IVF and Fertility Insurance Coverage

How Oma works with your insurance provider

While Oma does not directly accept fertility insurance, we make every effort possible to help our families get the most out of their insurance benefits. Families pay Oma directly for their treatment and we courtesy bill your insurance provider to help you get reimbursed for as much as your policy will allow. It is important to note that Oma does not courtesy bill for medication.

What is Courtesy Billing?

A courtesy bill is a claim submitted by Oma to your insurance provider after you have self-paid for your treatment so your insurer can reimburse you directly.

Finding your state’s fertility coverage regulations:

Insurance coverage of fertility services varies state-by-state. If you currently have employer-sponsored insurance, the size of your employer will determine how much they are legally required to cover.

Many fertility treatments are not considered “medically necessary” by insurance companies, so they are not typically covered by private insurance plans or Medicaid programs.

A handful of states require coverage of fertility services for some fully-insured private plans, which are regulated by the state. You can check online to see what your state regulations are here.

How to choose fertility insurance if your current plan is not enough:

If you don’t have fertility insurance or feel your current fertility coverage is not adequate, you might want to consider other insurance plans available. Some key things to look for in a fertility insurance plan include:

• Treatments offered: Which fertility treatments and elements of treatment (medication for example) are included in the plan?
• Providers in-network: You’ll want to check whether Oma works with or is in-network with different insurers in order to maximize your benefits.
• Rounds covered: Is there a maximum number of IVF rounds the insurance policy or provider will cover?
• Co-pays, limits, and deductibles: Like any health insurance plan, you’ll want to understand each plan’s co-pays, maximum out-of-pocket limits and deductibles.