Navigating your insurance benefits at IVF FLORIDA is an important step in your fertility journey. Understanding your coverage can help minimize out-of-pocket expenses and streamline your treatment process. This guide provides an overview of how to effectively navigate your insurance benefits and highlights common insurance codes related to fertility treatments.
Understanding your coverage
Initial consultation and treatment coverage: IVF FLORIDA patients often have insurance coverage for their initial consultation, and many have some coverage for infertility treatment.
Review your benefits summary: Obtain a copy of your benefits summary from your employer to understand what is covered under your plan. Be aware that benefits and out-of-pocket expenses can change annually.
Flexible spending accounts (FSA): Consider utilizing an FSA or Health Savings Account (HSA) to cover medical expenses not paid by insurance, such as deductibles, co-pays, and treatments not covered.
Verifying your benefits
Contact your HR department: If infertility coverage isn't listed in your benefits summary, reach out to your Human Resources department or benefits coordinator for clarification. They can provide detailed information about your specific plan.
Consult IVF FLORIDA Financial Educators: IVF FLORIDA's Financial Educators are available to explain treatment costs and help maximize your insurance benefits before starting therapy.
Gaining coverage
Employer-sponsored plans: Employers may offer plans that include infertility benefits. Discuss available options with your HR department.
Common insurance codes for fertility treatments
Familiarizing yourself with common insurance codes can facilitate discussions with your insurance provider and help ensure accurate billing. Here are some frequently used codes:
In vitro fertilization (IVF) procedures:
58970: Follicle puncture for oocyte retrieval
58974: Intrauterine embryo transfer
89250: Culture of oocyte(s)/embryo(s), less than 4 days
89254: Oocyte identification from follicular fluid
89268: Insemination of oocytes
89272: Extended culture of oocyte(s)/embryo(s), 4-7 days
Artificial insemination (AI) and intrauterine insemination (IUI):
89251: Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture
89255: Preparation of embryo for transfer
89258: Cryopreservation; embryo
89261: Sperm isolation; complex prep (e.g., Percoll gradient, albumin gradient) for insemination or diagnosis
These codes are based on the Current Procedural Terminology (CPT) system and are used for billing and insurance purposes. Discussing these codes with your provider and insurance company can help clarify coverage specifics. This list is regularly updated, and other codes could be billed for your treatment plan. Please speak with your Financial Educator for more information. This list is not a comprehensive list of all codes that may be billed but can serve as a helpful guide.
Additional tips
Pre-authorization: Some insurance plans require pre-authorization for certain fertility treatments. Ensure all necessary approvals are obtained before starting treatment to avoid unexpected expenses.
Keep detailed records: Maintain copies of all communications with your insurance company, including pre-authorizations, denials, and appeals.
Appeals process: If a claim is denied, don't hesitate to appeal. Provide additional documentation and work closely with your healthcare provider to support your case.
By proactively managing your insurance benefits and understanding the associated codes, you can navigate the financial aspects of your fertility treatment more effectively. For personalized assistance, contact IVF FLORIDA's Financial Educators who are ready to help you through this process.
A recent CBS Miami segment sheds light on a growing trend: more women over 40 are giving birth than teenagers, a shift fueled by personal choice, career planning, and advances in fertility care. IVF FLORIDA’s own Dr. Marcelo J. Barrionuevo, a board-certified reproductive endocrinologist, was featured in the story, offering key insight on why more individuals are delaying parenthood and how fertility care supports those choices. He emphasizes the importance of early fertility education and planning, empowering individuals to take control of their reproductive futures. Watch the full segment to hear Dr. Barrionuevo’s insights and learn more about the changing landscape of parenthood.
