Infertility Care
UBMD OBGYN

We are happy to share that UBMD OBGYN has reached out to provide educational resources regarding infertility insurance coverage, surrogacy, legal services to facilitate your family building journey.

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Insurance coverage

Understand the extent of insurance coverage for financial transparency  

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Surrogacy 

Legal guideline for intended parents looking to incorporate a surrogate into family building 

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LGBTQI+

Learn more about common legal

practices to ensure equitable guardianship for same sex parents

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FAQs 

Frequently asked questions and supportive resources can be found here

Fertility insurance coverage 

If you receive health insurance through a large-group market (businesses with 100+ employees) and you have been diagnosed with infertility, you are eligible for IVF and Fertility Preservation. Coverage includes single women and same sex partners though male couples may have greater difficulty obtaining coverage given the legal definition of infertility.  

What does this cover?

  • Up to 3 IVF cycles (fresh embryo transfer or frozen embryo transfer) over a member’s lifetime 

  • Medically necessary fertility preservation treatments (egg/sperm freezing and storage) for people facing iatrogenic infertility (caused by intervention such as radiation, medication, surgery, and/or other medical treatment). 

  • Every policy that provides for prescription drug coverage shall also include drugs (approved by the FDA) for use in the diagnosis and treatment of infertility 

4-point Checklist for Determining Insurance Coverage

Step 1: Obtain a copy of your evidence of coverage or certificate of insurance. You probably have a copy of the summary of benefits for your health insurance plan, but that may not be sufficient to find the information you will need to determine what your policy covers for fertility. You can ask for a full copy of your evidence of coverage from your employer’s human resources (HR) department or by calling your insurance company. If you already have a copy of this document, make sure it’s the latest version because they change frequently.

Step 2: Look for the sections within your insurance policy that address coverage, exclusions, and medication. Frustratingly, each insurance carrier and each insurance policy is a little different, so there is no single place you can look to find your coverage for fertility. Usually, you’ll find what is covered under the sections on coverage; however, you should also specifically check the portion of your policy that lists what is excluded. In both parts, look for words like fertility, infertility, in vitro fertilization (IVF), intrauterine insemination (IUI), artificial insemination, genetic screening, genetic testing, and semen analysis. Read carefully to see if limits exist. Those might include, but might not be limited to, the patient’s age, the number of IVF cycles covered, or the required order of treatment (for example, a certain number of IUIs before IVF will be covered). It’s also a good idea to check and see if telehealth appointments are covered by your insurance policy. In addition, check the section detailing your medication coverage. It might also be called prescription coverage. Look for what the policy says about medications needed for fertility treatment coverage. Are only certain drugs covered? Does this policy require that you use a specific pharmacy?

Step 3: Ask for help. Insurance policies can be confusing. There are three main places to ask for help in understanding your insurance coverage for fertility: Your employer’s human resources department, your fertility clinic or the insurance company itself. Most employers, depending on their size, have someone designated in human resources to answer questions about employee benefits. Most fertility clinics also have someone on staff who is knowledgeable about insurance coverage. While both your employer and your fertility clinic can be helpful, your insurance company will be the best resource for understanding their policy. When calling your insurance carrier, ask to speak with someone in member services. Have your policy number and employee number ready. Pro Tip: When speaking with an insurance representative, take notes and make sure to include the date and the name of the person with whom you spoke. Follow up and get any important information on coverage in writing from the insurance company.

Step 4: Ask for a letter of predetermination of benefits. Before you start fertility treatment, ask your insurance company to send you a letter of predetermination of benefits. (It may have a slightly different title, depending on your insurance carrier.) Your fertility clinic may ask for this letter on your behalf, but you should have a copy for your records as well. Don’t be intimidated by your insurance policy. Make a list of what you need to do to determine your insurance coverage for fertility and start checking it off to get one step closer to having the family you want.

If you don’t have coverage… 

  • Check to see if your fertility specialist’s (or reproductive endocrinologist’s) practice offers cost-savings or financial programs 

  • Look into how you can lower your out-of-pocket costs 

  • Set up a meeting with your employer’s benefits coordinator or HR representative to discuss fertility treatment coverage and request changes to your plan 

 

 Surrogacy is an option for a variety of reasons, particularly for single individuals looking to start a family and LGBTQI+ couples. 

