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Medication Coverage

Each couple’s infertility treatment plan addresses their individual needs, the same is true of the costs associated with that plan. We understand that cost is an important consideration when making decisions regarding your treatment, and have developed a comprehensive array of financial services to help you achieve your goal of having a child. Once your customized treatment plan is in place, one of our financial counselors will provide you with the cost information specific to your plan.

Financial Guidance
Financing Options
Treatment & Test Costs
Employer Benefits
Multi-cycle Programs
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Your Fertility Medication Benefits

SRM is dedicated to providing the best service and quality of care to all of our patients seeking fertility treatments. Understanding what your insurance company does and does not cover for fertility can be daunting and confusing. We encourage you to be fully aware of what your fertility coverage plan offers. Here are some questions to address with your insurance company:

  • Does my prescription formulary specifically cover oral fertility medications including Letrozole or Clomiphene (Clomid)?
  • Does my prescription formulary specifically cover fertility medications commonly used for injectable ovulation induction cycles or in vitro fertilization including; Gonal-F, Follistim, Menopur, Ganirelix, Cetrotide, Lupron, Human Chorionic Gonadotropin (hCG), Endometrin, Crinone and/or Progesterone in Oil?
  • Does my prescription formulary prefer Gonal-F/Cetrotide to Follistim/Ganirelix, and/or Endometrin to Crinone?
  • Does my prescription formulary specifically cover fertility medications used in frozen embryo transfer cycles or donor egg recipient cycles including: Lupron, Estrace, Endometrin, Crinone and/or Progesterone in Oil?
  • Which of my covered medications may also require a prior authorization?
  • Am I required to fill my prescription at any particular pharmacy?

Specialty Pharmacies

Local pharmacies generally do not carry injectable fertility medications, therefore prescriptions are sent to specialty mail-in fertility pharmacies.  Please let your care team know if a specific pharmacy is required by your insurance, otherwise, SRM coordinates with various specialty pharmacies to provide cash-pay patients with the best possible options.

The specialty pharmacy will call you to arrange for delivery directly to your home, and will provide storage instructions.  The specialty pharmacies are also a wonderful resource for information on the medications, and usually have a pharmacist available 24/7 to answer questions.