Gondra Center is contracted with most major insurance companies, infertility benefits in the state of Arizona are not considered “standard care” causing benefits to vary greatly between carriers and policies. We accept the following insurance companies. If you do not see your insurance carrier listed, please call our office to verify in-network participation.
- Blue Cross Blue Shield
- Great West
- Meritain Health
Declaimer: Each insurance carrier has multiple plan’s, it is the patient’s responsibility to know what their individual plan includes.
You may check to see if your insurance company is contracted with outside labs like LabCorp and Sonora Quest.
For patients with coverage, if you have co-pay, this is what you will pay for office visits. If you have benefits after a deductible has been met, ask your insurance company if you’ve met the deductible. If you have not, you may receive a bill for your visit(s).
You will receive coverage for the initial consultation and any diagnostic testing to determine the cause of infertility. After diagnostic testing, patients become self-pay for treatment.
Diagnostic and Treatment Coverage
Coverage from initial consultation and diagnostic testing through treatment. Treatment coverage varies and may include coverage for intrauterine insemination (IUI) and/or in vitro fertilization (IVF). Medications are not always a covered expense.
From the initial consultation through treatment, all patients without insurance benefits are self-pay.
Once you have determined your infertility benefits, there are some additional questions you should ask your insurance company, including:
- What initial diagnostic testing (i.e. consultation, ultrasound, blood work, HSG, semen analysis) is covered?
- What treatments (i.e. IVF, IUI) are covered?
- Do I have coverage for genetic testing? (i.e. Cystic fibrosis testing, SMA)
- What are my deductible, co-pay, co-insurance and out of pocket maximum amounts?
- Are there any exclusions?
- Is there a yearly or lifetime maximum allowance for infertility treatment?
- Does my insurance require a prior authorization before treatment begins?
- Does my insurance require a referral from my PCP or OB/GYN for treatment?
- Is there a contracted lab (i.e. Sonora Quest, LabCorp) that I must use?
- Are injectable fertility medications covered?
- IF YES, are there specific pharmacies that participate with my plan?
- Is prior authorization required and if so, what is the process for obtaining it?