Care Affordability
Affording Care
About 10% of American couples experience infertility. The average cost of an IVF cycle in the US is $12,400. Ohio IVF costs mirror the national average. At Ohio Reproductive Medicine we understand that dealing with the costs of infertility care can be perplexing.
Fortunately, Ohio residents may find some relief in the new Ohio law that became effective on October 12, 2016.
This new law mandates health insurance coverage for basic health care services, when medically necessary. By definition, basic health care services include preventive health services, which are defined specifically to include voluntary family planning services, and infertility services. Infertility services are defined as “diagnostic and exploratory procedures to correct medically diagnosed diseases of the reproductive organs, including but not limited to:
- Endometriosis
- Clogged or collapsed fallopian tubes
- Testicular failure
Thus, Ohio residents are entitled to health insurance coverage for the conditions listed above. That means that procedures used to diagnose infertility may be covered. Your initial consultation may also be covered. Procedures to correct medically diagnosed diseases of the reproductive system may be covered. Many procedures fall into a gray zone, including IVF, which leaves much to interpretation and denial of claims. Our staff can provide codes for your treatment to help you determine your exact benefits.
Note also that employers who self-insure and large companies are exempt from the requirements of this law.
Insurance companies have specific guidelines. They are obligated to provide you with this information but you must ask. Ohio Reproductive Medicine suggests that patients call their health insurance company and ask the following questions:
- Do I have coverage for fertility treatment?
- Do I need a referral from my primary care doctor or prior authorization before contacting Ohio Reproductive Medicine?
- Is there a lifetime maximum for fertility treatment?
- If yes, what is the amount?
- Does this amount include fertility medications?
- If yes, what is the amount?
- Am I covered for fertility drugs?
- If I am covered, do I need prior authorization?
- If so, how do I get prior authorization?
- Is there a lifetime maximum for fertility drugs?
- Do I have to use only pharmacies that participate with my insurance plan?
- If I am covered, do I need prior authorization?
- Does my plan include coverage for artificial insemination (IUI)?
- If IUI is a covered service, do I need prior authorization for this procedure?
- Does my plan include coverage for other assisted reproductive technologies like IVF?
- If IVF is a covered service, do I need prior authorization for this procedure?
Insurance Coverage
Financial Questions
Many families have the same questions about infertility treatment services and Ohio Reproductive Medicine’s history. The following questions are the ones we’re most frequently asked.
How much does treatment cost?
The costs for infertility treatments vary widely, depending upon the chosen treatment plan.
Will my medical insurance cover infertility treatment?
Insurance plans and benefits differ. Ask your insurance provider about the level of infertility treatment covered by your plan.
What other financial matters should I be considering?
Look for financing terms that offer flexibility and meet your specific needs. Financial options, such as a refund program, a discount program, and options that cover medication costs, may be available.
Fertility Financing & Grants
If your insurance does not cover infertility treatments
If you’re facing the financial challenges of affording fertility treatment, please know that you’re not alone—and your situation is far from hopeless. On this page, you’ll find a collection of resources that have helped other patients in similar circumstances access the care they needed.
We understand that even with some level of insurance coverage, unexpected costs—like certain medications or uncovered procedures—can still create a heavy financial burden. That’s why we’ve gathered a range of financial assistance options that may be relevant to you, whether your insurance covers none, some, or only specific aspects of your fertility treatment.
Being informed about all your options can help you feel more empowered to make decisions that align with your goals and move forward with the care that’s right for you.
CapexMD
CapexMD specializes in patient financing services for all fertility treatment options. The vast majority of our Loan Specialists have gone through the IVF journey.
Through our partnership with CapexMD, we can offer customized loan programs with highly competitive rates that include various loan types. Their simple loan process makes the experience of fertility financing relatively stress-free.
Their loan programs cover all fertility treatment options — including fertility medications and genetic testing if necessary — so you can be sure that none of your expenses are left uncovered.
Once approved, our financial counselors will work closely with their Fertility Loan Specialists to ensure your funds are secured on time, and your treatment is not delayed.
Together with CapexMD, we can make sure financial issues do not get in the way of your dream of having a baby.
Some of CapexMD’s many advantages include the following:
- Specialist in Fertility Financing
- Highly Competitive Rates
- Approval within 24 Hours
- Highest Confidentiality
- No Prepayment Penalties
- Personal Attention
- Easy and Secure Online Application
- Flexible Terms
- No Annual Fees
- Retain Your Existing Credit Sources
Apply online and receive your pre-approval within 24 hours. Learn more about CapexMD by visiting their site or by calling 1-888-497-8414.
