Benefit Decisions
These policies may not apply to all Progyny members. Please reach out to your Patient Care Advocate to see if these benefit decisions apply to you.
OON Donor Purchase
All donor egg purchases must be authorized at an in-network egg bank.
Members must use an in-network egg bank for donor egg purchases as determined by their benefit.
Exceptions for specific genetic characteristics or religion will be considered on a case-by-case basis for out-of-network coverage.
Consecutive Donor Purchase
The purchase of donor tissue is limited to one per egg and sperm source at a time.
The number of cohorts of donor eggs or vials of donor sperm are limited to 1 cohort of donor eggs per sperm source and 4 vials of donor sperm per egg source as determined by their benefit.
A fertilization attempt is required prior to purchasing additional cohorts/vials and embryo banking policy applies.
Exceptions will be considered on a case-by-case basis.
Voluntary Sterilization
Coverage may be denied for those individuals who have undergone voluntary sterilization.
Diagnostic testing and treatment for those who have had a medical procedure for permanent sterilization may not be covered as determined by their benefit.