referrals, and costs.
Insurance Plans and Networks
We currently work with:
- AdventHealth
- Aetna PPO
- Allegiance
- Florida Blue
- Cigna
- Cigna Disney
- First Health PPO
- Health First
- Mayo PHCS
- MultiPlan
- Orlando Health
- Oscar
- Partners Direct
- PHCS
- UnitedHealthcare
- UMR
Employer-Sponsored Fertility Benefits
We work with several employer-sponsored fertility benefit programs, including:
- Carrot
- Kindbody
- Maven
- Progyny
- WINFertility
Military and Veteran Benefits
Brown Fertility works with TRICARE, TriWest, and VA benefits. Coverage, referral requirements, and eligible services vary, so we must review each patient’s benefits individually.
Active-duty service members and veterans may also qualify for our Military Discount Program.
Discounts, Financing, and Savings Options
If insurance does not cover all of your care, other resources may be available. Brown Fertility offers access to financing options and patient savings programs, including PatientFi, ARC Fertility, TruPath, and eligible medication savings programs.
Explore our fertility financing resources, or ask our financial team which options may apply to your treatment plan.
Insurance participation and benefits vary by plan, provider, location, and service. Please contact us to confirm your current coverage.
Understanding Your Fertility Coverage
Insurance coverage for fertility care can differ considerably from one plan to another. You may have benefits for testing but not treatment. IVF may require prior authorization, medications may be handled through a separate pharmacy benefit, and employer-sponsored fertility benefits may not appear in your regular medical plan.
The sections below explain the plans we work with, what fertility insurance may cover, and how our team helps verify your benefits.
Does Brown Fertility Accept Insurance?
Yes. Brown Fertility works with the insurance plans and networks listed above. However, participation can vary by location and provider, and being in network does not mean every fertility service is covered under your policy.
If your plan does not cover IVF or IUI, other parts of your care may still be covered. Depending on your benefits, this could include consultations, bloodwork, ultrasounds, diagnostic testing, or treatment monitoring. Our financial team can help you review the details before treatment begins.
Insurance participation can change. Please contact us to confirm whether we currently participate with your plan.
What if My Employer Offers Fertility Benefits?
Some employers offer fertility benefits in addition to regular medical insurance. Programs such as Carrot, Kindbody, Maven, Progyny, and WINFertility may help with testing, medications, IUI, IVF, fertility preservation, or other family-building services.
What is included depends on the program your employer selected. You may need to complete enrollment, receive authorization, or use certain providers before treatment begins.
When you contact us, tell us about any employer fertility benefits, even if you are unsure how they work. We can help you identify what you need to move forward.
Does Brown Fertility Accept TRICARE?
Yes. We are an approved TRICARE provider, but coverage and referral rules depend on your TRICARE plan.
We are out of network with TRICARE Prime. If your primary care provider sends an approved referral specifically to Brown Fertility, we may be able to bill TRICARE directly for eligible care.
A referral may allow coverage for certain fertility evaluations, diagnostic tests, or other approved services. It does not guarantee that TRICARE will pay for every service. Your final coverage depends on your benefits, referral, authorization requirements, and claim review.
If you have TRICARE Prime, begin by asking your primary care provider whether a referral to Brown Fertility is appropriate.
We also work with TriWest and VA benefits. We must review these benefits individually because eligibility and covered services can differ from one patient to another.
Active-duty service members and veterans can also learn more about our Military Discount Program.
What Can Fertility Insurance Cover?
No single list applies to every insurance plan. Some policies cover only the testing used to identify a fertility concern. Others include treatment, medications, or a separate employer fertility benefit.
Here are the areas we commonly help patients review.
Fertility Consultations and Testing
Diagnostic care is often handled differently from fertility treatment. Even when IVF is excluded, your plan may provide benefits for:
- A fertility consultation
- Hormone and laboratory testing
- Ultrasounds
- Cycle monitoring
- Semen analysis
- Ovarian reserve testing
- Other diagnostic procedures
A hysterosalpingogram, or HSG, may also be covered when your physician considers it medically appropriate.
Your deductible, copay, referral rules, and prior authorization requirements may still apply.
IUI Coverage
Some plans cover intrauterine insemination, or IUI. They may cover the procedure itself, monitoring appointments, or certain medications. Other parts of the cycle may be billed separately.
Your insurer may require prior authorization or specific medical criteria before approving an IUI cycle. Ask whether medications are included or processed through a separate pharmacy benefit.
IVF Coverage
Coverage for in vitro fertilization, or IVF, varies widely. Some plans include IVF. Some cover only parts of the cycle. Others do not include IVF at all.
When IVF benefits are available, they may depend on:
- Your diagnosis
- Your employer’s benefit selection
- Previous treatment
- Prior authorization
- Treatment requirements set by the plan
- A maximum number of cycles
- A lifetime benefit limit
- Use of a designated clinic, laboratory, or pharmacy
- Separate medication benefits
Once your physician recommends IVF, our financial team can help you understand which aspects of the treatment may be covered and which expenses may be your responsibility.
Fertility Medication Coverage
Fertility medications do not always follow the same rules as the rest of your treatment. They may be covered through your medical plan, pharmacy benefits, employer fertility program, or a designated specialty pharmacy.
Before filling a prescription, find out:
- Whether the medication needs prior authorization
- Whether you must use a particular specialty pharmacy
- Whether your plan has a separate fertility medication benefit
- Whether medication costs count toward your deductible or benefit limit
- Whether you qualify for a manufacturer or patient savings program
If medication coverage is limited, we can point you toward patient savings programs that may apply to your prescription and eligibility.
