Financial and Insurance Information
Fertility treatment coverage

Because insurance plans vary in coverage, the Center’s billing representatives can assist the patient in understanding the insurance coverage for their individual treatment. If your insurance plan does not appear on this list, call us at the number below.

Participating Insurance Companies

INSURANCE COVERAGE

Because insurance plans vary in coverage, the Center’s billing representatives can assist the patient in understanding the insurance coverage for their individual treatment. If your insurance plan does not appear on this list, call us at the number below.

INSURANCE COMPANIES WE PARTICIPATE WITH AS OF 06/17

(IN ALPHABETICAL ORDER)

  • AETNA PPO, POS, QPOS, Elect Choice, Open Access (not HMO)
    -Patients MUST CALL 800-575-5999 to REGISTER with: THE INFERTILITY PROGRAM and OBTAIN REFERRAL
  • BlueCross and BlueShield of Maryland
    -[Point of Service (POS) MUST HAVE REFERRAL]
  • BlueCross and BlueShield Preferred Provider
  • Blue Choice – NEEDS REFERRAL UNLESS OPEN ACCESS
  • Blue Choice – Healthy Blue
  • Carefirst Administrators – University of Maryland Medical Stystems; UM St. Joseph Medical Center
  • Cigna – Open Access Plans ; PPO ; HMO
  • Coventry (HMO & PPO Plans) Diamond/Medical Assistance Plans NOT ACCEPTED
  • Employer Health Programs (EHP) *JHH may not be covered here, JHU is okay… MUST CALL EHP TO GET AUTH NUMBER FOR CONSULTATION
  • First Health Network/ Coventry National Plan
  • Great West Health Plan
  • Humana Group Health
  • Integrated Health Plan
  • Kaiser
  • Lifebridge
  • MAMSI, Optimum Choice, Alliance (now OneNet) -NEEDS REFERRAL & PREAUTH
  • Medstar Select – Accepted with out-of-network benefits
  • MultiPlan
  • NCAS
  • National Provider Network (NPN)
  • Principal Health Care (PPO Only)
  • Private Health Care Systems (PHCS)
  • USA Health Network
  • United Healthcare (Community Plan not accepted/MCO); MDIPA – need authorization and referral
  • Tricare

FOR CONSULTATION

Aetna: SOME REQUIRE REFERRAL (PATIENTS MUST CALL 800-575-5999 to REGISTER WITH THE INFERTILITY PROGRAM AND OBTAIN REFERRAL) Billing Department (410) 296-6132

*We do not participate with Managed Care Organization Plan – Amerigroup; Maryland Physicians Care; Medstar Family Choice; Reiverside Health of Maryland; Jai Medical Systems; Medicare; MedicAid; John Hopkins Advantage Plan PPO*

Affording your Infertility

IVF, ICSI AND DONOR EGG 100% PATIENT REFUND PROGRAM

We offer a 100% patient refund program for IVF, ICSI and donor egg. This program includes up to six treatments cycles of either IVF, ICSI or donor egg. If you do not have a livebirth during this time, you will receive a 100% refund which you can use to pursue other family building options.

GLOBAL IUI, DONOR SPERM INSEMINATION, IVF, ICSI, EMBRYO THAWING AND DONOR EGG PACKAGES

We offer affordable IUI, Donor sperm insemination, IVF, ICSI, embryo thawing and donor egg packages for all age groups. Our global packages include all of the fertility center charges from the beginning of the ovarian stimulation to the day of the insemination or embryo transfer. The packages exclude medications, outside labs, lab work before and after treatment, and egg donor compensation.

For more information about these global packages, please do not hesitate to call our office at 410-296-6132.

IVF COVERAGE IS MANDATED BY MARYLAND LAW

The in vitro fertilization (IVF) program at the Fertility Center of Maryland follows the guidelines established by the American Society for Reproductive Medicine. In Maryland, there is a law that mandates benefits for IVF. Regretfully, not all insurance companies are required to follow this mandate. Some companies have several medical prerequisites or limitations. For example, many companies will not cover tubal blockage or vasectomy due to previous sterilization or cycles done with donated eggs or sperm. House Bill No. 1484 mandates insurance coverage for patients with “out of state” policies who live and work in Maryland. You are entitled to obtain a copy of these two bills from your State Legislator.

