Can I Use Progyny Fertility Insurance at PNWF?

by | Apr 21, 2022 | Resources

A guide to Progyny’s employer-based fertility benefits

Many of our patients use Progyny fertility benefits for treatment at PNWF. Progyny’s approach to fertility coverage streamlines the experience, allowing for personalized and flexible benefits that meet your needs and timeline. PNWF is pleased to partner with Progyny, and we’ve created this article as an introductory guide to how Progyny fertility insurance works at our clinic

How Does Progyny Fertility Insurance Work?

Progyny offers fertility coverage through employer-sponsored health insurance. Essentially, companies can outsource fertility benefits to Progyny as part of their employees’ benefits package.

Progyny uses a system called Smart Cycles to provide flexible and streamlined coverage. Under this system, employees receive a certain number of Smart Cycles through their employer’s plan (the number varies from employer to employer). Progyny has assigned all fertility treatments a Smart Cycle value. For instance, a full frozen IVF cycle, including egg retrieval, fertilization, and embryo transfer, equals one Smart Cycle. On the other hand, intrauterine insemination (IUI) uses ¼ of a Smart Cycle.

In this way, patients and their fertility specialists can look at their available Smart Cycle balance and easily determine how much coverage is available for their custom treatment plan.

You can read more about how Progyny assigns Smart Cycle values on their website.

What Is Included in a Progyny Smart Cycle?

Progyny benefits cover a wide and inclusive range of fertility treatments, including:

  • IUI
  • Fresh IVF Cycle
  • Frozen IVF Cycle
  • Donor Egg IVF
  • Donor Sperm Fertilization
  • Shared/Reciprocal IVF Cycle
  • Egg Freezing

The Smart Cycle value of each treatment usually includes any required medications. Importantly, Progyny also covers certain fertility services that don’t count against your Smart Cycle Balance. For instance, initial fertility consultations, initial fertility testing, and genetic testing (both for intended parents and PGT) are all covered by Progyny without using up any of your Smart Cycles.

When it comes to collaborative reproduction, Smart Cycles may be used for donor egg cycles, fertilization, and embryo development. In addition, some companies offer reimbursement for gestational carrier/surrogate expenses that can supplement the Progyny benefits.

How Do I Use Progyny Fertility Insurance at PNWF?

First, review your employer’s health plan to make sure they offer Progyny benefits. If they do, then you can contact Progyny to review your specific coverage and available Smart Cycle benefits. At PNWF, Progyny coverage essentially works just like your standard health insurance. This means that we bill Progyny for covered services, and you are only responsible for any costs that Progyny doesn’t cover or that exceed your available benefits.

Sometimes we see patients who didn’t realize they have Progyny fertility benefits through their employer. In these cases, we alert the patient so they can register with Progyny and set up their benefits account. Unlike many insurance companies, Progyny offers retroactive authorization within a certain time period. For instance, if you are eligible for Progyny benefits but haven’t signed up before your initial consultation, we can still apply your benefits once you register. This means you don’t have to decide between delaying your fertility journey or paying for covered benefits.

What If My Employer Doesn’t Offer Progyny Fertility Benefits?

Progyny only provides coverage through employers; patients cannot individually purchase a Progyny plan. Many companies in the Seattle area and nationwide, especially large tech companies, already partner with Progyny. If your employer does not currently offer fertility and family building coverage, consider asking them to expand their benefits. Progyny can provide some information to help you start this conversation.

PNWF Is A Proud Progyny Partner

We work extensively with Progyny fertility benefits. In our experience, we have found Progyny to be helpful, streamlined, and invested in our patients’ fertility success. Applying Progyny benefits at PNWF is simple: to schedule your initial consultation, contact us today.

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