How Does Fertility Benefit Verification Work?
Our financial team can review your insurance information and help clarify the fertility benefits available under your plan. The review may also identify referrals, prior authorization requirements, benefit limits, and costs you may be responsible for.
1. Send Us Your Insurance Information
We will need a copy of your current insurance card. Tell us if your employer also provides a separate fertility benefit through Progyny, Maven, Carrot, Kindbody, WINFertility, or another program.
If you already know that your plan requires a referral, share that with us too.
2. We Review Your Benefits
Our team reviews the information available about your coverage. This may include benefits for consultations, testing, monitoring, IUI, IVF, embryo transfer, and medications.
We also look for deductibles, copays, coinsurance, treatment limits, and other details that could affect your costs.
3. We Check for Additional Requirements
Some plans will not approve a service until certain requirements have been met. You may need a referral, prior authorization, supporting medical records, or completion of another treatment step.
If we identify one of these requirements, we will explain what it means and what may need to happen next.
4. We Review the Financial Next Step With You
Your physician must first determine which care is medically appropriate. Once a treatment plan is recommended, our financial team can explain the available benefit information and your anticipated financial responsibility.
If your plan does not cover all recommended care, we can also discuss available financing and savings resources.
Benefit verification does not guarantee that the insurance company will pay a claim. Your insurer makes the final decision based on your eligibility, authorizations, medical necessity, services received, and plan terms.
Questions to Ask Your Insurance Company
A short call with your insurer can uncover details that are not obvious in your benefits summary. Ask the representative to explain the answers in the context of your specific plan.
Useful questions include:
- Do I have benefits for infertility or fertility treatment?
- Are fertility consultations and diagnostic tests covered?
- Does my plan cover IUI?
- Does it cover IVF or embryo transfer?
- Are fertility medications included?
- Are medications covered under my medical plan or pharmacy benefit?
- Do I need a referral?
- Is prior authorization required?
- What deductible, copay, or coinsurance applies?
- Is there a lifetime dollar limit?
- Is there a limit on the number of treatment cycles?
- Do I need to use a particular clinic, laboratory, or specialty pharmacy?
- Do I have out-of-network fertility benefits?
- Does my employer provide a separate fertility program?
Write down the date of the call, the representative’s name, and any reference number you receive. This information can help if you need to follow up.
What if Brown Fertility Is Out of Network?
An out-of-network status does not always mean that you have no fertility benefits. Some plans cover out-of-network consultations, testing, monitoring, or treatment.
These benefits often work differently from in-network coverage. You may have a separate deductible, higher coinsurance, a different reimbursement amount, or additional authorization requirements.
Ask your insurer how out-of-network claims are handled and what amount you may need to pay. Our financial team can then help you understand how that information relates to the care your physician recommends.
What if My Insurance Does Not Cover Fertility Treatment?
You do not need fertility insurance to become our patient. You can schedule a new-patient consultation without insurance, and we can discuss other payment options once we know your treatment needs.
Our fertility financing resources include:
- PatientFi, which offers monthly payment options for eligible patients
- ARC Fertility financing and treatment packages
- TruPath, which offers a defined treatment pathway for eligible patients
- Patient savings programs that may help with qualifying treatment or medication expenses
Each program has its own approval process, terms, and eligibility requirements. Once your physician has recommended a treatment plan, our team can help you understand which options may be relevant to you.
Frequently Asked Questions About Fertility Insurance
Does verifying my benefits guarantee that insurance will pay?
No. Verification tells us what information your plan provides at the time of the review. Your insurance company still makes the final decision after considering your eligibility, authorization, medical necessity, services received, and claim.
Do I need a referral to schedule a visit?
Many patients can schedule a consultation without a referral. Some insurance plans require one before covered services can begin. TRICARE Prime and certain managed-care plans may have specific referral rules. Check with your insurer or ask our team to help you understand the requirement.
Can testing be covered if IVF is not?
Yes, it is possible. A plan may cover consultations, bloodwork, ultrasounds, semen analysis, or other diagnostic services while excluding IUI or IVF. The answer depends on your individual benefits.
How do employer fertility benefits work with my insurance?
Some employers offer fertility benefits through programs such as Progyny, Maven, Carrot, Kindbody, or WINFertility. These benefits may work alongside your regular medical insurance or provide a separate allowance for eligible fertility services.
Coverage, enrollment requirements, and authorization steps depend on the program your employer selects. Tell our team about both your insurance plan and employer fertility benefits so we can review the available information.
Are fertility medications part of IVF coverage?
Not necessarily. Medications may be covered separately through your pharmacy benefit, employer fertility program, or a required specialty pharmacy. Some patients have treatment coverage but still pay out of pocket for medications.
What should I do if Brown Fertility is out of network?
Ask your insurer whether your plan includes out-of-network fertility benefits. Find out how reimbursement works, whether you have a separate deductible, and whether prior authorization is required. Share that information with our financial team so we can help you understand the next step.
LET’S REVIEW YOUR BENEFITS
Move Forward With a Better Understanding of Your Benefits
If you have questions about your insurance, employer fertility benefits, TRICARE, or possible coverage for testing, IUI, IVF, or medications, share your information with our financial team.
We can review the benefits available under your plan, identify any requirements, and help you understand the next financial step once your physician recommends a treatment plan.
Insurance participation, fertility benefits, financing options, and eligibility requirements can change. Your individual plan and insurance carrier determine coverage. Verification of benefits does not guarantee coverage or payment.