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4. Open Enrollment Is Coming: 5 Questions to Ask HR About Fertility Coverage Before You Choose Your Plan

Open Enrollment Is Coming: 5 Questions to Ask HR About Fertility Coverage Before You Choose Your Plan

Fall is one of the most important seasons for anyone thinking about starting or growing their family — not just because of the change in weather, but because open enrollment is right around the corner. Choosing the right health insurance plan can have a significant impact on your fertility treatment options and out-of-pocket costs. Before you lock in your benefits for the year, here are the questions you should be bringing to your HR department.

What to Ask About IVF and Fertility Benefits

Not all insurance plans are created equal when it comes to fertility coverage, and the details matter. Start by asking HR whether your plan covers IVF specifically, or only diagnostic testing. Then ask whether the plan has a lifetime maximum on fertility benefits and how many cycles are covered. New Jersey has a fertility insurance mandate, so depending on your employer size and plan type, meaningful coverage may already be available to you — but you need to confirm what applies to your specific plan.

Questions About Network and Clinic Access

Even a generous fertility benefit becomes limited if your preferred fertility clinic is not in-network. Ask HR which fertility clinics and specialists are included in the plan's network. If your employer offers a fertility benefits program through a partner like Progyny, ask specifically how that works and whether RSCNJ participates. Understanding network access before you enroll ensures you can receive care from a team you trust without unexpected costs.

Three More Questions Worth Asking

Beyond coverage and network, a few additional questions can help you make the most informed decision possible. Ask whether the plan covers fertility medications, since these costs can add up significantly. Ask whether there is coverage for fertility preservation, such as egg freezing, if that is relevant to your situation. Finally, ask what the process is for obtaining pre-authorization for fertility treatments, since some plans require this step before care can begin.

Make the Most of Open Enrollment This Year

Open enrollment only comes once a year, and the plan you choose will follow you through your entire fertility journey in 2026. Taking a few minutes now to ask the right questions can save you time, money, and stress later. At the Reproductive Science Center of New Jersey, we are here to help you navigate every step of this process — from understanding your benefits to building a personalized treatment plan. Contact us today to speak with our team.

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