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Changes in fertility health insurance in 2016

fertility insurance changes 2016

Welcome to the new insurance benefits year! If you're receiving or planning on receiving treatment related to fertility, insurance is something you need to keep up to date on, as benefits and policies do change from year to year. Here are several things you should know and plan for ahead of time with regard to health insurance:

  1. If you have a Blue Cross Blue Shield PPO policy from the Insurance Marketplace, it may no longer be available after 12/31/2015. Blue Cross Blue Shield representatives have notified us that they will not be renewing several of the previously available plans. While you may be able to obtain a different Blue Cross policy, it may or may not provide fertility treatment benefits. In addition, your new policy may require referrals and/or authorizations. You must contact your plan provider immediately if you have not received any paperwork outlining the changes to you!
  2. If you have an annual deductible, it will renew as of the first of January. Even if you just finished paying off your 2015 deductible, you will still be financially responsible for the new amount. In addition to renewing, it may have increased. Please contact your plan representative if you don’t want to be surprised with a large bill later.
  3. Pay attention to changes to your copay and occurrence fees. Even though your policy may have stayed the same, your copay or occurrence fee (fee for each visit to a medical office, with or without seeing your doctor) may have doubled.
  4. Your coinsurance responsibility may have increased, going from 100% coverage to 80% or less, meaning more money out of your pocket.
  5. Your referral/authorization requirements may have changed. Whereas before, you could go to any doctor, you may now be required to first obtain a referral to see a specialist or enroll in a special program. Not following your plan guidelines may lead to your claims being denied.

All of these surprises can easily be avoided by reviewing your plan documents or contacting your insurance provider directly. You may also speak to your human resources department (if your policy is through your employer) or your agent (if your policy is bought through an agent).

To see a fertility specialist who can help you answer your questions about fertility health insurance, make an appointment at one of InVia’s four Chicago area fertility clinics.


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Victoria Mostov

Victoria Mostov

Victoria Mostov received her BA in Psychology from UCLA in 2002. Upon completion of her undergraduate degree, Victoria received her MBA from the prestigious Kellstadt School of Business at DePaul University. She has 14 years of experience working in health care management and has been with Invia Fertility

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