Insurance Coverage for the Patient
The Conception Kit® can be covered either as a pharmacy benefit or as a medical benefit with an insurance plan. With or without insurance a prescription is required in the United States.
A pharmacy benefit is the benefit the patient uses at the pharmacy when they pick up their prescription.
The co-pay (their portion) varies from plan to plan.
Many insurance policies cover the Conception Kit® at-home system as a pharmacy benefit with simple co-pay as low as $25.
As each insurance plan is unique, patients should contact their insurance company pharmacy benefit manager (usually a number on the back of their card) to see if they are covered.
When the patient calls they should have available:
1. Their insurance card information
2. Product name: Conception Kit®
3. Product Nation Drug Code (NDC) number: 8597-1111-13
Depending on the patient’s insurance policy, patients may have a medical benefit on an infertility rider in the policy.
The patient can contact the insurance company to see if they would be covered.
They should call the medical benefits number on the back of the insurance card to see if this is the case.
The wording matters due to some medical benefits only cover test while others cover both tests and treatments.
Patients should be looking for the following wording:
Rx products for diagnoses and treatment of infertility on an outpatient bases, hospital, alternative facility, physician’s office or in a covered person’s home. Services provided by or under the direction of a physician.
Here is how this relates:
The Conception Kit® at-home system is a treatment that is done in a covered person’s home under the direction of a physician that has written a prescription.