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Coverage criteria policies

Infertility diagnosis and treatment – Minnesota Health Care Programs

These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage.

Administrative Process

Prior authorization is not required for infertility diagnosis and treatment.

Coverage

Infertility diagnosis and treatment is generally covered subject to the indications listed below and per your plan documents.

Indications that are covered

Covered infertility services are limited to diagnosis and treatment of medical problems causing infertility (e.g., pituitary or ovarian tumor, testicular mass).

Indications that are not covered

The following services are not covered:

  1. Artificial insemination, including in vitro fertilization
  2. Fertility drugs and all associated services

Products

This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy, contact Member Services at 952-883-7979 or 1-800-233-9645.

References

  1. Minnesota Health Care Programs (MHCP) Provider Manual: Family Planning. Revised 01-08-2016.

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Policy activity

  • 06/01/2017 - Date of origin
  • 07/01/2017 - Effective date
Review date
  • 05/2017

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