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| Resources > Newsletters > Understanding The NY Grant Program for IVF |
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| Understanding The New York Grant Program for IVF |
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| The New York State Commissioner of Health has established a Mandate program to provide grants to health care providers for the purpose of improving access to infertility services for those in need. The grant program guarantees that couples with medical indications for in vitro fertilization (IVF) do not bear the entire burden of the health care expense. It is available only to patients who are privately insured, and whose insurance policy excludes benefits for assisted reproductive technologies. Since every insurance plan is different, it is important for every patient to thoroughly understand her specific plan. |
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| GENESIS has been selected as the only provider in Brooklyn and Staten Island to offer this program. Co-payment for treatments is based on New York State residency, household income, and private health insurance. Couples are eligible for coverage only if the female partner is between the ages of 21 and 44 and meets the criteria outlined below: |
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Infertility Diagnosis
- Failure to conceive after 1 year (if 30 years of age or less)
- Failure to conceive after 6 months (if older than 30)
- Known or suspected uterine or tubal disease
- History of oligo/amenorrhea
- Irregular menstrual cycle
- Endometriosis
- History of in utero DES exposure
- Pelvic pain
- History of pelvic inflammatory disease
- Known male factor infertility
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Prior Medical History (indicating at least 1 criteria)
- At least 4 unsuccessful cycles of intrauterine insemination
- (IUI) and/or ovulation induction OR
- Have previously diagnosed tubal disease OR
- Other pre-existing medical condition that precludes or
- significantly reduces the likelihood of a successful IUI and/or
- ovulation induction OR
- Subfertile partner
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Covered Services include up to two cycles of IVF, inclusive of:
- Medications for ovulation induction
- Monitoring of ovulation induction
- All laboratory & sonography testing
- Egg retrieval
- Laboratory (in vitro) fertilization
- Intracytoplasmic sperm injection (ICSI) as required
- Embryo transfer of 2-5 embryos per cycle
- All facility fees
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Eligibility Requirements are as follows:
- Proof of NYS Residency - utility bill
- Proof of Age – driver’s license
- Proof of Insurance – current insurance card
- Proof of Income – tax return (top page of form 1040)
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Benefit
- Maximum of 2 completed IVF cycles per patient
- Patient cost share based on the income information provided
- by tax documents
- Payment is due prior to beginning medical care
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Ineligibility – (indicating at least 1 criteria)
- Medical contraindication to pregnancy OR
- Medical condition indicating very low likelihood of success (i.e. abnormal FSH level, history of 3 or more unsuccessful IVF cycles, or numerous incomplete cycles) OR
- Non New York State resident
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Non-Covered Services
- Assisted sperm retrieval methods (i.e. MESA, TESE)
- Obtaining donor sperm, donor eggs or donor embryos
- Pre-implantation genetic testing of embryos
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| The staff at GENESIS is proud to have been selected as one of the Centers of Excellence providing this program to patients in need. |
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| For further information about the NYS Mandate Program, please contact Michael Pagliuca at 718.283.6586 |
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