Understanding how insurance applies to fertility care can feel overwhelming, especially when you're already facing the emotional and logistical challenges of trying to build your family. At Advanced Fertility Center of Chicago (AFCC), we know that insurance coverage for infertility treatment and in vitro fertilization (IVF) can be straightforward or complicated depending on a wide range of factors. That’s why our team is here to guide you through the process. We work diligently to help you understand your coverage, minimize financial surprises, and maximize your benefits, so you can focus on what matters most: your path to parenthood.
A Dedicated Team of Fertility Insurance Experts
At AFCC, our experienced financial coordinators specialize in fertility insurance and are here to make the process as smooth and transparent as possible. From the moment you schedule your consultation, our team begins working on your behalf, contacting your insurance provider directly to verify benefits, review coverage details, and uncover any hidden opportunities that might ease your financial burden.
We break down your insurance plan clearly, explaining what’s covered (whether partially, fully, or not at all) and outlining any expected out-of-pocket costs upfront. By helping you understand your financial picture from the start, we minimize surprises and empower you to make confident decisions about your care. With AFCC handling the logistics, you can stay focused on your treatment and your future family.
Participating Insurance Providers
Navigating insurance doesn’t have to be overwhelming, especially with AFCC’s financial counselors by your side. From reviewing your plan to coordinating with your provider, we’re here to support you every step of the way. Our team helps you make sense of your benefits so you can move forward with clarity and confidence.
We accept a wide range of insurance plans and can work with patients who have any PPO plan. AFCC is an in-network provider for many major carriers, including:
- Aetna – PPO and POS
- Blue Choice (also Blue Options) – PPO and PPO/BCS
- Blue Cross – PPO
- Cigna – PPO and POS
- Humana – PPO and POS
- Optum Health (formerly United Resources Network) – all plans
- Progyny – all plans
- United Healthcare – PPO and POS
- Carrot Fertility
- Maven Fertility
Even if we are not in-network with your plan, many patients choose AFCC as an out-of-network provider due to our high success rates, personalized care, and strong reputation in the field.
Start Your Fertility Journey With Confidence
Your first step toward understanding fertility insurance starts with a consultation. At AFCC, we’ll handle the insurance verification process for you, so you don’t have to stress over the fine print. Our goal is to take the guesswork out of coverage, allowing you to focus on what truly matters: building your family.
Does Insurance Cover IVF and Fertility Treatments in Illinois?
Fertility insurance coverage in Illinois can vary greatly depending on your insurance provider and individual plan. Some policies may cover only diagnostic testing or medications, while others extend benefits to include intrauterine insemination (IUI), in vitro fertilization (IVF), or other advanced procedures.
Health insurance plans will often provide coverage for services related to infertility testing. However, many plans stop coverage once a diagnosis has been established, and treatment benefits become more limited. Outside of Illinois’ state mandate, it’s common for plans to either exclude IVF entirely or set a lifetime maximum, typically between $10,000 and $25,000, which limits how much the insurance company will pay.
At AFCC, our financial team reviews every patient’s coverage individually. Whether your plan offers full benefits, limited treatment options, or a capped amount, we’ll help you understand your coverage clearly and guide you through the next steps.
Understanding Fertility Insurance in Illinois
Illinois has a strong fertility insurance mandate: any health plan that includes pregnancy coverage must also cover infertility treatments, such as IVF, artificial insemination, and related services, for up to six egg retrievals, subject to certain conditions. However, this mandate excludes employers with fewer than 25 employees, religious organizations, and self-insured companies.
That means while many patients enjoy robust fertility benefits under Illinois law, others, whose employers fall into exempt categories, may still only have partial coverage, often limited to diagnostic testing or medically necessary services.
At AFCC, we take a personalized approach to every patient’s insurance situation. Our financial counselors carefully analyze your specific plan and advocate on your behalf, helping you fully understand your benefits and how they apply to your treatment journey.
What Fertility Services Are Typically Covered by Insurance?
Insurance coverage for fertility care often depends on the specifics of your plan, but many policies include some core services, especially when they’re considered medically necessary. At AFCC, we help you understand exactly what your plan includes and how it applies to your treatment.
