Insurance Coverage / Self-Pay Overviews

RHS is contracted with most plan products from UPMC, Highmark, Aetna, United Healthcare, and Cigna.  The information below will assist you in reviewing the potential financial responsibility at various points during IVF treatment whether you are self-pay or you have insurance coverage.  You may also use our Insurance Benefits Worksheet and Medication Coverage Worksheet to assist you in gathering information for different treatment options.

Insurance Coverage

 Verify coverage:  
Both you and the financial office will verify coverage to find out if coverage has limits including:
Set amount of attempts – If so, determine how many, if any are remaining
Dollar limit – determine the remaining balance available
Medication – determine if it is included in your dollar limit or if you have separate medication benefit.
Cost Sheets:   You will be given cost sheets for pre-ivf testing & IVF cycle
ASC fee –UPMC / UHC/ Cigna – You will owe a $1,000 fee.  BCBS / Aetna – Will be billed to insurance company
Cryo Deposit – If not covered by insurance, you will owe a cryo preservation deposit in the amount of $1,650
Other- May also owe anything not covered by insurance company – examples:  sperm thaw, assisted hatching.
 Pre-testing – 
May be billable to insurance. You will be responsible for non-par or non- covered charges as well as any co-pays, co-insurance, and/or deductibles
 
Pre-Art Appointment – you will discuss Final Costs:
What is billable to insurance and what you may owe at injection class
That you may be billed for co-pays and co-insurance
That if you meet your maximum insurance coverage you will owe 100% of the charges billed
 
Authorization:  RHS gets authorization for cycle, if needed
 Injection class:
You must pay in full for charges which are not covered by your insurance (Excluding co-pays, co-insurance, or deductibles which may be due later)
 

Self-Pay No Insurance Coverage

Cost Sheets:  You will be given information and cost sheets relating to pre-testing and any/all programs.  Cost of individual IVF cycle:  $12,250 – $14,000 – depending on treatment plan*
Additional Available Programs (if eligible):
  Fee for Service Discount  (for multiple cycles)
          Multi-cycle (2 cycles + FETs)
          Shared Risk / 100% Refund (4 cycles + FETs)
          
Pre-Testing:  
Pre-testing may be billable to your insurance.  
You will be responsible for non-par or non-covered charges as well as any co-pays, co-insurance, and/or deductibles.
Pre-art Appointment:
You will meet with an RHS Financial Coordinator and will be given final costs for programs you are eligible for and the amount that is due on the day of injection classes
Injection Class
         Full payment for your IVF cycle as well as anything not covered by your insurance coverage is    
         due on the day of your injection class
Contract Completion:
With all of our IVF programs, once you have a live birth the contract is ended.

*All prices provided are based on current pricing available. Please check with your financial counselor to verify that no pricing changes have occurred.
In order to ensure current and accurate insurance coverage,
RHS recommends that you contact your insurance carrier directly

Patient Payment & Financial Responsibility Agreement