Financial Information
We understand that navigating the financial side of healthcare can feel complex and sometimes overwhelming. Our goal is not only to provide high-quality care, but also to help you feel informed, prepared, and supported throughout your healthcare journey.
Affording Care
Understanding Your Insurance Plan
Insurance plans vary in their rules around coverage, referrals, and prior authorizations. While we are in-network with many commercial plans, coverage may vary based on the type of visit and your location. Understanding your benefits ahead of time can help prevent unexpected costs.
PPO (Preferred Provider Organization):
Offers greater flexibility. Referrals are not usually required to see specialists, though some services may still require prior authorization.
POS (Point of Service):
Combines elements of HMO and PPO plans. You may need referrals for certain services, and out-of-network coverage may vary.
HMO (Health Maintenance Organization):
Typically requires a referral from your primary care physician before you see a specialist. Make sure a referral is submitted before your appointment. Without it, your insurance may deny coverage, and you may be responsible for the full cost of the visit.
High-Deductible / HDHP Plans:
Often paired with HSA or FSA accounts. You are responsible for out-of-pocket until your deductible is met.
HPN (Health Plan Network):
Uses a defined network of contracted providers. Coverage is typically limited to in-network care, and referrals may be required depending on the plan.
For plan-specific details, we recommend contacting your insurance provider using the member services number on the back of your insurance card.
Key Things to Check on Your Plan:
1
Deductibles, copays, and coinsurance
2
Network restrictions for providers and facilities
3
Referral or pre-authorization requirements
4
Fertility or specialized procedure coverage
Coverage for Specific Services
Fertility Services
Fertility coverage varies significantly by insurance plan, and not all plans include fertility benefits. We recommend confirming your coverage before your visit. If your plan does not include these benefits, you may choose to proceed using our self-pay rates.
Fertility Benefit Managers
Some insurance plans use a fertility benefit manager, a third-party organization that administers fertility benefits separately from your primary insurance. These programs can help optimize coverage and manage out-of-pocket costs.
We partner with several fertility benefit managers, including:
• Kindbody
• Progyny
• Maven
• Carrot
• WIN
If your plan includes a fertility benefit manager, enrollment is required before benefits can be applied. Once enrolled, please notify us so we can update your information. Some plans may also require prior authorization before treatment begins.
How to find out if you have a fertility benefit manager:
If you have employer-sponsored health insurance, contact your HR department or review your benefits documentation.
Vasectomy
Vasectomy Coverage for vasectomy procedures varies by insurance plan. Many plans consider vasectomy a covered preventive or elective procedure, though referrals or prior authorization may be required. Copays or deductibles may apply. For additional details, including self-pay rates, please visit our vasectomy page.
Surgical Procedures
Coverage for surgical procedures varies depending on your insurance plan and the specific service. Some procedures may not be covered or may only be partially covered. Out-of pocket costs such as deductibles or coinsurance may apply. Elective or non-preventive procedures are not typically covered.
Common procedures include:
• Sperm Extraction
• Varicocele Repair
• Vasectomy Reversal
Special Programs & Memberships
Employers
Some employers have special arrangements that may affect how your plan covers certain services. If you’re employed by one of these companies, please contact us through the patient portal so we can review your specific benefits.
- Topgolf Callaway Brands
- Elbit America
- Fluor
- InBank
- Chicago Public Schools
- TeamHealth
- Momentum
HRT Club Members
Please message us through the patient portal for pricing information.
Financing Options
We offer trusted financing solutions to help make your care more affordable and accessible.
Care Credit:
We partner with CareCredit a healthcare financing program that allows you to pay for medical expenses over time. CareCredit offers a variety of payment plans, often with low or no interest, helping make care more manageable.
Capex MD:
If your insurance doesn’t fully cover fertility-related procedures or if you prefer more flexible payment options, we partner with Capex MD, a specialized fertility financing partner. They offer loans above $3,000 with competitive fixed rates, repayment terms, and no prepayment penalties. For more information, visit their website at https://www.capexmd.com/.
Self Pay Rates
New Patient: $475
Returning Patient: $275
Frequently Asked Questions
Please upload your insurance card and related documents before your first appointment to help us verify coverage. You can do so on your patient portal here.
As a courtesy, we submit insurance claims on your behalf for services rendered. Once the claim is processed, your insurance carrier will determine coverage and payment. Any portion not covered or paid by your insurance will be your responsibility.
If you have insurance that we do not participate in, our office can file the claim on request.
You may receive a bill for copays, deductibles, coinsurance, or services not covered by your plan.
Yes, we accept HSA and FSA payments.
Our clinics do not accept Medicare, Medicaid, Tricare, or TriWest insurance plans. However, patients are still welcome to receive care on a self-pay basis.
We offer a 20% discount for self-paying military personnel.