Policy limits can apply to any period the insurance company chooses and specifies. You could have a quarterly limit. Many policies have annual limits, and with fertility insurance, often there is a lifetime limit or maximum. This could be a coverage limit to a maximum...
Exclusions refer to what is not included, what the insurance policy does not include for coverage. Insurance policies may cover one kind of procedure but “exclude” or refuse to cover a similar procedure. They can exclude coverage in many ways, by age, by a...
Often we see that a minimum amount of medical services must be purchased before any insurance coverage is activated. It might be $300 in a calendar year. If you only spend $250 in a year, none of it might be covered. Usually, reaching the minimum expenditure triggers...
Insurance companies are usually very specific about what they will and won’t cover. They get down to the procedure and diagnostic codes and set conditions on when they will cover, how much they’ll cover, and when that changes. Coverage is a general term...
Does your insurance require that you see only certain providers – those within their network, for example? Do the providers have to meet specific requirements for you to be reimbursable? Does your fertility clinic have to meet certain standards? Have the...
