Insurance & savings

Affording fertility care

Understanding the costs of fertility care is an important part of your journey, and at SCCRM, we’re here to help you make sense of it all. From navigating insurance coverage and maximizing benefits to exploring personalized financing options and savings plans, we’re committed to making fertility care more accessible. Our team will work closely with you to create a plan that fits your unique situation, so you can focus on what matters most—building your family.

Understanding fertility costs

At SCCRM, we believe in providing fair and transparent pricing for fertility treatment, ensuring that patients only pay for what they need and receive what they pay for. Our goal is to maximize success while keeping costs reasonable and straightforward.

  • While many insurance plans cover infertility diagnostics, such as office visits and lab tests, not all plans extend coverage to fertility treatments like medications, intrauterine insemination (IUI), or IVF. We recommend confirming your benefits with your insurer before your initial visit, as coverage approval is ultimately at their discretion.

    Once we verify your insurance benefits, we provide a detailed estimate so you know exactly what to expect. We also clarify how your deductible applies and explain which services are covered in-network, out-of-network, or not at all.

    SCCRM partners with Progyny, the leader in fertility benefit solutions. Learn more in the section below.

  • For those without IVF coverage, we offer a competitive global fee for cash-pay patients, which includes most aspects of your IVF cycle—from ultrasounds and office visits to blood work, egg retrieval, lab services, and embryo transfer.

  • Please note that your personalized estimate will not include medication costs, as these vary based on the type and dosage required.

  • We use a Global Fee Structure, which provides one comprehensive price tailored to your specific treatment protocol.

    What’s Included in the Global Fee:

    • All ultrasounds and blood tests during the cycle

    • Physician fees

    • Anesthesia for egg retrieval

    • Surgery center facility fee

    • Laboratory fees (culture, fertilization, embryo preparation)

    • ICSI (intracytoplasmic sperm injection)

    • Assisted hatching (if needed)

    • Embryo freezing

    What’s Not Included:

    • Pre-cycle diagnostic testing, ultrasounds, and procedures

    • Medications (varies by individual)

    • Specialized lab charges (e.g., embryo biopsy for PGT)

    • Infectious disease screening

    Special procedures, such as embryo biopsy for genetic testing (PGT), are priced fairly to minimize cost increases.

Developing your financial plan

  • Learn about diagnostic tests and possible treatments for your condition. Review your health insurance policy and speak with a representative to understand what is and isn’t covered. While many plans don’t cover treatments, they often do cover testing.

    Most couples need only basic treatments, such as ovulation support (e.g., clomid, gonadotropins) or intrauterine insemination (IUI), which generally cost a few hundred to a few thousand dollars per cycle. Advanced treatments like IVF can cost several thousand dollars per cycle, depending on specific procedures and medication needs. In some cases, a minor procedure or surgery might solve the issue, and insurance may cover these options.

  • Set realistic goals, expectations, and budgets for your fertility treatment journey, aiming for a timeframe of 1-2 years. Celebrate any success along the way!

    Understand the costs, benefits, and value of each treatment for your situation. For younger women (<35), starting with simpler treatments like clomid and IUI offers a reasonable success rate (5-10% per cycle), low risk of multiples, and manageable costs. If this isn’t successful after a few cycles, IVF may be a better option due to its higher success rate (>50% per cycle), controlled risk of multiples, and potential for future-use embryos.

    For older women (>40) with lower success rates on clomid (<5% per cycle), starting with more advanced treatments like gonadotropins with IUI or IVF may be more effective.

  • In an ideal world, we’d know which treatment would lead to pregnancy. Since that’s not possible, make wise choices by avoiding low-yield therapies that cost time, money, and fertility. Most pregnancies occur within the first three cycles of a treatment like clomid with IUI, with chances decreasing afterward.

    Monitoring through ultrasounds or blood tests is essential to track effectiveness and guide treatment adjustments. You may decide to switch strategies sooner if needed, investing in a higher-yield treatment with a better chance of success.

Insurance & benefits

Insurance coverage

Navigating your insurance coverage for fertility care can feel complex, but breaking it into steps can simplify the process. Here’s how to get started:

  • Review your insurance policy to determine if it covers fertility care, such as diagnostic tests, fertility medications, or treatments like IVF, IUI, or egg freezing. Look for specific terms like “assisted reproductive technology (ART)” or “infertility treatment.”

  • If fertility care is covered, identify any restrictions, such as:

    • Lifetime maximum benefits or dollar limits.

    • Required prerequisites, like trying less invasive treatments before moving to IVF.

    • Coverage exclusions for donor eggs, sperm, or surrogacy.

  • Confirm that SCCRM is in-network to maximize coverage and minimize out-of-pocket costs.

  • Some treatments require prior authorization or pre-approval from your insurance provider. Work with your care team to submit the necessary documentation.

