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Infertility Insurance Coverage in Fairfield County

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As you go through fertility treatments, you may be surprised to see how quickly the costs can add up. Procedures and fertility medications can be expensive, and many times, more than one course or cycle is necessary.

In order to help pay for some of the cost, many couples look to their insurance companies. There are 15 states that currently have mandates in place that require insurance companies to offer infertility insurance coverage or to cover the treatments. Fortunately for Fairfield County residents, Connecticut is one of the states that has an infertility insurance mandate in place.

Infertility Insurance Inclusions and Exemptions in Connecticut

Connecticut’s infertility insurance law can be found in the Connecticut General Statutes. The law requires health insurance companies to provide coverage for medically necessary treatments or diagnostics related to infertility.

Under this law, infertility is defined as the inability to conceive after one year of trying to become pregnant. The treatments covered include ovulation induction, IUI, IVF, uterine embryo lavage, embryo transfer, GIFT, ZIFT, and low tubal embryo transfer.

There are certain stipulations for the infertility insurance law. Only couples who have covered under the plan for at least one year are eligible. The covered individual must be under 40, and the treatments must conform to the guidelines by the ASRM or SREI.

Also, there are limitations on the number of procedures covered under the policy. There is a lifetime maximum coverage of four cycles of ovulation induction, three cycles of IUI, and two cycles of IVF, GIFT, ZIFT, or low tubal embryo transfer, with not more than two embryo transfers per cycle.

The infertility insurance law was amended in 2005 to provide an exemption for coverage that goes against the religious beliefs of an employer or individual.

Before you begin your fertility treatments, it is a good idea to talk directly with a representative from your insurance plan so you can know definitively what will and will not be covered.