Robert Howe M.D.,P.C.
281 Maple Street, East Longmeadow, MA 01028
Tel: (413) 525 - 5160 / Fax: (413) 525 – 5170
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Do You Have Insurance Coverage for Infertility Treatments?

Contacting Your Insurer – Before calling your insurance company, HMO or employer, have this information:

________________________________________Name of the insured individual
________________________________________Employee/Patient ID# or Social Security #
________________________________________Name of the employer
________________________________________Name of the plan
________________________________________Group code/number
________________________________________Patient’s name and date of birth

Be sure to get the name of the person to whom you are speaking and his or her telephone and extension numbers and possibly confirmation # or letter to verify information given.

Questions for your employer (Human Resources or Benefit Representative)

• Are fertility treatments covered on my current health plan?

• Is there another plan that has infertility coverage?

• Are there restrictions to the infertility benefits?

• What is the waiting period before I can start treatment for pre-existing infertility conditions?

Questions for your insurance company

• Do I need a referral for the initial appointment with the doctor and/or referrals for treatment appointments after the initial appointment?
  
  • What are my infertility benefits?
  
  • What is excluded?
  
  • Is there any age restriction? If so, what is it?
  
  • What do the benefits cover?
  ________ Diagnostic Procedures?
  ________ Treatment Procedures?
  ________ Drug Therapy?
  
  • Which of the following are covered?
  ________ Blood work: Progesterone, Estrogen, FSH, LH, TSH, HCG, Rubella, Cystic Fibrosis and
                 Prolactin levels?
  ________ Semen Analysis?
  ________ Post-coital test?
  ________ Endometrial Biopsy?
  ________ Ultrasound?
  ________ HSG (hysterosalpingogram)

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