Infertility Services - (0089)

Cigna covers diagnostic evaluation and medically indicated infertility treatments (e.g., ovulation induction, IVF/ICSI and associated services, selected reproductive surgeries, and limited cryopreservation) only when the individual's benefit plan or an applicable state mandate provides coverage, and explicitly excludes reversal of voluntary sterilization, donor/surrogate services, and numerous procedures/tests deemed experimental or unproven. Coverage requires that the infertility/fertility-preservation benefit be in the plan (or a state mandate), and medical records documenting infertility per the plan (history/physical, specified labs such as TSH/FSH/AMH, imaging, semen analyses, and prior treatment history) plus specific criteria for cryopreservation and ART be submitted to support medical necessity.

"Testing to determine fertility is available only under an applicable infertility benefit plan."