The benefit structure of the Duke Select and Duke Options health plans requires patients receiving infertility services to pay a copay based on a packaged group of services. Care must be provided at Duke Fertility. Employees and their covered spouse/partner are eligible after two years of continuous service.
- In vitro fertilization (IVF) - Patient pays $4,000. *
- IVF with ICSI - Patient pays $4,500. *
- 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.
Note: The patient should use the Express Scripts prescription card at a participating pharmacy to purchase infertility drugs.
Please note that, effective January 1, 2022, Member Copayments, Coinsurance, Deductible amounts, and Prescription drug costs incurred for Infertility Services do not accrue towards the Plans' Out-of-Pocket Maximums.