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The IVF Fertility Blog

FAFTA: Is IVF Cost Coverage Mandated When You’ve Had Prior Failed Cycles?

Women Holding BabiesEven if you have excellent medical coverage under a large-group insurance provider in New York, there may be a fine-line in determining whether you’re covered for up to three IVF cycles by the newly enacted Fair Access to Fertility Treatment ActFAFTA. Questionable coverage could arise if you’ve undergone previous multiple IVF cycle failures. If your large-group medical insurance carrier did not provide coverage for your past IVF cycle failures, it should be now mandated under FAFTA to pay for up to three cycles.

FAFTA Coverage

A patient who has failed multiple IVF cycles should be covered by their large-group insurance provider under FAFTA – although it is a gray area presently. To ensure that you have the best chance of being covered by your large-group provider for the cost of up to three IVF cycles under the newly enacted FAFTA – our fertility specialists recommend that you:

  • Make an appointment with a fertility specialist and undergo a thorough medical evaluation and diagnostic testing to target the cause of your infertility
  • Obtain a medical diagnosis of your infertility
  • Receive counseling from our in-house financial counselor to review and determine your insurance policy’s coverage
  • Choose a customized infertility treatment plan recommended by your doctor to be optimal for your chance of pregnancy success
  • Your customized infertility treatment plan will then be in the best position to comply with your insurance coverage requirements

It is in your best financial interest to make sure you comply with your medical insurance provider’s coverage guidelines in advance of submitting a claim – not the other way around. Preparing will help you to qualify for the mandated coverage under FAFTA.

We are ready to help you take advantage of New York’s FAFTA law mandating that large-group providers cover the cost of up to three IVF cycles.

FAFTA Mandated IVF and Fertility Preservation Cost Coverage

As a New Yorker, you may now have insurance coverage for the cost of treating infertility through IVF and fertility preservation.

Infertility is defined as not being able to get pregnant after 12 months of unprotected, regular sexual intercourse.

All large-group insurance plans must now cover the cost of egg and sperm freezing – for fertility preservation – in cases where patients have been diagnosed with:

  • Sickle Cell Anemia
  • Cancer
  • Endometriosis

FAFTA is a major accomplishment in making sure New Yorkers have deserved insurance coverage to help them afford the cost of building their families – today – and in the future.

New York’s Large-Group IVF Insurance Coverage Mandate

New Hope Fertility Center accepts Major Health Insurance in the U.S. Our in-house financial and insurance counselors will help you predetermine your coverage.

  • Aetna
  • BlueCross BlueShield
  • Cigna
  • GHI
  • United Health Care
  • Oxford Health Plans

FAFTA Coverage Expertise

It is important to work with a fertility care team having the experience required to design a customized fertility treatment plan meeting your personal medical and financial needs. To schedule your initial consultation with the fertility specialists at New Hope Fertility Center – click the icon below – or call 212.969.7422.

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