This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in your medical policy. If there is a difference between this summary and your policy, the terms of your policy will apply.
Providers, this summary is for members, to review the terms of your participation agreement, please visit uhcprovider.com
FAMILY PLANNING
| Birth Control Pills | See Prescription Drug Section for pharmacy benefits. | See Prescription Drug Section for pharmacy benefits. |
| ParentSteps(SM) | Not Applicable. | Not Applicable. |
| Fertility Solutions | Fertility Solutions provides education, counseling, infertility management and access to a national Network of premier infertility treatment clinics. For infertility services and supplies to be considered Covered Health Services, contact Fertility Solutions and enroll with a nurse consultant prior to receiving services. To enroll in the program and obtain information concerning infertility treatment, to talk to a Health Care Advisors nurse at 1-888-651-4004. | |
| Infertility Services and Fertility Solutions
Benefits are limited to the following procedures:
To be eligible for Benefits, the Covered Person must:
|
To take part in the Fertility Solutions program, call a Health Care Advisors nurse at 1-888-651-4004. The Plan will only pay Benefits if Fertility Solutions provides the proper notification to the Designated Facility provider performing the services (even if you self-refer to a provider in that Network).
Same as:
Benefits for infertility services are limited to $15,000 per Covered Person during the entire period you are covered under the Plan. Prescription charges are limited to a separate $10,000 lifetime maximum. |
Not Covered |
|
Reproduction
Female contraceptive services, supplies and voluntary sterilization are covered the same as Preventive Care Benefits as defined under the Health Resources and Services Administration (HRSA) requirement. |
Same as:
The following are covered:
|
Same as:
The following are covered:
|
| Reproduction-Exclusions |
The following services are not covered:
|
|
| Tubal Ligation | Female contraceptive services, supplies and voluntary sterilization are covered the same as Preventive Care Benefits as defined under the Health Resources and Services Administration (HRSA) requirement. | Female contraceptive services, supplies and voluntary sterilization are covered the same as Preventive Care Benefits as defined under the Health Resources and Services Administration (HRSA) requirement. |
| Vasectomy | Same as:
|
Same as:
|