Coverage - Benefit Description

 
Infertility Coverage

To provide added value to members who may be experiencing infertility, Abbott is pleased to introduce an innovative program called Reproductive Resource Services (RRS) which provides education, counseling and acts as an access point to a national network of premier infertility treatment centers. 

RRS Centers of Excellence (COE) network clinics have been selected because they provide exceptional clinical outcomes as well as a reduced risk of complications due to multiple births.  Nurse consultants along with the RRS Web site assist participants with questions such as:

  • What are my treatment options?
  • When should I start treatment?
  • Where is the best place to seek treatment?

Infertility Benefits
Your plan covers many services for infertility, up to $35,000 lifetime for medical expenses and up to another $15,000 lifetime for prescription drugs. The plan covers most approved fertility treatments such as artificial insemination and in vitro fertilization, as well as surgical procedures to repair medical causes of infertility. 

  • Facilities. Infertility coverage is only available at RRS Centers of Excellence facilities.  Network physicians who contract with Blue Cross and Blue Shield, but do not participate in RRS will not be covered by the plan, and no out-of-network benefits are available. Locate a facility.
  • Precertification. All infertility treatments and any consultations with a reproductive endocrinologist must be approved by RRS, prior to receiving services, to receive benefit coverage.

Call the RRS Nurseline at (866) 774-4626 between 8:00 a.m. and 5:00 p.m. (CT) to pre-certify infertility benefits, receive information on which centers are in-network as part of RRS, and to access a variety of educational information.  If you do not complete the pre-certification process, you will not receive benefits, even if your provider or facility is part of the RRS network.

You may also contact Blue Cross and Blue Shield of Illinois (BCBSIL) customer service at (800) 671-1210 for details on your medical benefits for infertility.

Healthy Expectations® Program
Achieving pregnancy is the first step in the process of delivering a healthy baby. RRS nurses are available to provide you with information regarding considerations and care for pregnancy, as well as to refer you to the BCBSIL Healthy Expectations program. Please notify the RRS nurse as soon as you become pregnant and she will help you facilitate your enrollment. 

Blue Cross and Blue Shield of Illinois (BCBSIL), an independent licensee of the Blue Cross and Blue Shield Association, and Reproductive Resource Services (RRS) have each independently contracted with Abbott/TAP. BCBSIL provides administrative claims payment services to the Abbott/TAP benefit program. RRS provides infertility education and support services for the Abbott/TAP benefit program.