Non Participating Insurances
Most Point of Service plans allow you the flexibility to choose at
the "point of service" to seek medical care out of network. If you have
out of network benefits, please see below:
Step One
- Confirm that your plan has both out of network and infertility
benefits.
- Payment is required at the time of service and prior to the
start of any treatment cycle. Please call your RMA of New York
Billing Coordinator to discuss financial payment options: credit
card, check, cash, wire transfers, or loan programs.
Step Two
| |
Health Options |
PPO Plans |
| |
In Network
|
Out of Network
|
| Calendar Year Deductible |
None |
$250.00 amount per individual $500.00
amount per family |
| Calendar Year Out of Pocket Maximum |
Dollar Amount Deductible Per Individual |
$250.00 deductible 80% of Reasonable and Customary Charges*
up to $2,000.00 Out Of Pocket, then 100% for the remainder of
the calendar year. |
| Outpatient Doctor Visit |
100% After $10 co-pay |
80% of reasonable charges after deductible |
Using the above example and applying to a typical
IVF cycle, the
following is an approximate cost:
Estimated Cost for IVF
Cycle |
$ 9,215.00 (1) |
LESS: Est. Deductible |
$ 250.00 |
Coinsurance (20%) |
$ 1,800.00 |
Estimated insurance reimbursement to you for
a typical IVF Cycle |
$ 7,165.00 |
* Your insurance company determines reasonable and customary charges.
For better reimbursement, you can submit a pre-determination letter that
includes the breakdown of fees and CPT codes to your carrier.
(1) Estimated IVF Cycle cost does not include
ICSI,
Embryo Storage, PGD,
Medications, or services rendered prior to the start of your
IVF cycle or after the first pregnancy test.
|