Insurance FAQ's

What can I expect if SRM contracts with my insurance company?
Insurance coverage for the services SRM provides is a complicated issue. For example, while SRM may contract with a particular insurance company, the individual’s plan may NOT cover infertility diagnostics and treatment.

Depending on the situation, diagnostic evaluation, gynecological, reproductive endocrinology and non-infertility issues MAY be covered by the insurance company. This applies to surgical procedures as well. For an idea of the kind of services we provide, please click here.

Our financial counselors can help assist you in determining your coverage if you have any questions.

What can I expect if SRM does not “take my insurance”?
Conversely, in a situation where SRM does not contract with an individual's particular insurance provider, the lack of infertility coverage would require the patient to pay for services regardless of which infertility specialist chosen.

In other words, if you go to a provider who is “covered” by your insurance, your out-of-pocket expense may not differ because anything related to infertility may not be covered anyway. There are very few insurance companies that have infertility benefits.

Because of this, we recommend that you choose your care based on where you think you will get the BEST possible care, not who you think will be covered.

Our financial counselors can help you determine your benefits, if any.

What does Out-of-Network Coverage mean?
This does not necessarily mean you do not have ANY coverage at all!

In some cases, SRM may not be a contracted provider for your insurance. As many plans allow for "out-of-network" coverage, you may find that you have some level of coverage at SRM even though we do not have a contract directly with your plan.

In these cases, we do not bill insurance directly. We will provide you with an insurance form showing all applicable information required for you to obtain reimbursement. All you need to do is send this form to your insurance company, provided your coverage includes benefits for the type of care we provided.

How much you will be reimbursed depends on many factors and can vary widely, even with the same insurance company, as it can vary based on your particular employer who negotiated the contract with the insurance company.

Because of its complexity, we highly recommend that you work with our financial counselors to first determine the level of coverage your insurance company provides and then evaluate your options. SRM offers several unique ways to fund your infertility/gynecological treatment when you are out-of-network that may make treatment at SRM more affordable than thought possible.

Revised June 12, 2008