IVF FLORIDA supports the recent correspondence from the Fertility Providers Alliance (FPA) to the President in response to the February Executive Order on IVF. We support the recommendations for agency action and proposed legislation in four categories: Protecting Access to IVF; Increasing Awareness of IVF; Increasing Access to IVF; and Increasing Affordability of IVF. The full letter from the FPA is pasted below:
By email President Donald J. Trump 1600 Pennsylvania Avenue NW Washington DC 20500
Re: Executive Order: Expanding Access to In Vitro Fertilization
Dear President Trump,
On behalf of the Fertility Providers Alliance (FPA), an organization committed to supporting fertility care providers, enhancing patient care, and helping patients build their own families, we are writing to provide enthusiastic support for the recent Executive Order: Expanding Access to In Vitro Fertilization (the “IVF EO”).
FPA Wishes to be a Resource to the Domestic Policy Council
We commend your Administration's interest in this issue and agree whole-heartedly with the President’s statements in the IVF EO that Americans need reliable, affordable access to IVF. We support the Administration in its goal to provide support, awareness, and access to affordable fertility treatments and are eager to collaborate with you to develop and ensure the successful implementation of policies that will achieve those goals.
The US currently has the best IVF success rates in the world because of our current access to care and technology. That is due to many factors but primarily because of the favorable regulatory climate. We look forward to working with the Administration on policies that build on this success.
As an initial matter, we would respectfully suggest the following policy goals for your consideration:
Protecting Access to IVF
Agency Action – Health and Human Services FPA suggests that you require the Secretary of the Department of Health and Human Services to, consistent with applicable law, take all appropriate actions to promote access to infertility treatment, including IVF, and standard fertility preservation services, including by issuing regulatory and sub- regulatory actions, which may involve the following laws, programs, issues, or documents:
Medicare or Medicaid conditions of participation or conditions for coverage (i.e., requiring IVF treatment and services to be part of each state’s Medicaid coverage).
Promulgate regulatory and sub-regulatory guidance specifically stating that physician consultation in connection with infertility treatment and fertility preservation may be performed via telemedicine.
Update Affordable Care Act Essential Health Benefits (EHB) requirements to include fertility services by defining the existing EHB for maternity and newborn care to include infertility treatment, including IVF, and standard fertility preservation services.
Remove any regulatory prohibition on issuers (i.e., insurance companies that issue plans available on the ACA marketplace) and allow states to add infertility treatment, including IVF, and standard fertility preservation services as an EHB by updating their EHB-benchmark plans.
Revise EHB prescription drug benefit requirements to include medications associated with infertility treatment and fertility preservation.
Agency Action – Tort Reform FPA suggests that you require the Department of Justice to convene State Governors and Attorneys General to coordinate efforts and develop tort reform initiatives to discourage or eliminate fertility services-specific causes of action that are duplicative of existing state law causes of action (such as those for personal injury, professional liability, and negligence).
Recommended Legislation – Right of Access to Fertility Treatments FPA suggests that you encourage Congress to introduce and enact legislation that provides a statutory right to access infertility treatment, including IVF, and standard fertility preservation services.
Recommended Legislation - ERISA FPA suggests that you encourage Congress to introduce and enact legislation that requires private insurers that cover obstetrical services to also cover infertility treatment, including IVF, and standard fertility preservation services.
Increasing Awareness of IVF
Agency Action – Health and Human Services FPA suggests that you require the Secretary of the Department of Health and Human Services to develop and publish resources on the topic of infertility treatment, including IVF, and fertility preservation, such as developing a “Featured Topic Site” on the HHS website.
Increasing Access to IVF
Agency Action – Health and Human Services FPA suggests that you encourage Congress to introduce and enact legislation to address the growing need for reproductive endocrinologists (REIs) and embryologists through creation of a health workforce grant program at the Health Resources and Services Administration (HRSA).
Agency Action – Health and Human Services FPA suggests that you encourage the Congress to introduce and enact legislation to incentivize and support the creation of new residency tracks to train REIs and embryologists at academic medical centers and universities nationwide, especially those that commit to sending health professionals to practice at least part time in under-and-unserved areas.
