Insurance Coverage

Participating Insurances

RMANJ participates in several leading insurance plans, including Aetna, AmeriHealth, Cigna, Great West, Horizon Blue Cross/Blue Shield, Oxford, QualCare, and United Health Care. If you have an out of state BCBS plan that falls under Blue Card, RMANJ may be considered participating. Because coverage and authorization requirements vary, we recommend that you contact your insurance or an RMANJ Financial Coordinator before embarking on infertility treatment.

If RMANJ does not participate in your health plan, you may still be eligible for coverage for a percentage of the costs of certain treatments as an out-of-network benefit through your own insurance plan. If you have a non-participating insurance company, RMANJ will require payment upfront for all services. Payment will be expected at the time of service for all non-IVF services and 2 weeks prior to the start of your cycle for IVF.

We will submit claims on your behalf and request that insurance reimburse you directly. RMANJ accepts several forms of payment: credit card, check, cash or FFP loan programs. Most POS and PPO plans allow you the flexibility of seeking medical care out-of-network. The following is an example of an out-of-network plan.

Please note that this is only an example. For information that is specific to your plan, please contact your insurance company directly.

HEALTH OPTIONS PPO PLAN - IN NETWORK PPO PLAN - OUT OF NETWORK

Calendar Year Deductible

None

$250 amount per individual $500 amount per family

Calendar Year Out of Pocket Maximum

Dollar amount deductible per individual

$250 deductible

80% of reasonable and customary charges up to $2,000 out of pocket then 100% for the remaining 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:

Cost: $ 10,010.00*
Deductible: $250.00
Coinsurance: $1,793.00

The estimated insurance reimbursement to you for cycle = $7,265.00

* Estimated IVF Cycle cost does not include ICSI, Assisted Hatching, or Medications.

** Remember that your insurance company will reimburse you using their reasonable and customary rates. For example, if your insurance pays 80% for out of network services and we charge $50 but the insurance r&c rate is $40, they will reimburse you at 80% of the $40 amount, not our full fee.

Prices may be subject to change without notice.