Infertility Treatment Coverage

COVERAGE

All three of Dartmouth's health plans provide expanded coverage for infertility services, including in-vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT) and prescription drugs to treat infertility, etc.

  • Physician's Office - Covered same as plans physician's office services
  • Inpatient Facility - Subject to annual deductible and coinsurance
  • Outpatient Facility - Subject to annual deductible and coinsurance
  • Inpatient Professional Services - Subject to annual deductible and coinsurance
  • Outpatient Professional Services - Subject to annual deductible and coinsurance
  • Some related services are considered experimental or non medically necessary and are not covered.  For more information contact Cigna at 855-869-8619

Please note that some infertility services may be subject to prior authorization.

TOTAL COVERAGE/LIFETIME MAXIMUM

All related health care services and prescription drugs will be subject to a lifetime plan maximum:

  • Medical Services:  $15,000 lifetime maximum per covered individual through Cigna
  • Pharmacy Services:  $25,000 lifetime maximum per covered individual through Express Scripts
  • Covered spouses have their own $15,000 medical and $25,000 lifetime maximums

This plan maximum applies regardless of FTE status.

COST SHARING

This expanded coverage will also be subject to cost sharing (e.g. deductibles, coinsurance, copays) based upon the type of services provided. You will be responsible for your portion of the applicable deductible, coinsurance and/or copayments.  The portion covered by Cigna and/or Express Scripts will be applied toward your lifetime maximum. Some services coded as diagnostic or not coded as infertility may still be covered under your regular medical plan, and will not be deducted from your life time maximums.

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QUESTIONS

For additional questions please contact the benefits office directly at 603-646-3588 or at Human.Resources.Benefits@Dartmouth.edu