Financial options

We recognize that fertility treatments can be expensive and feel out of reach for many people. Our goal is to provide a variety of treatment options – with transparent pricing – for patients with insurance coverage as well as those who may not have insurance fertility benefits.

Insurance Coverage

Understanding your insurance benefits is an important step in your journey, and we are here to help you understand your benefits. Every insurance policy is different, and we encourage you to contact your insurance company directly to find out if you have coverage for fertility treatment. It is important to fully understand your particular plan, paying specific attention to covered benefits, exclusions, and restrictions.

We also encourage you to speak with our financial counselor, who can help guide you on what questions to ask your insurance company.

 The following tips may help when speaking with your insurance company:

  • Ask if you need a referral from your primary care provider.
  • Ask for your benefits for infertility and/or IVF.
  • Ask for a list of fertility treatments and medications that are covered.
  • Ask if there is a lifetime maximum or a cap on medication costs.
  • Ask if there are restrictions such as a lifetime max, or total dollar amount, for certain services such as IVF or IUI cycles.
  • Ask if there are restrictions on tests and procedures such as genetic testing, intracytoplasmic sperm injection (ICSI), or assisted hatching.
  • Ask if your plan has a participating benefit plan or partner.
  • Take notes, and ask for a reference number at the end of your call.

Insurance plans can be complicated, so we put together a list of terms and phrases that we think may help.

Common terms and phrases
  • Insurance plan (or policy): This is the agreement between you and a health insurance provider in which you pay a fixed cost each year to the insurance company, which then covers various medical expenses. You can find out which medical expenses your plan covers, and how much, by reviewing the “Summary Plan Description.” If you don’t have it already, you can ask your HR representative or insurance provider for a copy.
  • Covered services: These are the medical treatments and procedures that are covered in full or in part by your insurance plan. Your plan will pay for some or all of the medical treatments or procedures listed as covered services. You have to pay for any uncovered service that you receive.
  • Medical necessity vs medical benefit: A medical necessity is medical care that your doctor classifies as necessary; it may or may not be covered by your insurance plan. A medical benefit is something your insurance plan covers. Fertility treatment is not always considered a medical necessity.
  • State mandate to cover: Mandate to cover means that some or all insurance providers administering plans in these states are legally required to cover certain fertility treatments.
  • State mandate to offer: Mandate to offer means that while insurance providers administering plans in these states have to offer certain testing and treatment services, employers can decide which, if any, of those benefits to offer to people covered by their plan.
  • Group insurance plans: Most people are covered by group insurance policies. These are often plans offered by employers to their employees and some members of their family, and can be offered through a public or private provider (like Aetna and Cigna, among others). Unless you are a veteran or are current military personnel or their family, your plan is most likely provided by a private insurance company.
  • Public Insurance: These are government insurance programs like Medicare, Medicaid, Veterans Administration (VA), and TRICARE.
    • VA Insurance: VA health insurance coverage is available for those who served in the armed forces. It may cover certain conditions that result in infertility, and some patients may be eligible for coverage for IVF.
    • TRICARE: TRICARE is available for current military personnel and some members of their families. If you are covered by TRICARE, you may have coverage for certain reproductive services.
  • Affordable Care Act (ACA): ACA covers individuals and small groups and requires minimum essential coverage for certain benefits. However, infertility is not considered an essential benefit by the ACA, so coverage is not mandated by the ACA or federal law. However, several state regulations mandate at least some coverage for fertility treatment.

Every person’s situation is unique, and we are happy to discuss your needs and provide you with estimated pricing as well as a variety of financing options. To reach our infertility financial counselor and schedule a consultation, please call 205-996-3235.

If you don’t have coverage:

Talk to our financial counselor to see if you qualify for any cost-savings or financial programs. They may be able to help you find ways to lower your out-of-pocket costs.

Some options to discuss with the financial counselor include:

  • What scholarship and grant programs are available?
  • What financing options are available?
  • Can you help me review my insurance benefits?
  • Do you offer multi-cycle discounts?
  • Am I eligible for any military discounts?
  • What out-of-pocket costs can I expect?

Fertility Grants

Jewish Fertility Foundation

Residents of the Birmingham area may be eligible to apply to the Jewish Fertility Foundation (JFF) for a fertility grant, which can cover or help cover the cost of procedures such as IVF and IUI.

