The Firm covers fertility services for employees and dependents enrolled in the Firm’s Medical Plan through Cigna or UnitedHealthcare up to the $75,000 family-building lifetime maximum. You do not need to have a diagnosis of infertility to be covered. The benefit covers medical and prescription drug expenses and includes a variety of fertility treatments, including IVF, egg- and sperm-freezing (storage covered for 12 months).
After meeting your annual medical deductible, Cigna and UHC cover up to 80% of the cost of in-network fertility-related care. Additionally,
- Cigna covers 60% of the reasonable and customary cost of care provided by out-of-network providers after your annual deductible is met.
- UHC requires members to enroll in the UHC Fertility Solutions program and receive fertility treatment at a UHC center of Excellence to receive coverage. The program will help you maximize your fertility benefit and select effective treatment options.
Note: Members are responsible for paying their deductible and coinsurance for all fertility claims; these out-of-pocket costs are not eligible for reimbursement through the family building benefit and will not be applied toward the lifetime maximum.
UHC Fertility Solutions Program
Upon enrolling in the program, you will have access to care from a specialized fertility Center of Excellence. These Centers of Excellence provide best-in-class care from world-class practitioners. Clinics meet best-practice criteria based on pregnancy and delivery outcomes, which increases the likelihood of getting pregnant and lowers the likelihood of twins or triplets. Additionally, an experienced fertility nurse will help you make informed decisions about your health care and answer your questions throughout your fertility treatment.
If you are enrolled in the Firm’s health plan through UHC, you are required to use a Center of Excellence for all fertility treatments for your treatments to be covered by the plan. Any fertility services obtained at a facility that is not a UHC center of excellence or by an out-of-network provider will not be covered by the plan, and the participant will be required to pay the full cost of treatment.
To identify a UHC Center of Excellence, call UHC’s Fertility Solutions team at 1-866-774-4626.
For more information, refer to the Health Benefits and Insurances Summary Plan Description.