Understanding Insurance Coverage
At RADfertility, we recognize that a primary obstacle to pursuing fertility treatment is affording care. As part of your comprehensive treatment, we have a financial team who can help you through this process and offer a variety of financial options.
Understanding Your Insurance Coverage
It is important that you know what your benefits cover to ensure you understand your potential out-of-pocket costs. Your member services number is listed on the back of your card. Listed below are the most common types of insurance coverage and some questions you may want to review with your insurance carrier.
Types of Insurance Coverage
- HMO – These plans usually only offer in-network benefits. In addition, you will usually have to provide a referral for any visit.
- POS – These plans usually offer in and out-of-network benefits. However, you may still need a referral in order to maximize coverage.
- PPO – These plans offer both in and out-of-network coverage. You usually do not need a referral or authorization for these services either, but should always verify this with your insurance carrier.
Questions to Ask Your Insurance About Pharmacy Benefits
- Is there drug coverage?
- Are infertility drugs covered under the pharmacy benefit or medical benefit?
- What is the coinsurance or copayment for drug coverage?
- What prior authorization policies are in effect for medications?
- Are there 30-day drug prescription limits for infertility medications?
- Does the plan pay for self administered subcutaneous, under the skin injection (SQ) and/or oral (PO) medications?
- Does the plan pay for intramuscular (IM) medications?
- Are there discounts for mail order medications?
- Are infertility specialists encouraged to prescribe one drug over another?
- Can I get a medication that is not a preferred drug or formulary? Can I get a medication that is not covered? If so, am I expected to pay a higher copayment or coinsurance or pay for it completely? And what is that amount compared to the preferred drug copayment or coinsurance?
Always record when and who you spoke with, as well as the reason and the outcome. It is also suggested that you obtain a written pre-determination of your benefits. This is your most effective tool if you need to challenge a future decision made by your insurance company.
Affording Care
Request an Appointment
If you would like to schedule an appointment, please let us know which dates and times work for you. A Patient Navigator will contact you to confirm your appointment.
Learn More About Affording Care at RADfertility
In-Network Insurance Carriers
RADfertility has compiled a list of in-network insurance carriers to help you navigate your coverage.
Understanding Coverage
RADfertility has a financial team who can help you through this process and offer a variety of financial options.
Does My Company Provide IVF Coverage?
According to FertilityIQ, employers nationwide continue to implement increased or enhanced fertility benefits year after year.
Financing Partners
RADfertility has partnered with three different companies who finance fertility treatment to help you on the financial portion of your journey.
Treatment Discount Programs
RADfertility's discount programs can help offset some of the costs associated with treatment.
Medicine Discount Programs
In an effort to offset the costs associated with treatment, RADfertility participates in programs that offer medication discounts.
Delaware's Fertility Care & Preservation Law (SB139)
On June 30, 2018, history was made! Governor John Carney signed SB139, Delaware’s Fertility Care & Preservation Bill into law.
Newark Office
4735 Ogletown-Stanton Road
Medical Arts Pavilion 2
Suite 3217
Newark, DE 19713
Wilmington Office
Silverside Medical Center
2700 Silverside Road, Suite 2A
Wilmington, DE 19810
Dover Office
Eden Hill Medical Center
200 Banning Street, Suite 240
Dover, DE 19904
Phone: (302) 602-8822
Fax: (302) 602-8832
©RADfertility 2021