Intake Form for Outside Clinic Services
Your insurance may, or may not, cover infertility services. Under your insurance plan, you are financially responsible for all co-payments, co-insurances, and deductibles. You are also financially responsible for and will not be entitled to insurance discounts for all non-covered services or services that exceed your benefit limits or maximum benefits. For insurance benefits and coverage questions, please contact your insurance directly. A decision of covered or non-covered services is determined by your insurance provider in accordance with your insurance plan.