Infertility services
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 from 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.
To learn about coverage for Advanced Reproductive Technology (ART), including In Vitro Fertilization (IVF) coverage, please review Section 5(a) in the Official Plan Brochure. This coverage is only available in the Open Access HMO High Option plan offered in DC, MD and VA.
Get support from the Aetna National Infertility Unit (NIU)
Our NIU is made up of a dedicated team of registered nurses and infertility coordinators. They can help you understand your benefits and the medical precertification process. Learn more at AetnaInfertilityCare.com. Or call the NIU at 1-800-575-5999 (TTY: 711).
You can refer to our Clinical Policy Bulletin (CBP) for more information.
Aetna Enhanced Maternity Program®
The Aetna Enhanced Maternity 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 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
- One-on-one support from a fertility advocate to coordinate your care
Postpartum support
Our Enhanced Maternity Program offers resources and support to help you after delivery. Our Maternity Support Center, available through your member website, has educational materials to help you understand postpartum depression. And our experienced maternity nurses are also available to help. You can also find information on postpartum depression on Aetna.com. Please refer to Aetna.com/Health-Guide/Understanding-and-Overcoming-Postpartum-Depression.html for more information.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 1-800-272-3531 (TTY: 711) between 8 AM and 7 PM ET with questions or to enroll. Learn more about the maternity program and other pregnancy support here.Contraceptive coverage
Certain preventative care, including contraception, is covered at no cost by the Affordable Care Act. Details can be found in section 5(f) of your official plan brochure. 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 (PDF). You can review the Contraception Exception Process (PDF) 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.