At Columbia University Fertility Center, each patient’s infertility treatment plan addresses their own individual needs. The same is true of the costs associated with their care. Starting on this fertility treatment journey can be overwhelming and we understand that cost is one of the many factors affecting your decision regarding your treatment. As such, we have a team of dedicated patient financial coordinators (PFCs) that are happy to help along the way. As a new patient in our center, a PFC will reach out to you to help ensure that you have all information you need each step of the way. Once you and your physician have determined a treatment plan, your PFC will coordinate with you to review the financial services to help you achieve your goal of having a child.
Benefit coverage for fertility treatment varies significantly. Please be sure to review the benefits and requirements of your medical plan, especially as it relates to infertility coverage. While we make every attempt to verify coverage for new patients, you can avoid potential issues by understanding the details of your own insurance plan, benefits, and requirements. Many insurance policies cover procedures used to diagnose infertility. Your health insurance company may pay for blood tests, semen analysis, and initial examinations and consultations.
In-Network Infertility Care
We are pleased to be a center that offers comprehensive fertility care while accepting in-network managed care contracts for in-vitro fertilization (IVF). If you have insurance coverage for IVF, you can save thousands of dollars by selecting an in-network provider. To locate us under your insurance directory as in-network providers, look up one of our physicians by name.
Questions to Consider When Speaking With Your Insurance Company About Infertility Benefits
- What fertility benefits do I have under my current insurance policy?
- Is there maximum dollar expenditure for fertility service? If so, what is the dollar amount and how much have I used to date, how much do I have left?
- Are there specific requirements that I need to follow or criteria I need to meet that allow me to access fertility services (i.e., referrals or pre-authorization)?
- If referral and authorization are required, how often will they need to be updated?
- Is there a limit to the number of attempts allowed for in vitro fertilization (IVF)?
- Is there a limit to the number of attempts allowed for artificial insemination (IUI)?
- If my insurance covers fertility services, do I meet the medical criteria for fertility services?
- Are medications for fertility treatment covered? If yes, are they covered under the medical plan or a separate prescription plan?
- If my policy does not cover fertility services, will diagnostic treatment be covered?
In situations where our doctors or laboratory at Columbia University Fertility Center are not in-network with your insurance, you may still have out-of-network coverage. In these cases, we do not bill your health insurance provider directly. We will give you an insurance form (HCFA 1500) showing all necessary information required for you to obtain reimbursement directly from your insurance company.
The amount you are reimbursed depends on many factors and can vary widely. Because of its complexity, we recommend that you work with your assigned patient financial coordinator to first determine the level of coverage your health insurance company provides and then evaluate your options.
If your insurance is out-of-network, your PFC can review our self-pay fees. For self-pay, treatment cycle costs must be paid in advance. Columbia University Fertility Center is not responsible for determining pre-authorization or any other requirements for patients with out-of-network health insurance.
Partial medication subsidies may be available through pharmaceutical companies based on patient economic need.
New York State Department of Health Infertility Demonstration Program
Columbia University Fertility Center participates in the New York State Department of Health Infertility Demonstration Program, which provides financial support to insured patients without coverage for IVF. The program also covers qualified privately insured individuals whose insurance for these procedures is exhausted or inadequate, and who have exhausted basic infertility services. The patients must meet certain criteria including being a New York State resident between the ages of 21 and 44, be clinically infertile, and other clinical and program criteria.
This program is a cost share program. Fees for the treatment received as part of this program are paid by a combination of the patient, their insurance company, and New York state. The patient responsibility for the cost share amount varies based on the treatment received and patient household income, but cannot exceed ten percent of the patient’s gross household income in any one year.
Patients interested in determining their eligibility for participation in the program should ask their PFC for more information.