When embarking on the journey to build your family, every step matters, and with the right planning you can make the most of the resources you already have. FSA and HSA savings accounts are designed to help cover essential medical expenses and can be used for initial fertility consultations and testing.
Why FSA/HSA benefits are important
FSA and HSA funds allow you to set aside pre-tax dollars for eligible medical expenses, including fertility treatments. Whether it’s your first appointment or fertility testing to help diagnose potential challenges, these funds can be used to ease the financial burden. But be aware: FSA funds often expire at the end of the year, so it’s essential to take advantage now to ensure your hard-earned savings support your goals.
Patient tip: Reach out to your benefit plan administrator in advance to understand FSA / HSA savings application and service reimbursements
Questions to ask your insurance carrier
Understanding your insurance benefits is key to optimizing your care. As you prepare for your initial fertility consultation, consider asking your insurance provider these critical questions:
- Is the initial consultation covered by my plan?
- Do I need a referral from my primary care physician to see a fertility specialist?
- Do I need authorization (reference CPT codes listed below)?
- Does my plan cover fertility drugs or injectable medications?
- Is there a maximum benefit amount for fertility treatments? This could be a dollar limit, cycle limit, or both.
- Does my plan cover same-sex couples or domestic partners?
Key insurance codes for your reference
Understanding insurance codes can help you navigate your benefits more easily. Below are some important codes that may apply to your fertility care:
- Testing for infertility: ICD-10 codes Z31.41, N97.9
- Artificial insemination (IUI): CPT codes 58322, 58323, 89261; ICD-10 code Z31.89
- In vitro fertilization (IVF): CPT codes 58970, 58974, ICD-10 code Z31.83
- Egg freezing: CPT code 58970, 89337, ICD-10 code Z31.84
Having these codes handy may help clarify your coverage options and ensure you’re making informed decisions about your fertility care. Please note these codes update yearly and may have changed.
Prepare for open enrollment
As we approach open enrollment season, it’s the perfect time to review your health benefits and ensure that your insurance plan aligns with your family-building goals. Open enrollment is a limited window when you can make changes to your insurance, so being informed and proactive is essential.
Get started today
Your FSA and HSA funds represent more than just savings—they’re an investment in your future. Every dollar you put toward fertility testing and treatment brings you one step closer to your goal. By scheduling a consultation now and making the most of your benefits, you’re setting yourself up for success in your family-building journey.
Take that first step today and request an appointment. Together, we’ll turn your dreams into reality.
