The following services are covered up to a $30,000 total lifetime benefit maximum*:
- Artificial insemination / intrauterine insemination under medical supervision
- Advanced reproductive technologies:
- In-Vitro Fertilization
- Reciprocal IVF is covered if the patient receiving treatment is an eligible member and is enrolled in the program with WINFertility
- Frozen Embryo Transfer
- Cryopreservation for the following:
- Blastocysts(s) and embryo(s) from covered IVF cycles. Covered blastocyst and embryo storage is limited to one year.
- All frozen embryos stored after a completed cycle with ovarian stimulation must be utilized prior to coverage availability for another ovarian stimulation cycle. Embryo transfer guidelines per the American Society of Reproductive Medicine should be followed for all embryo transfers (fresh and frozen cycles) and elective single embryo transfer should be utilized when clinically appropriate
- Medically necessary diagnostic workup and radiology services
- Pathology and laboratory services, including:
- Hormonal assays
- Swimup semen analysis, as appropriate
- Ultrasound exams
- Ova identification
- Fertilization and embryo culture
- Embryo, gamete-zygote transfer
- Preimplantation Genetic Diagnosis* and Preimplantation Genetic Screening
- Medications necessary for the procedures above, including parenteral injection and oral ovulation induction drugs.
* Preimplantation Genetic Diagnosis may be covered under your Medical Plan.