ReUnite Rx Medication Discounts
ReUnite Rx works with drug manufacturers to bring improved service and affordability to its patient members. ReUnite Rx’s network of pharmacies work with every fertility clinic in the United States to improve the patient experience.
ReUnite Rx has discount medication programs, including ReUnite Assist (financial need-based program), ReUnite Assist for Veterans, ReUnite Oncofertility (fertility preservation for cancer patients), and many other programs.
Reunite Assist eligibility qualifications:
- Non-insured prescriptions (100% cash pay)
- Current proof of income (1040 tax document)
- Only available at participating ReUnite Rx pharmacies
- Discount expires one year from the date issued
- It cannot be combined with other discount programs
ReUnite Assist for Veterans
- DD214 form
ReUnite Oncofertility
- Self-pay patient (no fertility drug benefits)
- Female patients requiring cancer treatments affecting their fertility
- No prior chemotherapy
- Completed patient application form and oncologist form
- Current proof of income (1040 tax document)
For more information, visit www.ReUniteRx.com
WIN FertilityRx
Self-pay patients up to 40% savings on fertility medications.
Program Details:
- Medication BundlesSM delivers up to 40% savings on your total prescription.
- Financing options to help you pay for your medications over time
- FertilityCoachSM Nurses are available 24/7
- Medication Fertility Order Review to ensure you know what to do with your meds and how to store them.
- Available to all patients with a valid US physician prescription. No coupons, forms, cards or special financial criteria to participate.
- FREE Express Shipping in the 50 United States.
- 24-Hour, Next-Day Delivery* Sunday deliveries are not available
For eligibility information, program details, and enrollment form, Call 877-952-LIFE (5433) or visit www.WINFertilityRx.com or call 855-678-3255
EMD Serono: Compassionate Care Program
The Compassionate Care Program is designed to provide income-eligible patients with savings on EMD Serono fertility medications. Patients who demonstrate financial need and have a valid prescription may qualify for 50% to 75% off the self-pay price of EMD Serono fertility medications or $10 off per unit after completing a mail-in rebate. Eligibility is based on qualifying annual household gross income and first-time participation in the Compassionate Care Program.
Contact: For eligibility information, program details and requirements, and enrollment form, please visit www.EMDSeronoCompassionateCare.com or call 1-855-541-5926
EMD Serono: Compassionate Corps Program
The Compassionate Corps Program is a program for eligible, uninsured veterans suffering from infertility due to a service-related injury or whose spouse is suffering from infertility due to their service. This program allows them to receive free fertility medicine manufactured by EMD Serono. The Compassionate Corps Program is available for up to 2 cycles per year. Patients must reapply each year.
Qualifications: patients must be a retired member of the military or the spouse of one; be a veteran or the spouse of a veteran who is infertile due to a service-related injury, not privately insured for infertility medications and medically retired; and have been diagnosed by a physician as infertile and requiring IVF/ART. Those U.S. military veteran patients who do not qualify for the Compassionate Corps Program and do not have insurance for fertility medications are encouraged to apply for EMD Serono’s Compassionate Care Program in which they will now receive an automatic discount of 25% off the self-pay price of EMD Serono fertility medicines. These patients can also qualify for 50 to 75% off of EMD Serono fertility medications if they meet the financial and other eligibility criteria of EMD Serono’s Compassionate Care Program. Contact: visit www.CompassionateCorps.com or call 1-866-538-7879.
Gaia Family Financing
Gaia helps you move forward with a clear plan and financial protection. With unlimited embryo transfers, discounted medication, and another retrieval if things don’t go to plan, Gaia maximizes your chances of success while providing 1:1 support every step of the way.
With a single fixed price and the flexibility to pay monthly or upfront, Gaia manages all your bills so you can focus on what matters most.
Learn more: gaiafamily.com
Ferring Pharmaceuticals: IVF Greenlight
IVF Greenlight is a patient savings program offered by Ferring Pharmaceuticals to make fertility treatment more affordable for cash paying patients. The program offers savings on human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), progesterone, and human chorionic gonadotropin (hCG) products. Eligible patients will receive a 50% discount on BRAVELLE and 15% discount on MENOPUR, NOVAREL, and ENDOMETRIN. IVF Greenlight is available to all cash pay patients, irrespective of income. There are no financial criteria to qualify or income verification documents to complete.