IVF Patient Refund Program

Many couples pursuing IVF do not have adequate insurance coverage. Our IVF Patient Refund Program offers couples with no insurance coverage up to six fresh attempts to have a baby through in vitro fertilization without the worry of exhausting their financial resources. If you do not have a livebirth during this time, you will receive a 100% refund which you can use to pursue other family building options. We offer this program as an alternative financial option on a strictly voluntary basis.The concept of a Patient Refund Program for IVF was carefully reviewed by the American Society for Reproductive Medicine (ASRM)**. They found that with the appropriate informed consent this type of program is ethical and provides great benefit to patients without health insurance coverage for IVF.** The Ethics Committee of the ASRM. Shared-risk or refund programs in assisted reproduction. Fertility and Sterility 2004; 82, S249-S250.

How does this program work?

If you decide to participate with the program, you may do up to six complete IVF cycles (in addition to cryopreservation and later transfer of the embryos from those six cycles) for a fee of $20,000. If you need ICSI, the fee for the program is $22,000. When you have a livebirth, our Center has earned the fee. If after all of these attempts you have not had a livebirth, 100% of the $20,000 or $22,000 is returned to you.

The program works because if you do not have a livebirth, we assume the cost and refund the money. In contrast, couples achieving a pregnancy on the first attempt will pay more with this program than other traditional payment methods.

Which patients are eligible for this program?

Couples who undergo full medical screening and are determined to be good candidates for IVF/ICSI by our medical staff. The female partner must be less than 39 years old upon completion of all the IVF cycles. We estimate that it will take 18 months to complete six IVF cycles and related embryo thawing cycles. Therefore, the female partner will need to be 37½ years old or younger at the beginning of the program. Medical screening must be normal including: cycle day 3 FSH and estradiol levels, normal endometrial cavity and endometrial biopsy. Previous records, including prior IVF cycles are also considered.

What is included in the fee?

All medical and laboratory services at the Fertility Center of Maryland up to six complete IVF cycles from the beginning of the medications that stimulate egg production through the initial blood pregnancy test.
The cost of a “mock embryo transfer” done before the stimulation starts.
The cost of cryopreservation (freezing) of viable embryos not transferred during the fresh cycle.
The cost of embryo transfer cycles using those cryopreserved embryos until you have a baby or you choose to withdraw from the program.

A complete IVF cycle is considered one in which an embryo(s) developed and is (are) transferred or frozen. If the cycle is canceled by the physician, if no eggs are retrieved or no embryos develop, it does not count as one of the six cycles. If there was no transfer and the embryos are frozen, it will count as one completed cycle. If you become pregnant but have a miscarriage, a stillborn or an ectopic pregnancy it is considered as one of the six cycles.

What is excluded?

  • IVF screening tests prior to the initiation of medications for you and your partner, such as hysterosalpingogram, endometrial biopsy, semen analysis and cultures.
  • All medications.
  • Laboratory tests sent to outside laboratories.
  • Anesthesia fee.
  • Costs associated with complications, hospitalizations or non-IVF surgery, like D&C for miscarriage or laparoscopy for tubal pregnancy.
  • Urologist fees which may be necessary for procedures, like testicular biopsy.
  • Donor sperm fees.
  • Frozen embryo or sperm storage fees for embryos or sperm remaining after completion or withdrawal from our program.
  • Acupuncture.
  • Blood work and ultrasound(s) done for early pregnancy monitoring after your initial pregnancy test.
  • Donor egg and gestational carrier cycles.

Can we withdraw before the six cycles?

You have the right to withdraw from the program at any time. If you withdraw or the female partner turns 39 prior to the sixth stimulation cycle, we will charge you $3,000 for every completed IVF cycle, $3,500 for every completed ICSI cycle, $1000 for embryo freezing if you have embryos in storage and $750 for every embryo thawing cycle done prior to your withdrawal. The remaining balance will be refunded to you. If you withdraw from the Medication Program, $1,800 will be deducted for the medication used for each IVF, ICSI or egg donation cycle.

