Assisted Fertilization

With the UPMC Health Plans, individuals experiencing fertility complications may be able to obtain infertility treatment based upon the provisions of their employers health plan. Infertility is defined as services provided to achieve pregnancy including monitoring and evaluation of the treatment plan. Individuals must use participating physicians to obtain coverage under the "Infertility Benefit Program."

Additional details about the list of authorized medications and benefits level are below. If you have specific questions regarding the level of infertility coverage or participating physicians, please contact UPMC Health Member Services at 1-888-876-2756.

  Fertility Testing Benefits Level
Diagnosis and treatment up to diagnosis of Infertility Covered in Full
Assisted Fertilization Procedures $250 copayment (medical procedures)

$10,000 medical procedure lifetime benefit
Infertility Prescriptions (Prescriptions must be dispensed from a participating pharmacy $10,000 prescription lifetime benefit

20% coinsurance on prescriptions

Authorized Prescription Drug List
  • Gonal F
  • Follistim
  • Pergonal
  • Humegon
  • Metrodin
  • Repronex
  • Clomphene Citrate
  • Profasi