Infertility treatment FAQs
Choose a category below to see questions and answers about infertility treatment.
Call the Member Services number on the back of your insurance Aetna International member ID card. Member services can also connect you with our clinical care team.
Precertification is highly recommended before you seek infertility treatment to help ensure you've met certain medical criteria and your care will be covered under your plan..
If you have questions regarding copays, deductibles, claims or appeals call the Member Services telephone number on the back of your insurance card.
Once there is a plan for infertility treatment using ovulation induction with injectable fertility medications, artificial insemination, or assisted reproductive technology (ART), you'll need to submit your medical records to us for review. Call us at the number on the back of your member ID card for details on where to send this information.
We’re here to answer your questions. If your pharmacy benefit is through Aetna, give Aetna Pharmacy Management a call at 1-888-792-3862(TTY: 711).
Call the number on the back of your member ID card for help finding the right provider for you, in or out of the United States.
If you're seeking infertility care in the U.S. only, you can also log in at Aetna.com to search for in-network providers.
If you have questions regarding copays, deductibles, out-of-pocket limits, claims, or appeals; please contact the Member Services telephone number on the back of your insurance card.
Check your employer’s plan document for information on your infertility coverage. Plan benefit documents are available through your secure Member Portal. You can also read our Clinical Policy Bulletin on infertility. Clinical policy bulletins are not a guarantee of coverage. They provide information on the services and procedures we consider medically necessary, or experimental and unproven.
Beginning 1/1/2019 for plans with cycle limits, an ART cycle is defined as:
| Procedure | Cycle |
| One complete fresh IVF cycle with transfer (egg retrieval, fertilization, and transfer of embryo) | One full cycle |
| One fresh IVF cycle attempted egg aspiration (with or without egg retrieval) but without transfer of embryo | One-half cycle |
| Fertilization of egg and transfer of embryo | One-half cycle |
| One cryopreserved (frozen) embryo transfer | One-half cycle |
| One complete GIFT cycle | One full cycle |
| One complete ZIFT cycle | One full cycle |
If your Infertility benefit has a dollar limit maximum, please contact the Member Services number on the back of your insurance card. Member Services can tell you what dollar amount has been paid out based on claims that have been submitted, and what dollar amount remains on the dollar limit maximum.
Important note for New York members
Find fertility coverage exceptions for your state on our clinical policy bulletins page.
Compliance with the federal parity law is the responsibility of self funded plan sponsors and Aetna cannot provide legal advice in this regard. Plan sponsors should seek their own separate counsel for legal guidance on application of the federal parity requirements. Aetna’s interpretation and approach to federal parity compliance will apply to those Plans as they migrate to Aetna operational platforms. Any questions about Aetna's approach to Federal Mental Health Parity may be referred to your Aetna sales or account representative.