Laser Vasectomy Cost
New York, along with 14 other states, has infertility insurance coverage laws that might help you if you are seeking medical assistance in order to conceive. Understanding exactly what the law covers and does not cover as well as how to obtain insurance that includes infertility coverage can be difficult. Here I will help you to understand exactly what you must know about this state’s law.
Before we explore what and who is covered under this mandate, you need to know what is not covered. The following procedures are not included and your insurance is not required to cover them:
- in vitro fertilization
- gamete intrafallopian tube transfers
- zygote intrafallopian tube transfers
- reversal of elective sterilizations (vasectomy or tubal ligation)
- sex change procedures
- cloning
- medical or surgical services or procedures that are deemed to be experimental in accordance with clinical guidelines
The thing to remember is that just because these procedures are not mandated to be covered, you still need to read your health care benefits plan to see if your plan excludes them or not. Until you know for sure though, assume that they are not covered. Also, if your employer provides health coverage under a “self-insure” plan, they are not required to follow the state mandate, and do not have to provide any infertility coverage. To find out if your plan is a self-insure plan or not, talk to your human resources manager or call your health care plan’s benefits provider.
Now, lets find out who is covered as well as what is covered under New York’s State Mandate. First, you must be between the ages of twenty-one and forty-four years of age (this is for both men and women). The person covered under the policy must have been covered for at least 12 months under the existing policy or under a previous policy that was converted. So if you have not been covered for at least 12 full consecutive months, the infertility coverage will not be in effect.
The following diagnostic tests, and medical procedures are covered under New York’s State Mandate:
- hysterosalpingogram
- hysteroscopy
- endometrial biopsy
- laparoscopy
- sono-hysterogram
- post coital tests
- testis biopsy
- semen analysis
- blood tests
- ultrasound
- prescription drugs approved by the FDA for use in the treatment of infertility
As you can see, New York’s mandated coverage is not the best possible, but it does cover an extensive number of diagnostic and treatment procedures. New York also has a grant program that is funded by the tobacco control and insurance initiatives pool that provides funding to assist with the expense of infertility procedures that are not covered by insurance. To learn more about this grant program and to find out if you might qualify to have some or all of your expenses for non-covered procedures paid from this grant, you need to contact your reproductive endocrinologist or your fertility clinic.
The current amount that has been set aside for April 1, 2010 through March 31, 2011 is five million dollars. If you do qualify for the above grant program, and your only option of getting pregnant is with IVF, GIFT or some other non-covered procedure, you could find yourself feeling like you won the lottery by having your procedure paid for.
About the Author
Debbi Carter has been researching, advising, and studying infertility causes and treatments and preconception issues for over 11 years on the Trying To Conceive Yahoo support group, as well as through her websites TTC Dreams where she offers information about preconception and infertility, and Introduction to Infertility, which is a free online course about infertility that allows you to learn about the basics of infertility from the comfort of your home at your pace.
