Fertility Treatment Costs - Financial Information
Insurance coverage for infertility services varies greatly. Most health plans reimburse diagnostic services that enable the physician to determine the cause of your infertility but few plans reimburse treatment procedures such as intrauterine insemination (IUI) or in vitro fertilization (IVF).
Financial Policies
We would like to make you aware of our current financial policies regarding services performed at the Center. The Center participates with most health insurance plans. Please check with us to confirm we participate with your insurance plan(s).
Covered Fertility Treatments
If the Center participates with your current insurance carrier(s) and the service performed is a covered benefit, we will accept the amount your carrier deems reasonable or allowable. If our charge is greater than the allowable amount determined by your insurance, as participating providers we will reduce our charge to the allowable amount. Your responsibility may be a co-payment (a fixed dollar amount per visit) or coinsurance (a percentage of the allowable amount). The Center requires all co-payments be made at the time of service. Otherwise you will be billed for coinsurance amounts.
Non Covered Services
If the Center determines any service is not covered by your insurance carrier, you will be required to pay for those services when rendered. The Center also offers self-pay packages for IUI and IVF cycles that are not covered by insurance. The package amount includes all monitoring services and the treatment procedure. You will be billed for a single total amount instead of each service separately. The package amount will be calculated by Kristy, will be due prior to the beginning of your treatment cycle and will be posted to our computer system when received. Non covered charges will not be submitted to your insurance. We will provide you with a receipt for the package amount.
Any outstanding balances must be paid in full prior to beginning treatment. Balances from prior treatment cycles must also be paid in full prior to beginning a new treatment cycle.
Payment Types
The Center accepts checks, cash, debit cards, Visa, Master Card, or Discover.
Initial Visit
Some patients are enrolled in HMOs (health maintenance organizations) or POS (point of service) health insurance plans. It is your responsibility to obtain the appropriate referral(s) for your initial visit from your primary care doctor. After your initial appointment, Kristy will investigate which future services need referral or pre-authorization.
Billing of Services
Infertility is a disease process that involves two individuals which complicates the billing of services rendered. The majority of infertility charges will be billed to the female. The male will be billed for all sperm related charges. It is important for you to review your health insurance coverage(s) since both of you will be billed for infertility services. The Center has created patient fee sheets that detail the costs of services and to whom those costs will be charged. Kristy can provide these to you.
Other Infertility Financial Considerations
Flexible Spending Benefits
Some employers allow employees to set aside a specified amount of your salary on a pretax basis for unreimbursed medical expenses. This allows you to pay your medical bills with pretax versus post-tax dollars. Check with your employer and determine if flexible spending benefits are offered to you or your spouse.
Income Tax Deduction
If your out-of pocket medical expense is high you may be able to deduct a portion of your medical bills on your income tax return. To do this you must be able to itemize deductions on your tax return and your medical expenses must exceed 7.5% of your adjusted gross income (AGI). Consult your tax advisor for details.
Home Equity Line of Credit – HELOC
Refers to a loan in which the lender agrees to lend a maximum amount within an agreed period. HELOC loans have become very popular in the United States in recent years, in part because interest paid is typically (depending on specific circumstances) deductible under federal and many state income tax laws. This effectively reduces the cost of borrowing funds. Consult your banker and tax advisor for details.
Alternative Forms of Payment
Other payment options you may want to consider include using a credit card for medical payments. Some credit cards offer perks such as airline mileage, a percentage back of total charges or percentage discounts on automobiles or other services. Remember, however, you may not wish to pay with a credit card unless you can pay the balance in full before you incur finance charges.
Questions
If you have any questions regarding any of the above information please contact Kristy Turner at 336-841-7070. Thank you.