Commonly covered services may include:
- Fertility evaluations and diagnostics
- Ultrasounds and bloodwork
- Ovulation induction medications
- Intrauterine insemination (IUI)
- In vitro fertilization (IVF), partially or with limitations
- Fertility preservation when medically necessary (e.g., before cancer treatment)
Services that are less commonly covered:
- Elective egg freezing
- Preimplantation genetic testing (PGT)
- Donor eggs, sperm, or embryos
- Gestational surrogacy
Our financial counselors will walk you through your benefits in detail, offering clear, personalized guidance on which services are covered, which are not, and what your out-of-pocket costs might look like.
How Much Does IVF Cost With and Without Insurance?
Understanding the cost of IVF is an essential part of planning your fertility journey. At AFCC, we provide clear, up-front pricing and personalized financial guidance to help you make informed decisions every step of the way.
- With insurance: If your plan includes fertility benefits, insurance may help cover specific aspects of IVF, such as diagnostic testing, monitoring appointments, or medications. However, you may still be responsible for co-pays, deductibles, and any services not included in your plan.
- Without insurance: For those without coverage, the cost of a single IVF cycle typically ranges between $13,000 and $20,000, depending on your treatment plan. This often includes monitoring, egg retrieval, fertilization, embryo transfer, and laboratory services. Medications, anesthesia, and preimplantation genetic testing (PGT) may be billed separately.
No matter your coverage situation, AFCC’s financial counselors will help you understand your full cost breakdown and explore available financing options. We’re here to make sure nothing catches you off guard – financially or otherwise.
Frequently Asked Questions About Fertility Insurance
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In Florida, there is no specific legislation about fertility care written into its insurance code. As a result, insurance coverage for fertility treatment and IVF varies depending on your specific insurance plan. Some insurance plans do offer coverage for fertility treatments, including diagnostic tests, medications, and procedures like IVF. However, the extent of coverage can vary widely, and not all plans provide comprehensive coverage. It’s important to review your insurance policy carefully and consult with your fertility clinic to understand what is covered and what costs you may be responsible for.
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With insurance coverage in Illinois, out-of-pocket IVF costs depend on your specific plan. Many policies cover diagnostic testing, monitoring, medications, and sometimes IVF procedures, but you may still be responsible for co-pays, deductibles, or services not fully covered. Illinois law requires fertility benefits under certain plans; however, coverage can include lifetime caps (often $10,000–$25,000) or limitations.
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Without insurance, the average cost of a single IVF cycle in Illinois ranges from $13,000 to $20,000, depending on complexity. These figures typically include office visits, monitoring, egg retrieval, fertilization, embryo transfer, and lab procedures. However, they may not include medications, anesthesia, or optional services like preimplantation genetic testing (PGT).
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In most cases, elective egg freezing isn’t covered by insurance, even in Illinois. Fertility benefits mandated by law typically focus on medically necessary treatments for infertility, not elective preservation. Some plans may partially cover fertility preservation when it’s medically necessary, such as before cancer treatment, but elective cycles usually fall outside of covered benefits.
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Insurance policies differ when it comes to covering IVF after a tubal ligation. Elective reversal is often not covered, but many plans recognize tubal ligation as a medical barrier to pregnancy and may cover IVF as a medically necessary treatment. Coverage depends on your specific plan’s fertility benefits and exclusions.
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Coverage for IVF after a vasectomy often depends on whether your insurance plan treats vasectomy as a medical barrier to pregnancy. Many plans that include fertility benefits do cover IVF under these circumstances, though coverage levels vary widely. Some might cover diagnostics and IVF entirely, while others may only offer partial reimbursement or impose limits.
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Fertility insurance coverage for LGBTQ+ individuals varies widely and depends on your plan’s wording and inclusivity. Many modern insurance policies cover fertility treatments regardless of marital status or gender, recognizing the medical necessity of IVF for LGBTQ+ couples or individuals. However, some older or less inclusive plans may limit eligibility.
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Coverage for IVF medications varies depending on your insurance plan. Some policies provide partial or full reimbursement for fertility drugs like gonadotropins, while others exclude medications entirely. In Illinois, mandated fertility benefits often focus on diagnostic and procedural care, not meds.
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Whether IVF counts toward your insurance deductible depends entirely on your specific plan. Some insurance policies apply IVF-related costs, such as diagnostics, monitoring, procedures, and even medications, to your deductible or out-of-pocket maximum. Others treat fertility services separately, meaning those expenses may not help meet your deductible.
Ready to Start? Schedule a Consultation Today
Understanding your insurance is just the beginning. At AFCC, we’re here to guide you through every step of your fertility journey with clarity, compassion, and expert support. Schedule your consultation today and take the first step toward growing your family.