Guide to Surrogacy

Step 3:  Arrange for a Surrogate/Gestational Carrier medical workup 

  • Surrogate/Gestational Carrier will need medical releases from PCP, OBGYN, and other specialists they may see 

  • Pre-conception labs 

  • Saline infusion sonogram 

  • Mock cycle to understand how her uterine lining develops in response to estrogen  

Step 4:  Decide who’s eggs & sperm you will use  

Egg

  • Yours: you will need to complete FDA infectious disease testing within 30 days of retrieval to ensure the safety of your carrier (bloodwork, urinalysis) 

  • Donor: these eggs are pre-screened, may be ordered from an Egg Bank  

Sperm

  • Yours: you will need to complete FDA infectious disease testing within 30 days of retrieval to ensure the safety of your carrier (bloodwork, urinalysis) 

  • Donor: these eggs are pre-screened, may be ordered from an Egg Bank  

Testings a surrogate may go through  

  • In-person interview 

  • Psychological testing & evaluation 

  • Medical records evaluation 

  • Infectious disease screening 

  • Criminal background check  

Step 2:  Find a Surrogate/Gestational Carrier 

Gestational Carrier

Gestational surrogacy is when a woman carries a baby for intended parents that she shares no DNA with – her eggs are not used – an embryo is transferred into her uterus. 

  • Your attorney may find a surrogate/gestational carrier for you or you may independently identify a surrogate/gestational carrier  

  • In the event that either yourself or a surrogate/gestational carrier would like to keep identifying information confidential, your attorney may facilitate discussions between parties to ensure everyone feels more comfortable and secure with the process 

  • Agencies

  • New York Surrogacy Center 

  • ConceiveAbilities 

  • Los Angeles Surrogacy 

Surrogate

Typically become pregnant through artificial insemination, and have a genetic connection to the child or children they carry for their intended parents. 

 

Surrogacy

Step 1: Contact a Reproductive Law Attorney 

 

Common Legal Practices for Same Sex Parenting

We understand that there can be unease over how a non-biological parent would be able to obtain legal guardianship when it comes to same sex parenting. Here are some legal practices that provide information on your rights. 

Pre-Birth Order (PBO)

A court proceeding that establishes parental rights prior to the birth of the child. These are only available in certain states (including New York State). In other states, it may be possible to obtain a post-birth order.  

Voluntary Acknowledgement of Paternity

Allows a birth mother to designate a father, sometimes without the need for a court proceeding 

 

Custody Order

 Grants custody of a child to the intended parent(s). 

 

Second-Parent Adoption

Permanently establishes the non-biological parent’s rights to the child. It’s advisable to obtain a second-parent adoption. Even when it is possible to obtain a pre-birth order or a post-birth order, parents should know that not all states recognize parentage conferred in this way. By contrast, adoptions are recognized nationwide.   

Wills and Estate Planning

Ensures that guardianship of the child is provided in the death of one or both parents. When a couple lives in a state or country where same-sex marriage isn’t legal, it becomes even more important to establish these documents.  

Frequently asked questions

What specific diagnostic tests and procedures do group policies need to cover?

  • Post coital tests

  • Testis biopsy

  • Semen analysis

  • Blood tests

  • Ultrasound

  • Hysterosalpingogram

  • Hysteroscopy

  • Endometrial biopsy

  • Laparoscopy

  • Sono-hysterogram

  • Federally funded insurances (Medicaid, Medicare)

  • Self-funded health plans (employers who self-insure)

  • Employees of companies in individual and small group markets (fewer than 100 employees)

  • Excludes coverage of GIFT, ZIFT, reversal of elective sterilization, sex change procedures, cloning, or experimental procedures

What are exceptions to NYS Mandated Coverage?

Does fertility preservation cover egg and/or embryo storage?

  • Egg and/or embryo storage is covered if it is considered medically necessary until the 3 cycles of IVF are complete.

Any recommendations on supportive resources?

  • Fertility Out Loud: How to deal​

Navigating fertility challenges is already hard. Dealing with people's insensitive comments makes it harder. This online resource offers tips and advice from the community on how to handle hurtful remarks.