# Covering the Cost of Medication

Covering the Cost of Medication

Most fertility medications need to be filled by a specialty pharmacy rather than a standard walk-in pharmacy. If a plan includes medication coverage, the insurance company will typically have a preferred in-network specialty pharmacy and an approved list of covered medications.

Some medications are sold under more than one brand name. If a prescribed medication isn't covered or available through the in-network pharmacy, your care team can often identify a suitable alternative that meets coverage requirements.

Even with comprehensive insurance coverage, some out-of-pocket cost for fertility medication is anticipated. The amount depends on the plan, the deductible status, and any copay or coinsurance requirements. If a plan has a lifetime maximum for fertility benefits, it's also worth keeping track of how much has been spent on medications — that balance affects what remains for the rest of treatment.

It's also important to know that medication coverage is often tied to a treatment authorization. That authorization must be on file with the pharmacy before a prescription can be filled — so confirming this is in place before treatment begins helps avoid delays.

For medications paid out of pocket, specialty pharmacies often offer competitive pricing, and patients are welcome to compare options across pharmacies to find the best price for what's been prescribed. Income-based assistance programs and manufacturer coupons may also be available and are worth exploring directly.

Medications cannot be returned or reimbursed once dispensed. Following the prescribed dosing instructions and filling based on what the clinical team has ordered helps ensure nothing goes to waste.
