How do I find out if I have coverage for infertility care?
Call the Member Services number on the back of your insurance card. Member services can also tell you if you have a specific provider network.
Is precertification needed for infertility treatment?
Yes. Infertility providers are responsible for treatment authorizations. If you are doing treatment with an infertility specialist and change practices, inform the National Infertility Unit so that the unit can issue treatment authorization.
If you have questions on copays, deductibles, claims or appeals call the Member Services telephone number on the back of your insurance card.
If I do have coverage for infertility care, what do I do next?
You need to register with the National infertility Unit (NIU) once there is a plan for infertility treatment using ovulation induction with injectable infertility medications, artificial insemination, or assisted reproductive technology (ART).
You do not need to register with NIU to see a physician to determine why you are having trouble getting pregnant, or to start oral medicated timed intercourse cycles.
How do I register with the National Infertility Unit?
Log in to your secure website and complete the registration form.
You or your doctor can fax the completed form to us at 1-860-607-7476. An infertility staff member will review the form and contact your doctor’s office to let them know if you meet initial criteria to start using your infertility treatment benefits.
Who works in the National Infertility Unit?
The National Infertility Unit (NIU) has an experienced staff of nurses and care coordinators. Staff assists members and providers to help them through the infertility process.
How do I find out if my infertility medications are covered under my insurance and benefits plan?
We’re here to answer your questions. If your pharmacy benefit is through Aetna, give us a call at 1-866-782-2779.
How do I find an infertility specialist?
If you need help finding an in-network infertility doctor, use our directory. Search for a “Reproductive Endocrinologist” in your area. Aetna has an Institute of Excellence (IOE) infertility network, which is a limited network of providers that offer high-quality, high-value infertility care.
Search for infertility doctors
Where can I learn more about assisted reproductive technology?
Watch a short video about assisted reproductive technology (ART) procedures.
Can a family member access my infertility care information for me?
Due to Health Insurance Portability and Accountability Act (HIPAA), we need your verbal or written permission to speak with anyone other than you about your care. This includes partners or family members calling for you. Release forms are available on your secure member website or by calling the Member Services number on your insurance card.
Where should I go for more information on infertility coverage?
Check your employer’s plan document for information on your infertility coverage. You can also read our Clinical Policy Bulletin on infertility. Clinical policy bulletins are not a guarantee of coverage. They provide information on the services and procedures we consider medically necessary, cosmetic, or experimental and unproven.
Aetna’s Clinical Policy Bulletin on Infertility (CPB) #0327
Where can I get more information if I am pregnant?
If you are registered in the National Infertility Unit, your physician should let us know when you become pregnant. If your plan includes the Beginning Right Maternity program, contact them at 1-800-272-3531. They can answer questions and assist you to have a healthy pregnancy.
What if I am not infertile, but my doctor suggests In Vitro Fertilization (IVF) to freeze my eggs before undergoing cancer treatment?
If your doctor recommends IVF to freeze eggs prior to cancer treatment, log in and complete the infertility registration form. You or your doctor can fax the form to 1-860-607-7476. We will review your plan to see if there is coverage for assisted reproductive technology when you have a cancer diagnosis. If you do have coverage, we will contact your doctor for any medical information needed by your plan.
What if I am not infertile, but my partner or I are carriers of a genetic condition that could affect my baby?
Log in and fill out the registration form (you can use the link above). Fax it to 1-860-607-7476. We will review your plan to see if there is coverage for pre-implantation genetic diagnosis (PGD). If you do have coverage, we will contact your doctor for any medical information needed by your plan.
Compliance with the federal parity law is the responsibility of self funded plan sponsors and Aetna cannot provide legal advice in this regard. Plan sponsors should seek their own separate counsel for legal guidance on application of the federal parity requirements. Coventry Plans, including those managed by MHNet are in process of migrating to Aetna as a result of Aetna’s 2013 acquisition of Coventry. Aetna’s interpretation and approach to federal parity compliance will apply to those Plans as they migrate to Aetna operational platforms. Any questions about Aetna's approach to Federal Mental Health Parity may be referred to your Aetna sales or account representative.
