Some Kaiser Permanente members may have fertility insurance coverage. Fertility benefits may or may not be part of your insurance plan. Fertility coverage is generally not linked to a specific insurance company and can vary from member to member. The best way to find out your coverage information is to contact member services.
Full Answer
Is Kaiser good health insurance?
To view your eligibility and the status of your coverage, you must be signed on to kp.org. Once you’re signed on: Select “Coverage & Costs” from the dashboard. Under “Plan Ahead,” select “Eligibility and benefits.”. View your eligibility summary, which includes your coverage effective and termination dates.
Does Kaiser insurance cover fertility treatments?
Some Kaiser Permanente members may have fertility insurance coverage. Fertility benefits may or may not be part of your insurance plan. Fertility coverage is generally not linked to a specific insurance company and can vary from member to member. The best way to find out your coverage information is to contact member services. Depending on your location, we highly …
Does Kaiser accept Aetna Insurance?
Special testing and many additional infertility services might not be covered by your Kaiser Permanente plan. Contact Member Services about your coverage plan before any tests or treatments. Examples of tests and treatments your doctor may recommend that might not be covered: Semen analysis
What insurance does Kaiser accept?
It can check the condition and size of the ovaries during treatment for infertility. It can also be used to check a woman's egg supply (ovarian reserve). This is done by counting the number of follicles in both ovaries during a certain phase of the menstrual cycle (antral follicle count). Pelvic Ultrasound; Hysterosalpingogram
Does Kaiser California cover IVF?
Assisted reproductive technology (ART) treatments like IVF, male fertility services, and fertility preservation, are largely non-covered services; however, certain KP health plans do include these benefits.
Do any Covered California plans cover IVF?
California law requires insurers and health care service plans to offer coverage of infertility treatment, except IVF.
Does insurance cover IVF?
Fertility treatments are expensive and often are not covered by insurance. While some private insurance plans cover diagnostic services, there is very little coverage for treatment services such as IUI and IVF, which are more expensive.Sep 15, 2020
Does Medi cal cover infertility treatment?
Health & Safety Code § 1374.55 and Cal. Insurance Code § 10119.6 require specified group health care service plan contracts and health insurance policies to offer coverage for the treatment of infertility, except in vitro fertilization.Mar 12, 2021
Does Kaiser cover fertility treatments?
A small group of Kaiser Permanente members may have fertility insurance coverage.
How much fertility treatment does Kaiser cover?
Kaiser Permanente insurance will cover either 50% or 100% of fertility diagnosis and treatment.
Can any Kaiser member see a fertility specialist?
It is essential to understand that only patients who do have fertility coverage are allowed to see a fertility specialist within Kaiser Permanente....
What are the causes of infertility?
Causes of infertility. The most common causes for infertility are a low sperm count (35 percent to 40 percent of couples), or lack of ovulation or blocked fallopian tubes (another 35 percent to 40 percent). In 15 percent to 20 percent of infertile couples, both partners have problems that contribute. Sometimes infertility is caused by one specific ...
How long does it take to get pregnant after infertility?
Infertility is not being able to get pregnant after one year of regular, unprotected intercourse. (Women over 35 should talk to their doctor after six months of trying to conceive.)
What is the postcoital test?
Postcoital test: Looking at cervical mucus under the microscope several hours after intercourse to see if there are live sperm present. Specialized blood hormone tests used to find the cause of infertility. Clomid therapy: To cause ovulation. Any infertility services provided by a non-Kaiser Permanente provider.
Can infertility be identified?
Sometimes infertility is caused by one specific cause that is easy to identify. In many cases, all tests are normal and the cause for infertility can't be identified. The good news is that many women with unexplained infertility eventually become pregnant.
What is an infertility test?
What are infertility tests? Infertility tests are done to help find out why a woman cannot become pregnant. The tests help find whether the problem is with the man, the woman, or both. Tests usually include a physical exam, semen analysis, blood tests, and special procedures.
What is a hysterosalpingogram?
A hysterosalpingogram is an X-ray test that looks at the inside of the uterus and the fallopian tubes. The pictures can show a blockage of the fallopian tubes that would prevent an egg from reaching the uterus or prevent sperm from moving into a fallopian tube to join (fertilize) an egg.
Why do we do genetic tests?
Genetic tests may be done to help find the cause of infertility. Ultrasound uses sound waves to make a picture of structures inside the body. It may be done to see whether a problem in the testicles is causing a problem with the sperm.
What is anti-mullerian hormone?
The anti-mullerian hormone test is a blood test that is sometimes used to check a woman's egg supply (ovarian reserve). It may be used for women who are considering IVF. Anti-mullerian levels go down as a woman's egg supply decreases, which usually happens with age.
Does Kaiser Permanente cover all treatments?
The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description.
Can you get pregnant with assisted reproductive technology?
Infertility in men is often less successfully treated than infertility in women. But you may still be able to become pregnant using assisted reproductive technology, which can treat male or female problems.