Can I become ineligible for the Program after I start?

We reserve the right to withdraw you from the Patient Refund Program if very rare events occur. These may include, but are not limited to, an unexpectedly poor ovarian response to stimulation, failure to fertilize normally, even with ICSI, or failure to develop embryos. In this rare event, you will get 100% of the refund from one or both programs back regardless of how many cycles you have already completed.

IS THERE FINANCING AVAILABLE FOR FERTILITY TREATMENT?

We accept Visa and Master Card. In addition, you can get financing for treatment and medications as well as other IVF packages through Advanced Reproductive Care, Inc. (ARC), the largest network for fertility financing.

IS THERE FINANCING AVAILABLE FOR FERTILITY TREATMENT?

We accept Visa and Master Card. In addition, you can get financing for treatment and medications as well as other IVF packages through Advanced Reproductive Care, Inc. (ARC), the largest network for fertility financing.

FAQ’s from our billing department

How do I know if infertility is covered by my insurance?

You need to call your insurance company and verify the benefits being covered under your plan.

What are the questions I have to ask when calling my insurance company?

1. Do I have coverage for infertility diagnostic testing and treatment?
2. Do I need a referral or authorization?
3. Do I have a co-pay?
4. Do I need to register for infertility coverage?
5. Is there a pre-existing condition or a waiting period for infertility in my policy?
6. At what percent is my coverage?
7. Do I have a maximum amount on my infertility coverage?

Do I have a co-pay with each visit?

If there is a co-pay with your insurance most likely there is a co-pay with each visit. Co-pays are due at time of service. The front of most insurance cards indicates if co-pays are required for specialist visits.

Is there financing available?

We accept Visa and Master Card. In addition, you can get financing for treatment and medications as well as other IVF packages through Advanced Reproductive Care, Inc. (ARC), the largest network for fertility financing.

What benefits do JHH and JHU employees have with FCM?

Johns Hopkins Hospital employees must have services performed at JHH. Johns Hopkins University employees may have services performed at FCM. Benefits depend on your insurance contract.

Does my insurance cover tubal reversal?

State of Maryland employees get 1 reversal per lifetime. A reversal is considered elective surgery. Our doctors offer a discounted fee for self-pay patients, but there will be hospital and anesthesia charges as well.

Does insurance cover same-sex partners or single women?

There are plans that will cover your treatment needs. Call your insurance company to check. We have found that more insurance companies are implementing contracts to include infertility services for same sex partners and single women. However, we suggest you contact your insurance carrier to verify coverage for those services.

What is the "Global Package Fee" for IVF and what does it include?

It is a discounted fee for patients without insurance coverage for IVF. It includes visits, ultrasound monitoring, blood hormone levels performed at our center, egg retrieval and assisted hatching. The global fee covers treatment from the beginning of the ovarian stimulation until embryo transfer. It also includes embryo freezing and storage for one year. It excludes ICSI, medications, screening tests, anesthesia and outside laboratory services.

How does your Global Package compare with other centers?

Our prices are competitive. Keep in mind that this is a high tech treatment with numerous visits and that increases the costs. We encourage patients to call and compare cost and success rates with other centers. In addition, be sure to ask for the pregnancy rates for your age group and diagnosis. It is really important to understand the success rates when comparing costs. Always look at an IVF cycle in conjunction with a thaw cycle when looking at success rates. Certainly, for more information about our center, we would love for you to schedule an appointment or come to one of our seminars and take advantage of the free consultation for attending the seminar.

Can I receive financial information from the Fertility Center of Maryland without being a current patient?

Absolutely! Our passion and goal is “helping childless couples become parents.” We understand the emotional impact of struggling with infertility, especially as it relates to financial concerns. As much as we would like you to be a patient with us, we understand that is not always possible. If providing you financial information helps you have a child, even without our direct help, we have done our job!