Qualifications: No financial eligibility criteria – Cash pay patients need a valid prescription for at least 10 vials of Bravelle and 10 vials of Menopur. Information: For eligibility information, program details, and enrollment form, visit www.ivfgreenlight.com.
Ferring Pharmaceuticals: Heart for Heroes Program
This program offers select fertility products to eligible infertile veterans and their spouses at no cost through MDR Pharmaceutical Care. A physician certifies the veteran’s eligibility on the medication order form and sends it to MDR. The medication is shipped directly to the veteran and his/her spouse.
Qualifications: Medically separated from active duty; Department of Defense Category 2 or 3 veteran; the service related injury resulted in infertility requiring assisted reproduction; must be a resident of the U.S.; patient and/or spouse has no insurance for IVF medications. Contact Information: For eligibility and program details, contact MDR Pharmaceutical Care at 1-800-515-DRUG (3784) or www.heartforheroes.org.
Baby Quest Foundation Grants
Awarded two times yearly. Provides a dollar range of $2,000-$16,000 (a combination of money and medications). Open to all genders, singles, same sex couples, all who are permanent residents of the U.S., etc. Baby Quest funds a range of procedures including egg and sperm donation, egg freezing, artificial insemination, in vitro fertilization, embryo donation, and gestational surrogacy. Applications fees apply – $50 Application fee. Contact: Visit www.babyquestfoundation.org for more information about Baby Quest’s grant or email [email protected]
The Tinina Q. Cade Foundation
This grant is offered twice per year – Once in the spring and once in the fall. Provides up to $10,000 per funded family to help with costs of medical infertility treatments and domestic adoption. Open to all; applicants must have a diagnosis of infertility from their doctor and be legal, permanent U.S. residents. Applications fees apply- $50 Application fee. Contact: www.cadefoundation.org
Footprints of Angels
Footprints of Angels is a nonprofit organization supporting women impacted by recurrent miscarriages and infertility. Gift funds can be used to pay for the following: infertility medications, supplies, and treatment from any reproductive endocrinology practice of the recipient’s choice, including in-vitro fertilization, oocyte vitrification (egg freezing), embryo cryopreservation (embryo freezing), and third party reproduction. Requirements for the Scholarship: Applicants MUST be citizens or legal residents of the United States and have a diagnosis of infertility certified by a medical provider. Applicants who are single, or part of a same sex couple, are eligible to submit applications.
Contact Information: Visit www.footprintsofangels.org for more information about Footprints for Angels or email [email protected]
The Hope for Fertility Foundation National Grant
There are up to two grant cycles per year. Dates of cycles can be found on the website. Multiple grants may be awarded per grant cycle, depending on available funds. Grants are up to $5,000. Grant may not be applied to medications or travel expenses. The grant is available to couples who are married, are legal residents of the United States, and have been officially diagnosed with infertility by a medical professional. Applications fees apply – $50 Application fee.
Contact information: Visit www.hopeforfertility.org for more information about The Hope for Fertility National Grant or email [email protected].
Pay it Forward Fertility Foundation – Fertility Grant
The grant applies only to in vitro fertilization treatment (IVF), IVF with donor eggs, and embryo adoption. Grant amounts vary among the grant recipients, and partial and full grants can be awarded. The age limit for the female partner is under 40 years old unless using donor eggs or doing embryo adoption. The application states that the female patient must be under the age of 40 when starting an IVF cycle. Applicants must be United States (U.S.) citizens or permanent U.S. residents. Application Fee: $50 donation fee for processing application. Contact Information: Visit www.payitforwardfertility.org for more information on how to apply. Email: [email protected]
Worth the Wait Charity Grant
Worth the Wait is a national charity that helps cancer survivors with fertility grants.
Learn more: worththewaitcharity.com
Our Military Discount
At Ohio Reproductive Medicine, we are incredibly grateful for those who serve our country. Our dedication to helping veterans build loving families extends beyond special holidays and is a daily commitment – 365 days a year.
We offer a Military Program that discounts infertility treatments to individuals and spouses of the U.S. Armed Forces, Reserves, veterans, and retirees. We strive to make this program accessible to all military community members, including active-duty military members. We want to ensure that those who have served our country have access to the care and support they deserve.
This program offers 10% off the cost of treatments for IVF, and Donor Egg IVF.