Topic Overview
Infertility treatment has great potential for squandering some of your most precious resources—money, time, and peace of mind. Before you start infertility treatment, decide how much money, time, and emotional energy you can afford to spend on infertility treatment. Take control of a process that can so easily take control of you.
Financial limits
What your insurance coverage will pay for. Be aware of all exclusions in your policy.
Time limits
Before you start infertility treatment, plan how long you each envision trying to conceive with medical help. Talk to your doctor ahead of time about what is a reasonable period of time to try treatment for your specific condition.
Overview
Infertility means that you haven't been able to get pregnant after trying for at least 1 year (or 6 months if you're over 35). It doesn't mean you'll never get pregnant.
When should you call for help?
Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.
Where can you learn more?
Enter C591 in the search box to learn more about "Infertility: Care Instructions".
What are the payment methods for Kaiser Permanente?
Methods of payment include cash, debit cards, and credit cards (Visa, MasterCard, American Express). Cashier’s check and money orders are also accepted and must be made payable to Kaiser Permanente Health Plan. Personal checks are not accepted.
What is genetic testing?
Genetic testing involves a biopsy of embryo tissue in the KP embryology lab and testing of the tissue in an outside, non-KP genetics lab. Testing fees are not included in KP’s fees and should be paid directly to the outside genetics lab.
Is assisted reproductive technology covered by KP?
Assisted reproductive technology (ART) treatments like IVF, male fertility services, and fertility preservation, are largely non-covered services; however, certain KP health plans do include these benefits. Prior to starting treatment, it is important to note the differences in the benefits and confirm whether they are included in your plan.
Does Kaiser Permanente cover fertility preservation?
As of 2020, Kaiser Permanente will cover fertility preservation for certain medical indications.
Can prices be changed without notice?
(1) Prices are subject to change without notice#N#(2) All treatments are based on Physician Recommendation#N#(3) Refunds will be issued in the same form that payment was received once all services have been rendered
How much does fertility treatment cost?
Most patients pay out of pocket for fertility treatment, which can amount to well over $10,000 depending on the services received. This means that in the absence of insurance coverage, fertility care is out of reach for many people.
What is infertility in a heterosexual relationship?
Infertility is most commonly defined 1 as the inability to achieve pregnancy after 1 year of regular, unprotected heterosexual intercourse, and affects an estimated 10-15% of heterosexual couples. Both female and male factors contribute to infertility, including problems with ovulation (when the ovary releases an egg), structural problems with the uterus or fallopian tubes, problems with sperm quality or motility, and hormonal factors ( Figure 1 ). About 25% of the time, infertility is caused by more than one factor, and in about 10% of cases infertility is unexplained. Infertility estimates, however do not account for LGBTQ or single individuals who may also need fertility assistance for family building. Therefore, there are varied reasons that may prompt individuals to seek fertility care.
What is iatrogenic infertility?
Iatrogenic, or medically induced, infertility refers to when a person becomes infertile due to a medical procedure done to treat another problem, most often chemotherapy or radiation for cancer. In these situations, persons of reproductive age may desire future fertility, and may opt to freeze their eggs or sperm (cryopreservation) for later use. The American Society for Reproductive Medicine ( ASRM) encourages clinicians to inform patients about fertility preservation options prior to undergoing treatment likely to cause iatrogenic infertility.
Does Medicaid cover fertility?
Fifteen states require some private insurers to cover some fertility treatment, but significant gaps in coverage remain. Only one state Medicaid program covers any fertility treatment, and no Medicaid program covers artificial insemination or in-vitro fertilization.
Do I need fertility assistance to have children?
Many people require fertility assistance to have children. This could either be due to a diagnosis of infertility, or because they are in a same-sex relationship or single and desire children. While there are several forms of fertility assistance, many services are out of reach for most people because of cost. Fertility treatments are expensive and often are not covered by insurance. While some private insurance plans cover diagnostic services, there is very little coverage for treatment services such as IUI and IVF, which are more expensive. Most people who use fertility services must pay out of pocket, with costs often reaching thousands of dollars. Very few states require private insurance plans to cover infertility services and only one state requires coverage under Medicaid, the health coverage program for low-income people. This widens the gap for low-income people, even when they have health coverage. This brief examines how access to fertility services, both diagnostic and treatment, varies across the U.S., based on state regulations, insurance type, income level and patient demographics.
Is fertility treatment covered by insurance?
Many fertility treatments are not considered “medically necessary” by insurance companies, so they are not typically covered by private insurance plans or Medicaid programs . When coverage is available, certain types of fertility services (e.g., testing) are more likely to be covered than others (e.g., IVF).
Does insurance cover IVF?
Four states with insurer mandates do not cover IVF. Eleven states do, but with a dollar limit on coverage (e.g., $15,000 lifetime max in AR and $100,000 in MD and RI) or a limit on the number of cycles they will cover (e.g., one cycle of IVF in HI and three cycles in NY).