Infertility is when a person is unable to achieve pregnancy after:
- One year of egg-sperm contact efforts when the person attempting conception is under age 35, OR
- Six months of egg-sperm contact efforts when the person attempting conception is age 35 or older
Egg-sperm contact can be from sexual intercourse or artificial insemination (intrauterine, intracervical or intravaginal). Infertility may also be caused by a problem with the reproductive tract that makes egg-sperm contact ineffective. This explanation applies to all individuals regardless of sexual orientation or the presence/availability of a reproductive partner.
To learn more about infertility coverage, limitations and exclusions, please refer to the Official Plan Brochure.
You can also refer to our Clinical Policy Bulletins (CPBs) for more information.
Healthy Pregnancy Program
Our Healthy Pregnancy Program provides tools and support for every stage. You can get trusted information and guidance about family planning, maternity support and postpartum care.
With this program, you’ll also have access to:
- Nurses who are trained in obstetrics and high-risk pregnancy
- Behavioral health support, including referrals to resources to help with stress, depression and anxiety
- Postpartum depression screening and support
- Resources and educational materials through our Maternity Support Program
- Genetic counseling and testing
- Preeclampsia prevention — If you’re identified as high-risk, you’ll get helpful information about the risk factors and the benefits of aspirin therapy.
- On-on-one support from a fertility advocate to help you with your infertility journey, fertility preservation, same-sex conception needs and more. They’ll also provide support and guidance during fertility treatment and if you become pregnant. To reach a fertility advocate, call 1-833-415-1709 (TTY: 711).
We’re here for you
Our experienced maternity nurses and professionals are here to help no matter where you are in your pregnancy journey. The maternity program is optional and available at no cost to you. Your treatment plan is still in the hands of you and your doctor. Call 1-855-282-6344 (TTY: 711) between 8 AM and 9 PM ET with questions or to enroll.
The Centers for Disease Control and Prevention (CDC) HEAR HER™ Campaign seeks to prevent pregnancy-related deaths by sharing potentially life-saving messages about urgent warning signs. For more information on the HEAR HER Campaign visit CDC.
Our Healthy Pregnancy Program also provides you and your partner 24/7 access to Maven’s digital health platform and quality providers via unlimited video appointments, messaging and classes.
Your Maven membership includes support on adoption, surrogacy, fertility, maternity and postpartum care:
- A personal care advocate who serves as a trusted guide to help you navigate the Maven platform and connect you with providers throughout your journey
- Unlimited video chat and messaging with doctors, nurses, and coaches across 35+ specialties, including fertility, mental health, doulas, sleep coaches, pediatrics and more
- Provider-led virtual classes and vetted articles tailored to your journey
- Counseling and expert guidance via Maven Adoption and surrogacy coaches through different adoption and surrogacy pathways and key considerations in the process
You can find more information in the Official Plan Brochure.
Under Certain preventative care, including contraception, is covered at no cost by the Affordable Care Act. If your doctor decides you need contraception that isn’t covered, they can request an exception. Ask them to fill out the Contraception Exception Form. You can review the Contraception Exception Process to learn more.
For information about contraceptive resources and reproductive rights, visit the Office of Personnel Management (OPM) and the Department of Health and Human Services (HHS) websites.If you need help with contraceptive coverage or other reproductive health, email OPM at Contraception@opm.gov.