Waiting Period (Insurance)

Many employer-sponsored health plans that include fertility benefits impose a waiting period — commonly 12 months of trying to conceive before IVF or IUI coverage activates. Some plans waive this for documented diagnoses such as azoospermia, bilateral tubal occlusion, or PCOS.

Patients over 35 are often recognized by their insurer or RE as having a shortened waiting period of 6 months. LGBTQ+ individuals and single parents by choice may face different criteria depending on the plan and state mandates.

Reviewing your Summary of Benefits and Coverage (SBC) and calling your insurer's fertility case management line can clarify what documentation is needed to begin coverage sooner.