Fertility benefits | Adobe Benefits

Your medical plan offers several infertility treatment options, including fertility drugs, surgery, artificial insemination, and assisted reproductive technology.

Questions?

Aetna fertility advocate

866-984-0074

Kaiser

800-464-4000 (CA)
888-901-4636 (WA)

Aetna fertility benefits

When you use an in-network provider, Aetna covers these precertified fertility services at 90% (HealthSave or HealthSelect EPO) or 80% (HealthSave Basic) after you meet your deductible (lifetime maximums may apply):

Artificial insemination (AI)
Ovulation induction (OI)
Assisted reproductive technology (ART)
- In vitro fertilization (IVF)
- Gamete/zygote intrafallopian transfer (GIFT/ZIFT)
- Frozen embryo transfer (FET)
Intracytoplasmic sperm injection (ICSI) or ovum microsurgery
Testis biopsy, gonadal tissue, percutaneous epididymal sperm aspiration (PESA)
Freezing and storage of sperm, eggs, and embryos (any or all of the ART cycles covered under the plan can be used for elective fertility preservation)

If you’re using a gestational carrier, some services may be covered, including fertilization, culture, and semen analysis.

Review the Aetna fertility benefits flyer [PDF] and watch this video to learn more.

Prescription benefits

Your Aetna prescription benefits apply to fertility drugs. For the HealthSave and HealthSave Basic plans, you pay the full cost until you’ve met your deductible, and a copay after that.

For the HealthSelect EPO plan, no deductible applies.

Many fertility medications are specialty medications that need special storage and handling. You may be required to fill these through CVS Specialty Pharmacy.

The plan pays up to a lifetime maximum of $60,000 for fertility treatment drugs.

Getting started

To access your fertility benefits, call the Aetna fertility advocate at 866-984-0074 (Monday–Friday, 5 am–1:30 pm PT). Your fertility advocate will:

Be your single point of contact to help you understand your benefits and options and to coordinate your care.
Help you find the right in-network doctors and facilities.
Work with you to complete a patient registration form, which will help determine which benefits and services you’re eligible to receive. You can also complete and submit the form on your own. Find it by logging in to the Aetna website (or SSO) and clicking Forms.

Precertification is required

Before any treatment, your doctor will need to get precertification from Aetna.

In-network providers will manage this process for you. If your provider is not in-network, you can ask your doctor to call Aetna at 800-575-5999, or you may need to call Aetna yourself for precertification.

Equal access to care

Adobe’s plans offer consistent access to care and resources, regardless of the state where you live. The Aetna medical plans cover fertility services and will reimburse travel expenses (subject to IRS limits) for an employee or covered dependent who must travel 100 miles or more to a state that can provide these services.

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Kaiser fertility benefits

Your Kaiser medical plan covers the diagnosis and treatment of infertility, including artificial insemination, ovulation induction, and assisted reproductive technology (ART), including IVF, GIFT, and ZIFT. Services are covered if they are part of an active cycle to create pregnancy. The plan pays 90%, and you pay 10% for most covered services.

You’ll need a referral from your primary care physician to access these benefits, so start by speaking with your physician, and then visit a KP Center for Reproductive Health location.

Watch the Kaiser fertility video, and learn more about California Infertility Services [PDF] or Washington Infertility Services [PDF]. Get full details in your Kaiser Evidence of Coverage booklet.

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