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Does the New York IVF and Fertility Preservation Law change anything if my plan excludes all infertility coverage?
Are my fertility treatments covered by insurance if I have a qualifying medical condition?
The new mandate requires all insurance plans, including small group and individual market plans, to cover fertility preservation (egg or sperm freezing) for patients at risk of what’s known as “iatrogenic” infertility, or infertility caused by another medical intervention. This can include those at risk of infertility due to radiation or chemotherapy treatment for cancer, surgery for endometriosis, gender reassignment surgery or treatment, or other medically indicated reasons.
The mandate also requires insurers to cover the medications used in medically necessary egg freezing, as well as storage for the frozen eggs or sperm (with no defined time limit). It doesn’t cover using the frozen eggs, except as part of the mandated IVF coverage for those with an infertility diagnosis.
Is precertification needed for before fertility treatment in order for it to be covered by my plan?
In most cases, insurance carriers require precertification for both medication and treatment. However, it is best to check with your specific insurance carrier to confirm.
How do I check to see what my coverage is?
Each patient’s plan is different which is why it is important to first call your insurance company to review your benefits. Coverage details are dependent upon your individual plan and carrier treatment criteria.
If you have questions about your coverage, contact us and we’ll talk through it. Call or email us at: 1-212-810-2828 or firstname.lastname@example.org. Note: Please allow up to 48 business hours for an email response.