The benefit structure of the Duke Select and Duke Options health plans requires patients who reside in North Carolina and are receiving infertility services to pay a copay based on a packaged group of services. For employees who reside in North Carolina, care must be provided at Duke Fertility. Employees who permanently reside in another state may access a BCBS in-network provider for these services, but the package pricing listed below will not apply.
Employees and their covered spouse/partner are eligible after two years of continuous service, and applicable medical policy criteria must be met.
Treatment Options and Pricing
(applies to Duke Fertility patients only)
- In vitro fertilization (IVF) - Patient pays $5,000.*
- IVF with ICSI - Patient pays $5,500.*
- Controlled Ovarian Hyperstimulation (COH) - Patient pays $800.*
- Frozen Embryo Transfer - Patient pays $800.
* Note: Drugs are not included. For prescriptions dispensed on or after April 1, 2019, Duke employees pay 25% of the cost (as well as the $100 deductible if not yet met) of infertility medications purchased at an in-network pharmacy, including Duke Pharmacies. The medications must be prescribed by Duke Fertility physicians. Employees who permanently reside in another state and are under the care of a BCBS in-network fertility specialist must have prior authorization approval, per Express Scripts standard policy, in order to fill infertility medications under the Duke Options plan.
Note: The patient should use the Express Scripts prescription card at a participating pharmacy to purchase infertility drugs.
Please note that Member Copayments, Coinsurance, Deductible amounts, and Prescription drug costs incurred for Infertility Services do not accrue towards the Plans' Out-of-Pocket Maximums.