Does the New Healthcare Law Affect Fertility Coverage?

Absolutely! Before the new law passed a few years ago, few patients in California had coverage for fertility TREATMENT. But most patients with insurance could get diagnostic TESTING paid for.

In the last 2 years, many plans have dropped coverage for the testing. This is because they are now required to cover many other basic services for patients including preventative services, birth control and nutrition counseling. It is a trade-off: the health of many versus the specialized needs of a few.

What does this mean for you? It is now more important than ever to see a SPECIALIST who knows which tests are most important and how to get those tests done at the LOWEST cost.

We have always been cost conscious at Advanced Fertility Associates. Now more than ever, that benefits our patients as they must pay a bigger part of their care.

Examples of how insurance coverage doesn’t work:

Cystic Fibrosis Testing: This is the most common genetic mutation that Caucasians carry. Traditional insurance covered this test that is usually OVER $300. The new, high deductible health exchange plans “cover” it but if you haven’t met your deductible, the entire cost will be yours to pay – between $350-800 depending on the laboratory.
We can get this test for you for only $99!

Hysterosalpingogram (test to check the fallopian tubes): Most plans no longer cover this. If your primary physician or gynecologist orders it, you may be charged $800-2000! Even if it is covered, you may not have met your deductible and still be responsible for the full fee.

At Advanced Fertility Associates, we can check your tubes for only $400!

Pelvic Ultrasound: Even if your gynecologist codes this as a non-infertility test, you may be responsible for part or all of the cost (depending on your deductible). Again, it can be as much as $1000.

Dr. Ratcliffe will perform a more specific and complete ultrasound at the new patient visit – for FREE!