What you need to know
Get help with services such as egg freezing, IVF, and pre-implantation genetic screening through Progyny. Progyny benefits are only available for Meritain Health members.
Fertility treatment. It can be complicated, emotionally draining, expensive — especially if things don’t go as you hope. Meritain Health members have another resource to navigate this very personal journey: Progyny. Progyny is a fertility services provider that uses a preferred network to deliver positive results for families while reducing their risk of multiple births.
How to get started
To begin treatment, call Progyny at 833-838-5850.
You will not receive an insurance card. However, Progyny will provide a confirmation statement when you contact them to initiate your benefit and they authorize your services. Your confirmation statement is your proof of enrollment and will include your Progyny member ID, authorization number, and a list of in-network laboratories for diagnostic testing, preconception carrier screening, and preimplantation genetic screening (PGS).
Precertification is not required, and doctors have the flexibility to provide the most effective treatment the first time.
What does Progyny cover?
Patient concierge: included
Fertility lifetime maximum: 3 Smart Cycles
Surrogacy counseling: included
Egg and sperm donation: included as part of a Smart Cycle
Egg and sperm freezing: included for 1 year
Diagnostic testing: pre-implantation genetic screening (PGS or PGT-A)
Adoption reimbursements: $25,000
Pharmacy: Included in 3 Smart Cycles
Fertility-treatment drugs are covered through Progyny instead of CVS Caremark. If you've been receiving fertility prescriptions through CVS and have questions, contact a Progyny Care Advocate at 833-838-5850 for assistance.
What is a Smart Cycle?
A Smart Cycle is a complete set of fertility treatments for in vitro fertilization (IVF), fertility preservation (egg/sperm freezing), or intrauterine insemination / artificial insemination (IUI). Coverage for each Smart Cycle includes the consultation, diagnostic testing, monitoring and management of the fertility care, preimplantation genetic screening, intracytoplasmic sperm injection (ICSI), use of donor egg or donor sperm (if applicable), embryo cryopreservation, one year of embryo or semen storage, anesthesiology, personalized member education, and concierge service from a Progyny Patient Care Advocate (PCA).
Smart Cycle example
A Smart Cycle can be mixed and matched to provide coverage based on your needs. For example:
- A 37-year-old woman with a history of miscarriage can use half a Smart Cycle for a frozen IVF treatment, then half a Smart Cycle for each frozen embryo transfer
- Or a 32-year-old woman can use half a Smart Cycle for egg freezing and know that she can use her remaining half cycle if she experiences infertility some day in the future
- A woman requiring IUI can use her Smart Cycle for 4 IUI attempts
There is a lifetime maximum of three Smart Cycles, but there is no benefit dollar limit. Each Smart Cycle covers diagnostic tests and technologies that are normally paid out of pocket by you.
How a Progyny Smart Cycle works
The Progyny Smart Cycle benefit approach provides comprehensive coverage for all fertility treatments, thereby eliminating the need for precertification. To receive the most effective treatment, you will need to seek services from one of Progyny’s vast network of providers.
Once you’ve met your Meritain plan deductible, authorized fertility services will be covered at 90%. This means you’ll pay 10% of the cost until you reach your out-of-pocket maximum using Progyny’s preferred network.
Once your fertility treatment ends, you will receive an Explanation of Benefits (EOB) from Meritain outlining your costs. You will also receive an invoice from Progyny for these costs, which will be due upon receipt.
Watch a short video about Progyny fertility benefits.
What if I’m currently receiving fertility treatment?
Call Progyny at 833-838-5850 to speak to a Patient Care Advocate (PCA) who can assist you. PCAs are available Monday through Friday, 6 a.m.–6 p.m. PT. Your PCA can also help you locate in-network providers for fertility care.
Provider contact information
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