Welcome to RGI’s new website and to our new blog. We hope you are as excited as we are about the content we will be providing with our valued patient’s needs in mind. This information will help guide you and be a resource for your financial questions, particularly regarding expectations for PGT insurance coverage!
My name is Krissy and I am the Practice Manager at RGI. Having years of experience with RGI, I have seen insurance coverage evolve (or, at times, dissolve) just as quickly as I have seen new technologies and new treatments develop. This makes for the ever-difficult task of patients trying to understand their coverage and how to keep the cost of their IVF/PGT cycles to a reasonable minimum.
Any patient, regardless of their financial status, worries about the cost of treatment, because it is an expensive and stressful endeavor. As rewarding as this process can be for patients, I can imagine that they dread 3 things: the cost, the injections for IVF, and negative results. We hope this blog will make the first one easier!
In the first edition of the blog, we picked a topic that we get asked about often, not only at the end of the year but all year long. “What insurance should I choose for going through IVF/PGT process?” Patients ask us all the time if they should get a specific insurance since RGI is in-network with them. We remind them that we are just one piece of the puzzle. Patients have to keep in mind the overall cost of this whole process. The list below should be taken into consideration while evaluating your options for new insurance.
1) Diagnostics, Medications, and IVF coverage – Speak with your IVF center to get a better understanding of what and how they will bill for these services, as they will work with you directly on this portion.
2) Embryo Biopsy – In most cases, your IVF center will be billing you or your insurance for this service. If they are not able to perform your biopsy, RGI is able to perform this. Depending on the reason for PGT, billing your insurance may be an option for this service.
3) PGT-M, PGT-SR, or PGT-HLA coverage – These services will be to be reviewed by your insurance to see if coverage is available. Even if your policy offers benefits, the specific reason you are doing preimplantation genetic testing may not be covered. Insurance companies look at each case and determine if your history and reason for testing will warrant them paying for these services.
4) Maternity/Delivery coverage – Nothing is more exciting than finding out all the hard work of IVF/PGT has paid off and you are pregnant. We don’t want that excitement to diminish by finding out you need to pay out of pocket for your OB care.
In short, not all coverage is the same. Not all insurance plans are the same. Not all cases are the same. RGI is here to help navigate the process through comprehensive insurance consultations. Please feel free to reach out to me at krissy@rgiscience.com anytime and I would be happy to provide an individualized approach to see if insurance coverage may be available for your case. Our free insurance consults are available to all patients who would like to explore the option of using insurance or to discuss any billing related concerns. We look forward to working one on one with you to make the PGT process as seamless as possible.
Written By: Krissy, Practice Manager
Contact Us for a complimentary insurance consult or learn more about PGT online.
Hello, I have a balanced translocation and I need to do ivf with pgt sr testing to avoid having children with unbalanced translocations as I have one now. My insurance doesn’t cover ivf but I don’t know about testing. I want to submit a claim to inform them this ivf is for medical necessity and not for fertility reasons. What should my doctor bill the insurance for in order to at least partially cover some expenses. Thanks in advance
Once you establish care with our team, you will be able to schedule an insurance consultation to walk you through the options. Coverage varies by insurance provider. In most cases, you should be able to obtain a letter of medical necessity from our genetic counseling team to help with your claim if it is an out of network plan. When in network, we would try to obtain a preauthorization to ensure coverage. Feel free to reach out to our team at info@rgiscience.com