Insurance Agency Questions

Insurance Coverage Questions

Make Sure to Ask Them The Right Questions

  • Is Dr. Esteban Brown listed as a participating provider?
  • Do I need a referral from my PCP?
  • Do I need to preregister with an infertility case management program?
  • Do I have coverage for testing to diagnose the cause of infertility?
  • If yes, what is my co-pay?
  • Do I have coverage for treatment of infertility?
  • Are there age restrictions?
  • If yes, do I have coverage for sonograms related to infertility treatment?
  • Do I have coverage for Artificial Insemination (IUI)?
  • Do I have coverage for In Vitro Fertilization (IVF)?
  • If yes, what is my co-pay?
  • If yes, what is my co-insurance?
  • Explain my benefits (if any) for diagnostic testing for infertility?
  • Are there any age restrictions for infertility treatment?
  • Do we need any type of prior authorization or a referral to see a specialist?
  • Are there plan limitations, such as lifetime maximums or set limits for intrauterine inseminations (IUIs), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI)?
  • Are there any restrictions on frozen embryo transfer cycles?
  • What are the limitation of coverage, if any?
  • Is pre-certification required for IVF?
  • Is pre-certification required for outpatient surgery?
  • What is my annual deductible?
  • What is remaining for the¬†current year?
  • What is my lifetime maximum benefit for infertility?
  • Do I have medication coverage? Is this separate of inclusive of my other benefits?
  • Are donor sperm and/or donor egg covered procedures?
  • Are there genetic testing benefits?
  • Is cryopreservation of embryos covered?
  • Is pre-authorization required for any fertility medication?
  • Is pre-authorization required for treatment procedures performed in the office?
  • Will a previous sterilization procedure affect my insurance coverage?
  • Do I have medication coverage? Is this separate or inclusive of my other limits?
  • Are donor sperm and/or donor egg covered procedures?
  • Are there genetic testing benefits?
  • Can you put these benefits in writing?
  • Do you require a waiting period before I can start treatment?
  • If I have no coverage for an actual procedure, do I have any coverage for related services such as ultrasounds and blood work done for monitoring a cycle?