Increasing Affordability of IVF
Agency Action – Department of Defense FPA suggests that you require the Department of Defense to review the scope of TRICARE coverage for infertility treatment, including IVF, and standard fertility preservation services, and to direct TRICARE to provide reimbursement for infertility treatment, including IVF, and standard fertility preservation services. Currently, TRICARE only covers IVF services when they are provided within a limited number of Military Treatment Facilities.1 FPA urges you to require the Department of Defense to expand coverage for IVF services to include services provided outside of an MTF, and to amend the TRICARE provider handbook to include infertility treatment, including IVF, and standard fertility preservation services for covered persons, their partners and third-party donors (if applicable).
Agency Action – Department of Health and Human Services FPA suggests that you require the Department of Health and Human Services to review the scope of coverage for infertility treatment, including IVF, and standard fertility preservation services under the Medicare and in particular the Medicaid program, and to direct CMS to provide coverage for infertility treatment, including IVF, and standard fertility preservation services under Medicare and Medicaid.
Agency Action – Office of Personnel Management FPA suggests that you require the Director of the Office of Personnel Management to include provisions in the Federal Employee Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) programs call letter for the 2026 Plan Year specifying that eligible carriers, including the Foreign Service Benefit Plan, to provide coverage for infertility treatment, including IVF, and standard fertility preservation services to covered persons, partners and third-party donors (if applicable).
Agency Action – Secretary of Veterans Affairs FPA suggests that you direct the Secretary of Veterans Affairs to provide coverage for infertility treatment, including IVF, and standard fertility preservation services to covered persons, partners and third-party donors (if applicable).
Recommended Legislation – Internal Revenue Service FPA suggests that you encourage Congress to introduce and enact legislation to amend the Internal Revenue Code of 1986 to establish a tax credit for in vitro fertilization expenses. We also suggest that you encourage Congress to amend the Internal Revenue Code of 1986 to establish a tax credit for assisted reproductive technology expenses up to $20,000 and to expand eligibility for health savings accounts and increase the current contribution limits.
Millions of Americans have used fertility services, including IVF, to build their families. We appreciate the President and this administration’s highlighting the importance of these services, and in particular appreciate your work in developing policy initiatives to support access, awareness and affordability of infertility treatment, including IVF, and standard fertility preservation services.
On behalf of healthcare providers dedicated to helping Americans achieve their dreams of parenthood, we thank you for your leadership and commitment to expanding access to fertility treatments.
Members of our Board of Directors would appreciate an opportunity to discuss these policies with the leadership of the Domestic Policy Council. We can be reached through our Executive Director, Ross Weber, at (847)-264-5924 and ross@wjweiser.com to identify a time to meet in Washington or in a venue of the Domestic Policy Council’s choice.
1 IVF Services are provided only at the following Military Treatment Facilities: Fort Sam Brooke Army Medical Center (San Antonio, TX); Tripler Army Medical Center (Honolulu, HI); Walter Reed National Military Medical Center (Bethesda, MD); Womack Army Medical Center (Ft. Bragg, NC); Naval Medical Center (San Diego, CA); and Madigan Army Medical Center (Tacoma, WA).
When dealing with Polycystic Ovary Syndrome (PCOS), it can be challenging to conceive due to hormonal imbalances that disrupt the menstrual cycle and ovulation. However, a healthy and balanced diet can help those struggling to manage their symptoms.
Here are some key aspects of nutrition to consider:
Balancing Blood Sugar Levels: Focus on a low-glycemic diet that includes complex carbohydrates like whole grains, legumes, and vegetables to stabilize blood sugar levels and reduce insulin resistance.
Choose Healthy Fats:Incorporate healthy fats, like those found in avocados, nuts, seeds, and fatty fish, into your diet. These fats can help regulate hormones and support a healthy reproductive system.
Protein is Key: Include lean protein sources like poultry, fish, tofu, and beans to maintain muscle mass and stabilize blood sugar levels.
