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Your IVF coverage summary
In vitro fertilization (IVF)
Covered
Your plan includes coverage for IVF cycles including egg retrieval, fertilization, embryo transfer, and associated monitoring visits. Genetic testing (PGT-A) requires separate authorization.
Lifetime max
$25,000
Cycles covered
3 lifetime
Prior auth
Required
Fertility medications
Partial coverage
Injectable gonadotropins and oral medications are covered at 70% after deductible through specialty pharmacy. Some medications require step therapy — contact your benefits team to confirm your formulary.
Coverage
70% after deductible
Annual max
$5,000 Rx
Step therapy
May apply
Intrauterine insemination (IUI)
Covered
IUI procedures including semen analysis, preparation, and insemination are covered. Monitoring ultrasounds and bloodwork are billed separately under diagnostic benefits.
Attempts covered
6 per year
Cost per cycle
~$50–$200 copay
Prior auth
Not required
Egg & embryo freezing
Verify with plan
Elective egg freezing coverage varies. Embryo cryopreservation as part of an IVF cycle may be covered under your IVF benefit. Annual storage fees are typically not covered.
Cryo during IVF
Likely covered
Elective freezing
Verify needed
Annual storage
Not covered

Your prior authorization checklist

  • Medical necessity documentation from your OB-GYN
  • 12-month history of unprotected intercourse (or 6 months if over 35)
  •  
    Semen analysis results from your partner (if applicable)
  •  
    Ovarian reserve testing: AMH, AFC, Day 3 FSH
  •  
    HSG or saline sonogram confirming tubal patency
  •  
    Referral letter from your PCP or OB-GYN to REI