Some but not all Kaiser Permanente members will have fertility insurance coverage. Typically the insurance will cover either 100% of diagnosis and evaluation or 50% of the costs. It is important to note that only patients who do have fertility coverage are allowed to see a fertility specialist within Kaiser Permanente. All patients were no fertility coverage cannot book an appointment within the Kaiser health system. Exceptions are patients who experienced two or more miscarriages. Those patients can see a fertility specialist limited to two appointments.
Dr. Jovanovic currently sees fertility patients at Kaiser Woodland Hills once a week. The appointment can be scheduled by calling (818) 719-2315. The fertility treatments at Kaiser Permanente for insured members cover diagnosis and evaluation. This will typically include an initial consultation with a fertility specialist by either phone or in person appointment. A transvaginal ultrasound will be performed during the initial visit. This will evaluate the ovarian reserve and the uterine cavity. Both male and female will undergo sexually transmitted disease testing including HIV, hepatitis, syphilis and HTLV. Almost every patient will undergo a hysterosalpingogram (HSG) to evaluate the tubal status. Following the initial consultation and after completing the ordered tests, the patient will undergo a follow-up visit that will determine the treatment plan. This visit will review the results of male and female testing.
The fertility treatments at Kaiser Permanente are limited to ovulation induction and intrauterine inseminations. This can provide a substantial benefit for patients who have regular cycles and naturally do not ovulate. Typically these patients are provided with Clomid. Kaiser Permanente will also cover injectable gonadotropin's that are more potent and induce super ovulation. During this super ovulation cycle the ovary will mature and ovulate multiple eggs and the preferred medication is Menopur. These type of cycle is also known as controlled ovarian hyperstimulation and is in most cases combined with intrauterine insemination (COH/IUI). The injectable gonadotropin's in combination with inseminations provide a substantial increase in pregnancy success rate. The only treatment with higher success rate is in vitro fertilization (IVF). In vitro fertilization is not a covered benefit and Kaiser Permanente in Southern California does not have the embryology laboratory necessary for in vitro fertilization.
The fertility treatments are limited to patients under 43 years of age and there is a maximum of six fertility treatments cycles. After a successful birth the patient restarts the cycle count and can pursue additional fertility treatments. Due to the high number of patients, a patient will typically see more than one medical provider per treatment cycle. Intrauterine inseminations are typically performed during the week and on Saturdays.
Single female patients and homosexual lesbian couples can utilize donor sperm intrauterine inseminations. The patient will typically bring in the sperm on the day of insemination. Kaiser Permanente does not have the ability to store frozen sperm on site.
It is important to understand that Kaiser Permanente does not cover in vitro fertilization, egg donation or surrogacy. These are considered advanced fertility treatments and they are performed outside of Kaiser Permanente. Patients with blocked fallopian tubes or very low sperm count will need advanced fertility treatments. Such patients can utilize their Kaiser Permanente insurance to perform the preparatory bloodwork and a semen analysis. Once more advanced treatments are initiated, the patients cannot utilize the Kaiser medications or laboratory services given that advanced fertility treatments are not part of their benefit package. Patients can however utilize any leftover medication that has not been used during the COH/IUI cycles covered at Kaiser Permanente, but can not obtain new medication refills. Once the patient becomes pregnant, utilization of Kaiser Permanente services can be resumed. This may cover progesterone supplementation in early pregnancy and early obstetrical visits after a successful IVF pregnancy.
Egg Freezing for medical indications is a covered Kaiser Permanente benefit since 2020. If the patient is diagnosed with cancer and will undergo cytotoxic treatments, egg freezing is a mandatory benefit. Social egg freezing with no medical indication is not covered.
Another exception our employees of Kaiser Permanente will have additional fertility coverage purchased through the human resources department. Employees of Kaiser can utilize the health plan services for in vitro fertilization. Physician partners have unlimited fertility benefits including in vitro fertilization administered by Meritain insurance.
Dr. Jovanovic has extensive experience in navigating the Kaiser Permanente health services benefits given his association with Kaiser Woodland Hills. Patients who have 100% fertility coverage will only pay a small co-pay for the appointments and medications. The situation is however different for patients will have 50% fertility coverage, since those patients are be liable for half of the visit costs and medication costs. These patients are unable to apply for medication discounts and they will be paying 50% of the full indication price. It the same time in my be eligible for over 50% discounts through programs outside of Kaiser Permanente. Therefore a thorough cost-benefit analysis should be performed prior to moving on to fertility treatments with 50% coverage.
Will provide you with the typical costs that a 50% covered patient will incur during the fertility clinic visits. Please contact your clinic to verify the treatment costs.
Expected costs for the 50% self-pay fee for patients who do not have complete coverage
Tree of life Center will support any Kaiser Permanente patients to utilize their fertility insurance and provide additional services on top of your included benefits. Were experienced in obtaining medical necessity letters and finding the best solution for your individual situation. Please contact us if you have any other questions.