Fiber-Rich Foods: Fiber helps regulate digestion and can aid in managing weight. Opt for high-fiber foods like fruits, vegetables, and whole grains to support overall health and weight management.
Adequate Micronutrients: Ensure you're getting enough essential vitamins and minerals, especially folic acid, which is crucial for fetal development. Consider taking a prenatal vitamin to fill any nutritional gaps.
IVF Florida is proud to recommend Luminary Vitamins and Theralogix as both products are independently and third party verified and offer high-quality, evidence-based nutritional supplements to support patients along their fertility journeys.
Limit Processed Foods and Sugars: Highly processed foods and sugary snacks can exacerbate insulin resistance and hormonal imbalances. Minimize their consumption to support your PCOS management and fertility goals.
Hydration: Stay well-hydrated by drinking plenty of water. Proper hydration is essential for overall health and can aid in managing PCOS symptoms.
Portion Control: Be mindful of portion sizes to help with weight management, which is often a key factor in improving fertility for women with PCOS.
Lifestyle Tips for Enhancing Fertility with PCOS
In addition to dietary changes, consider these lifestyle tips to further improve your fertility when dealing with PCOS:
Regular Exercise: Engage in regular physical activity to help manage weight, reduce stress, and enhance insulin sensitivity. A combination of aerobic exercises and strength training can be beneficial.
Stress Management: High stress levels can worsen PCOS symptoms. Explore relaxation techniques such as yoga, meditation, or deep breathing exercises to manage stress effectively.
Fertility Awareness Checkup: Schedule an appointment with IVF FLORIDA to check your fertility. Our Fertility Awareness Checkup will provide a snapshot of your reproductive potential and fertility health to help you plan for your future or address any conception roadblocks.
Medication and Treatment: Consult with your IVF FLORIDA physician about medications or fertility treatments that may be suitable for your specific situation. These can include ovulation-inducing medications or assisted reproductive technologies like IVF.
Navigating PCOS on the journey to conception can be challenging, but by prioritizing nutrition, lifestyle changes, and professional guidance IVF FLORIDA, you can enhance your chances of getting pregnant. Remember that every individual's experience with PCOS is unique, so consult with your healthcare provider to create a personalized plan that addresses your specific needs and goals. With dedication and the right support, you can achieve your dream of starting or expanding your family.
Infertility comes with many obstacles, and for patients with limited or no infertility benefits, figuring out how to pay for treatment can present added hurdles. It is important to know that individuals and couples seeking fertility care have options, and we’re here to provide tips and resources, so you can make informed decisions -- without the stress.
1 - Evaluate Your Insurance Coverage Navigating your insurance coverage can be a daunting task, but if there was ever a time to go over your coverage with a fine-tooth comb, it’s now. Before you start treatment, review your insurance benefits to see if your plan includes diagnostic testing, consultations, or prescription coverage. If you need help, don’t be afraid to ask! Call your insurance provider for assistance to see what is and isn’t covered.
2- Consider Multiple Cycle Plans Patients going through In Vitro Fertilization sometimes need more than one cycle to achieve a pregnancy. To help patients looking to minimize their costs while increasing their chances of bringing home a baby, IVF FLORIDA offers multi-cycle discount programs through our Fertility Access programs. This will give patients a reduced, set cost for two or more cycles of treatment.
3 - Research Fertility Loans The cost of fertility treatment can be very high, and for some paying out of pocket just isn’t possible. To help cover some or all of the cost of treatment and medication, several companies specialize in medical loans for fertility treatment. These specialized loans offer lower interest rates than traditional loans and credit cards. A good credit score is still a must, and there is an approval process that is typically quick if you have a high credit score. To learn more about available loans and lending partners, visit IVF FLORIDA’s Financing Programs Page.
Whether you decide to pay for your fertility treatment through your insurance plan, the discount programs, financing, or a mix of all of the above, the fertility specialists at IVF Florida have a team of financial counselors available to help with questions. If you are struggling with infertility and would like additional information on our programs, contact us at 954-247-6200.
