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Top Three Questions to Ask During your Financial Consultation at a Fertility Clinic

A blog by RMA at Jefferson’s Financial Team, April 27, 2015

Visiting with a financial counselor at a fertility clinic can be a very overwhelming experience. With so many different factors playing a part: insurance coverage, payment options, treatment packages, and the fear of the unknown, there is no wonder your head is spinning. The process can be managed more easily if you know the right questions to ask. Below you will find the top three questions to ask during your financial consult and why they are important to get answered.

What is the difference between a diagnostic cycle and a treatment cycle?
Answer: A diagnostic cycle is used to identify the cause of your infertility. A treatment cycle is used to overcome infertility.
Why is it important to ask?: It is important for you to understand the different cycle types because many insurance policies will cover costs associated with a diagnostic cycle, but not necessarily the cost of a fertility treatment cycle. Knowing what type of cycle you are undergoing will help you determine whether your insurance will cover the cost of treatment or if you will be financially responsible.

Could you please explain deductibles, co-insurance, and co-pays to me?
Answer: A deductible is the amount you pay for health care services before your health insurance begins to pay. Coinsurance is your portion of the costs of a health care service. It is usually a percentage of the total charge for the service. You are responsible for coinsurance after you have met your plan’s deductible. A co-pay is a fixed amount you pay for a health care service, usually when you receive the service. It is determined by your insurance plan.
Why is it important to ask?: Insurance policies are complicated and use a variety of words to describe what you as the patient has to pay out of pocket for services. Understanding the specific terms of your insurance policy increases your knowledge of your financial responsibility and allows you to anticipate your out of pocket expenses.

When is payment due for a treatment cycle?
Answer: Typically, payment is due in full for any services not covered by insurance before the start of treatment. You are “financially cleared” to begin a treatment cycle when all of your coverage options have been investigated and you have been made aware of and met all of your personal financial obligations.
Why is it important to ask?: Knowing your financial obligation and when payment is due will help you plan for your treatment. It is important to note that situations may arise that can change your treatment plan and therefore change your financial responsibility.

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