  • Fertility medications can be costly, so check if they are covered under your prescription plan and if there are specific pharmacies you need to use.

  • If your policy doesn’t include fertility benefits, ask about supplemental plans, employer-sponsored programs like Progyny, or financing options.

  • Don’t hesitate to call your insurance company to ask detailed questions about your coverage. They can provide clarity on what’s included, what’s excluded, and what you need to do to maximize your benefits.

Benefits programs

SCCRM partners with fertility benefits programs to make fertility care more accessible and affordable for individuals and families. Unlike traditional insurance plans, these specialized benefits focus exclusively on fertility treatments and often provide comprehensive coverage for advanced procedures like in vitro fertilization (IVF), egg freezing, intrauterine insemination (IUI), genetic testing, and donor or surrogacy services. 

Some of the fertility benefits programs we work with include:

  • Progyny

  • WIN Fertility

  • Carrot Fertility

  • Maven Fertility

  • & more not listed above

Maven

Whether you’re trying to conceive, starting IUI or IVF, pursuing surrogacy, or considering adoption, Maven makes it easy to get financial, clinical, and emotional support. Through Maven’s digital platform, you can review your benefits, message a Care Advocate with any questions, and get 24/7 virtual support from over 30 types of providers and specialists—all in one place.

SCCRM is proud to be a partner of Maven, exceeding their rigorous quality and patient satisfaction standards.

Progyny

SCCRM partners with Progyny, a leader in fertility benefits solutions, to help make fertility care more accessible. With Progyny’s fertility benefits, you’re eligible to begin the most effective treatment for your needs right away—no need to try less effective options first. This approach aligns with SCCRM’s commitment to creating customized treatment plans that help each patient achieve a healthy pregnancy as quickly and smoothly as possible

Through this partnership, you’ll also have access to resources like:

  • Patient Care Advocate for comprehensive fertility support

  • Digital emotional tools through Happify to support emotional well-being

Check Your Coverage: many employers offer Progyny as a supplemental benefit. Contact your HR department or Progyny at (212) 888-3124 to confirm your coverage.

Financing options

Prosper Healthcare Lending

SCCRM partners with Prosper Healthcare Lending, the premier financing company in the fertility industry. With more than $5 billion funded and more than 300,000 loans inquiries serviced through their lenders, this is a name and a program you can trust.

Here are some of the benefits you’ll receive with a loan from Prosper Healthcare Lending.

  • Immediate decisions for loans under $35,000

  • Term options out to 84 months (affordable monthly payments)

  • No collateral required

  • No prepayment penalties

  • Fast & easy loan inquiry process

  • 100% Confidential

Three-Cycle Package Plan

For patients who require multiple IVF cycles to achieve their family-building goals, SCCRM offers a 3-Cycle IVF/PGT Batching Program. This discounted plan is specifically designed to help patients optimize embryo quality and quantity for genetic testing (PGT), while also reducing the overall financial burden of treatment.

  • This program addresses the unique challenges faced by patients who may not achieve the desired number of viable embryos in a single IVF cycle. By batching embryos from up to three cycles, it allows for a larger pool of embryos to be available for genetic testing, increasing the chances of selecting the healthiest embryos for transfer.

    • Significant Cost Savings: The program offers a discounted rate for patients undergoing three IVF cycles, with cost savings that exceed the price of one cycle’s biopsy fee. This ensures that patients requiring multiple attempts can benefit from a more affordable approach.

    • Optimized for Genetic Testing: Batching embryos from multiple cycles allows for a greater number of embryos to be sent for preimplantation genetic testing (PGT), increasing the likelihood of identifying chromosomally normal embryos for transfer.

    • Deferred Frozen Embryo Transfer (FET) Fees: Patients only pay for Frozen Embryo Transfer fees after the three-cycle batching process is complete, allowing them to focus on achieving a sufficient number of embryos without immediate additional costs.

    • Increased Chances of Success: By creating a larger pool of embryos, patients have more opportunities for successful transfers, reducing the emotional and financial strain of repeated single-cycle attempts.

    • Tailored Care: The program is personalized to each patient’s specific needs, ensuring a treatment plan that aligns with their medical history and fertility goals.

  • This program is ideal for patients who:

    • Have a lower ovarian reserve and need multiple cycles to retrieve an adequate number of eggs.

    • Are pursuing PGT to ensure the selection of genetically normal embryos for transfer.

    • Want to increase their chances of a successful pregnancy while managing costs.

This batching program reflects SCCRM’s commitment to transparent pricing and patient-centered care. If you’re considering this plan, our experienced team is here to answer your questions and guide you through the process. We’re committed to helping you achieve your dream of parenthood in a way that’s both effective and financially manageable.

For more information, contact our Billing Specialists at (949) 642-5236.