Other financial benefits through JFF include:

  • 20% discounts at partner clinics
  • Interest-free loans
  • Discounts on medications and genetic testing (of embryos) at partner clinics

Click here to learn more.

Team Maggie’s Dream

Team Maggie’s Dream is a program that provides financial assistance to young women and men for the purpose of preserving eggs and sperm. If you are interested in applying for a financial grant to help subsidize the cost, please click here to learn more and submit a grant application.

Livestrong Fertility

Livestrong Fertility provides fertility resources to help people with cancer achieve their family goals by easing the financial burden of fertility preservation.

The Livestrong Fertility Discount Program works with compassionate clinics nationwide that have all committed to at least a service discount for qualifying patients. Click here to learn more.

RESOLVE: The National Infertility Association

Resolve maintains a list of nonprofit organizations that provide fertility treatment scholarships and grants. Click here to see the list.

Progyny

The Progyny benefit is only available through your or your partner’s employer-sponsored benefits, and you must be enrolled in an eligible health plan. Your spouse/partner may also be covered if enrolled in an eligible plan. Talk to your HR or benefits team to confirm if your or your partner’s employer offers Progyny benefits.

Click here to learn more, or call Progyny at 833-233-1020 to confirm your eligibility

Financial Programs for Fertility Treatment

There are a handful of financial institutions that will provide loans for fertility treatment. UAB Medicine has partnered with Lending Club Financing for infertility financing through Lending Club Patient Solutions. Click here to learn more.

What costs can I expect?

Treatment fees

Costs depend on the type of treatment that each person receives. Since each person’s situation is unique, we cannot predict the exact price. However, our financial counselor will be happy to assist you in understanding your individual fees.

A few things to remember:

  1. All IVF fees must be paid on the day of your baseline ultrasound, at the start of treatment, and upon completion of your IVF medical checklist.
  2. Please be prepared to pay any/all co-payments, co-insurance, and/or meeting insurance deductibles.
  3. Patients who do not have or do not wish to use insurance must be prepared to pay for all services at the time of service/visit.
  4. If you do not have insurance or prefer that we do not file your fertility treatment with your insurance company, we offer cash pay packages for your visits.

Other costs

The charges for your office visits, labs, ultrasounds, and any procedures will be submitted to your insurance company for coverage. You may have co-pays or co-insurance for these charges specific to your insurance plan.

For patients who do not have insurance coverage for fertility treatment (“non-billable service”), we will collect payment for these charges at the time of service.

IUI/IVF costs

Please check with your insurance company to determine if you have coverage for these procedures. In general, IUI and IVF are not covered by most Alabama-based insurance companies (excluding PEEHIP/EDU policies from Blue Cross Blue Shield, which typically cover IUI).

If you have out-of-state insurance, your policy may cover IUI and IVF. Check with your insurance company to see if these are covered services. If so, a pre-authorization may be required, or specific criteria or prior treatment may need to be met for coverage to be provided. Please ask to speak with our financial counselor if you have questions about your coverage.

Medications

Fertility medications are sometimes paid for by insurance, but every policy is different. Our IVF clinical coordinator will go over your coverage, if any, at the time you need medications. If your plan provides coverage, it may be restricted to a specific mail-order pharmacy or require prior authorization.

Mail-order specialty pharmacies can help determine your fertility medication coverage and provide competitive pricing for these medications. Most of these pharmacies are out of state and can ship medications directly to you overnight.

Frequently used mail-order specialty pharmacies
MDR Specialty Pharmacy1-818-788-5858
SMP Pharmacy1-855-255-5005
Freedom Fertility Pharmacy1-800-660-4283
Prime Specialty Pharmacy (some BCBS coverage)1-877-627-6337
Walgreens Specialty Pharmacy1-888-487-8161
CVS Caremark1-800-237-2767
Alexander’s Twin Pharmacy1-877-750-7222
Mandell’s Clinical Pharmacy1-877-252-0553
Local pharmacy

Homewood Pharmacy (205-871-9000) carries most fertility medications. The cost may be higher than the mail-order pharmacies, but this option can be helpful for those who need medication immediately or need only a limited supply.

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