Understanding how insurance applies to fertility care can feel overwhelming, but you don’t have to figure it out alone. At Main Line Fertility (MLF), we’re here to help you navigate your coverage, maximize your benefits, and keep your focus on building your family.
Many patients are surprised to learn that while in vitro fertilization (IVF) itself may not always be covered, certain aspects of care often are, including diagnostic tests, medications, and related services. Our team works with a wide range of insurance providers to help minimize unexpected costs and make treatment more accessible.
No matter where you are in your fertility journey, you can count on MLF to guide you through the complexities of insurance with clarity and compassion.
A Dedicated Team of Fertility Insurance Experts
MLF has an expert team of financial counselors who can answer your questions and help you review your options. We understand that fertility insurance can be a confusing and complex topic, and we’re here to ease that burden by contacting your insurance provider, reviewing your benefits, and verifying your coverage.
As part of this support, we prioritize transparency, making sure you understand any potential out-of-pocket expenses upfront before moving forward. Our team can also help uncover hidden benefits in your plan that might otherwise go unnoticed. Regardless of your unique situation, MLF is here to help you begin your family-building journey with confidence.
Participating Insurance Providers
MLF participates with a number of insurance providers to help make fertility care more accessible and manageable for our patients. Below is a list of providers and plans we generally work with.
Even if you don’t see your plan listed, our financial counselors can help you navigate the details of fertility insurance coverage, so you can spend less time worrying about benefits and more time focusing on your family-building journey. Please note that this list is subject to change and may vary by physician and location. We encourage you to call and confirm coverage before your appointment.
Aetna
Cigna
Independence Blue Cross
Highmark
Maven
Optum Fertility Solutions/Optum COE
Progyny
Stork Club
WIN
UHC
Carrot
Start Your Fertility Journey With Confidence
Understanding your insurance coverage begins with a consultation with MLF's financial counselors. We're here to answer your questions, verify your benefits, and review your plan so you can start your journey to parenthood as quickly as possible.
Does Insurance Cover IVF and Fertility Treatments in Greater Philadelphia?
Fertility coverage in the Greater Philadelphia area varies depending on the specific plan you have. Before starting treatment, it's essential to research what your insurance plan covers, either online or by contacting the insurer or benefits representative ahead of your first visit. Determining your fertility coverage can be intimidating. We recommend obtaining written verification of your benefits to protect yourself from fees that your insurance plan may not cover.
Insurance companies have specific guidelines to help you understand the extent of your fertility benefits, and they're required to give you this information. Typically, the information is provided only in response to specific questions asked by the insured, and some important details may be unintentionally omitted.
Understanding Fertility Insurance in Philadelphia
Pennsylvania does not have a statewide mandate requiring insurance companies to cover in IVF or other fertility treatments. As a result, coverage can vary widely depending on your individual or employer-sponsored health plan.
At Main Line Fertility, our financial team is here to review your benefits, identify any eligible coverage, and advocate on your behalf to help minimize out-of-pocket expenses. We’ll work with you to make sure you understand your options and can move forward with confidence.
What Fertility Services Are Typically Covered by Insurance?
Fertility insurance coverage varies, but commonly covered services include:
If you’re unsure what your plan covers, our financial coordinators can help you navigate your benefits.
How Much Does IVF Cost With and Without Insurance?
Understanding the costs associated with IVF is essential before starting your journey. At MLF, we prioritize transparent and upfront pricing, whether you have insurance or are paying out of pocket.
With insurance: Depending on your insurance plan, you may have coverage for parts of IVF, like diagnostic testing and fertility medications. However, patients typically have to pay for co-pays, deductibles, and other services not covered by their plan.
Without insurance: The cost of a single IVF cycle can range from $14,250 to $20,000, depending on the specific treatment plan. These fees typically encompass ultrasounds, laboratory work, egg retrieval, fertilization, embryo transfer, and follow-up visits. Medications, anesthesia, and genetic testing are usually billed separately.
No matter your unique needs and treatment plan, we'll provide you with a clear outline of all expected costs and help you explore financing options and discounts to make treatment more affordable.
Frequently Asked Questions About Fertility Insurance
IVF coverage varies depending on your insurance plan. Before starting treatment, it’s essential to review your benefits and determine your coverage. Our financial team can review your policy and help maximize your benefits as much as possible.
The cost of IVF with insurance depends on your specific treatment plan and the type of coverage you have. Some policies cover only specific services, like diagnostics and medications, while others provide partial or complete coverage for IVF. Before you begin treatment, we'll review your benefits and outline your expected out-of-pocket expenses.
IVF costs range from $14,250 to $20,000. These prices typically include monitoring, retrieval, lab work, and embryo transfer. Medications, anesthesia, and optional services, such as genetic testing, generally are billed separately. At MLF, we prioritize transparency and ensure that you know what to expect before treatment.
Since egg freezing is considered an elective procedure, your insurance may not cover it. However, some insurance plans might provide coverage for fertility preservation if it's deemed medically necessary, such as before undergoing cancer treatment. We'll review your specific plan to determine what coverage options are available to you.
Similar to egg freezing, some insurance policies consider IVF after tubal ligation an elective procedure, especially if the sterilization was voluntary. However, others may provide partial benefits. We can review your specific situation and help determine the best coverage for you.
IVF after a vasectomy, like tubal ligation, is generally classified as an elective procedure and may not be completely covered by insurance. However, some insurance plans might provide partial coverage. The financial team at MLF will evaluate your insurance coverage and discuss financing options with you.
LGBTQ+ patients who want to have children may have coverage options based on their insurance provider. Some plans offer benefits for assisted reproduction regardless of sexual orientation, while others may have more restricted coverage. We're here to advocate for you from start to finish and clearly explain which services are included in your plan.
Certain plans cover fertility medications as part of their IVF coverage. Others may require separate pharmacy benefits or offer limited drug coverage. We can review your specific plan and any available discounts or programs that may apply to you..
Depending on how your plan classifies fertility care, eligible IVF-related services may apply toward your insurance deductible. Our financial counselors can explain how your deductible works, what costs are applicable, and what you can expect throughout your treatment.
Ready to Start? Schedule a Consultation Today
Main Line Fertility is dedicated to making fertility treatment accessible and affordable for our patients. From your initial consultation with our financial counselors to the start of your treatment, you can count on us to answer your questions and support you throughout the process. Schedule an appointment at one of our fertility clinics in Philadelphia, Bryn Mawr, West Chester, Havertown, Reading, or Fort Washington to learn more about fertility costs, accepted insurance plans, and more.
