Family Building Benefits
Employees and covered dependents who are enrolled in the Medical Plan have access to Family Building Benefits which includes the guidance and support of WINFertility.
Family Building Benefits can provide up to $35,000 for medical procedures and $15,000 for prescription drugs. These are lifetime limits, meaning once this limit is reached, no additional benefits will be available under the Plan. To unlock access to the higher Family Building Benefits medical lifetime limit of $35,000, you must enroll with WINFertility and complete a nurse consultation. If these steps are not completed with WINFertility, a reduced medical lifetime limit of $10,000 applies (rather than $35,000).
Covered treatment includes but is not limited to:
- Fertility treatments such as in vitro fertilization (IVF) and intrauterine insemination (IUI), whether or not you have a medical diagnosis of infertility
- Elective fertility preservation (egg, sperm, or embryo freezing with 12 months of storage)
- Associated prescription medications (There is a separate $15,000/lifetime prescription drug benefit).
Contact WINFertility at (833) 439-1517. Monday - Friday 9:00 a.m. - 9:00 p.m. Eastern time. Medical benefits (e.g., provider network, claims administration) will continue to be managed by your healthcare company — Aetna or Cigna. Prescription drug benefits are managed by CVS Caremark.
This lifetime limit does not apply to the services used to determine the initial diagnosis of infertility and/or its cause. All procedures and access will be governed by the healthcare company's clinical policies for determining appropriateness of care. Please also see the "Infertility Drugs" information under "What's Covered and Not Covered" for information on a $15,000* lifetime maximum on prescription drugs related to infertility treatment. Please contact your healthcare company for specific details.
Please Note:
- To receive benefits for Family Building services, you must contact your healthcare company and receive precertification before obtaining services.
- To have access to the $35,000 medical lifetime maximum you must enroll with WINFertility and complete a nurse consultation
* The lifetime maximum for prescription drugs under the Family Building Benefit includes the charges paid by the plan. Your prescription drug out-of-pocket expenses (dollars you pay towards the copayment and costs for non-covered drugs) are not included in the either the Medical or prescription drug plan lifetime maximum.