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Insurance & Mandates

Learn which insurance providers Illume Fertility accepts and get more information about Connecticut and New York state mandates for fertility coverage.

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Insurance Accepted by Illume Fertility

Note: We are not in-network with Medicare, Medicaid or Fidelis. If you have an HMO plan, you may require a referral to Illume Fertility. Have a question? Contact us!

How can a state infertility mandate help me afford treatment?

Only 19 states in the United States have infertility mandates for insurance coverage - and we are lucky to have mandated coverage in Connecticut and New York!

While these state mandates do have limitations and exclusions, they can help residents of both Connecticut and New York afford fertility treatment by requiring large group insurance providers to cover certain fertility tests, treatment and other procedures related to infertility.

Learn more about the CT and NY mandates:
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Fertility Insurance Coverage

Health insurance is indispensable, but it can certainly add to the complexities of the choices you make when pursuing fertility treatment.

At Illume Fertility, we try to lessen that stress by helping you work with your insurance company to determine your level of coverage and your out-of-pocket expenses (when applicable). We also review the specific details of your insurance plan for infertility treatment with you.

To help you get started, we explain the different types of insurance plans and offer infertility insurance tips below.

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Types of Insurance Plans

Learn more about the three main types of insurance plans and how they typically work.

Infertility Insurance Tips

When obtaining information on insurance coverage, don’t just rely on a phone call to your insurer. If you simply call and ask about coverage for a certain procedure, you risk getting incorrect information.

Instead, we strongly suggest that you request a written pre-determination letter or document from your insurance company detailing your exact benefits and any requirements that must be met in order to ensure coverage. This written document is your most effective tool if you need to challenge a decision or file an appeal for payment with your insurance company at a later date.

What else should I do?

Establishing a point of contact with a representative at the insurance company is a good idea and may make follow-up easier. Keep a log of all phone conversations with your insurance company, including the date and time of the conversation and the name of the person with whom you speak.

During that conversation, get answers to these important questions:

  • What specific procedures do I need to follow to ensure that my infertility treatment is covered? For example, do I need separate referrals or authorizations for each office visit, blood work, ultrasound or procedure?
  • What are the qualifying criteria for receiving my infertility benefit? (i.e. previous attempts, a certain number of IUIs before being able to move onto IVF)
  • Is there a maximum dollar amount associated with infertility treatment? If so, what is it and how much have I used to date?
  • Is there a limit to the number of attempts allowed for intrauterine inseminations (IUI)?
  • Is there a limit to the number of attempts allowed for in vitro fertilization (IVF)?
  • Do I have prescription coverage?
  • Do I have a separate prescription plan?
  • Must I get my prescriptions from a particular pharmacy?
  • Is there a separate phone number I need to call to find out about my drug benefits?
  • Does fertility medication require prior authorization? 

Common Fertility Insurance Terms

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Financial Planning for Fertility Treatment

Understanding fertility treatment financing is no simple task. We're here to help break it all down for you and make it just a little bit easier. Explore budgeting, how to maximize your insurance coverage, take advantage of open enrollment, learn about Illume Fertility's Opportunity Plans and much more.

Fill out the form to download your comprehensive guide to financial planning for fertility treatment today.

Have more questions?

Illume Fertility can help.

Our team of eight board-certified reproductive endocrinologists and comprehensive support staff are ready to help you create the family of your dreams.

Take the first step by scheduling your consult today to learn how Illume Fertility can help you achieve your goals, or download our free Financial Planning for Fertility Treatment eBook.

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