Progyny’s mission is to empower healthier, supported journeys through transformative fertility, family building, and women’s health benefits. We hosted a webinar to dive deeper into what members can expect from their Progyny fertility and family building benefit. Whether you are new to Progyny, or have already started your family building journey, this webinar provides insight into how to get started with the benefit, what to expect, and support available throughout your journey.
The webinar featured:
- Dr. Jaimin S. Shah, Reproductive Endocrinologist at Shady Grove Fertility
- Sherri Sawyerr, Progyny Member
- Jasmine Ahmad, Manager of Member Services at Progyny
- Christine Forcillo, Senior Manager of Provider Account Management at Progyny
This webinar focused on Progyny’s fertility and family building benefit. If you have access to Progyny’s additional family of benefits through your organization, including Pregnancy and Postpartum and Menopause and Midlife Care, you can call your Progyny Patient Care Advocate (PCA) to learn more and explore resources on our Educational Site.
Getting Started with Progyny
We understand the family building journey can be complex and are here to provide support and guidance to our members every step of the way. To get started with Progyny, call your dedicated Patient Care Advocate (PCA). Whether you just want to learn more about your options, are trying to conceive, or exploring fertility treatment and family building options, your Progyny PCA is there to support you each step of the way. For your first call with Progyny, you will speak to a welcome specialist who will take you through onboarding and match you with a specific PCA based on your fertility and family building goals. If you have already started on your family building journey but now have access to Progyny, your PCA can talk through your transition of care plan and help make the transition as seamless as possible.
What should I expect on my first call with Progyny?
Your PCA is there to walk you through the details of your benefit and what to expect, and any questions you may have. Topics covered during your initial calls may include:
- Coverage included through your specific benefit
- Process and timing for authorizing treatment
- Understanding your financial responsibility
- Next steps and expected timeline
- How to choose an in-network clinic that’s right for you
- What to expect at your initial consultation
How to choose an in-network provider?
After activating your Progyny benefit, choosing an in-network clinic is an important next step. Your PCA can help you locate an in-network provider that will be aligned with your needs, and we also offer our Provider Search Tool where you can find detailed information for each clinic including provider profiles, sub-specialties, and clinic offerings. Selecting a clinic is a personal choice and working with your clinic should feel like a partnership where you can have open communication and feel good throughout the journey.
As a Progyny member, you will also have access to the Progyny member portal, available on the web or as an app. Through the portal you can view coverage details, review upcoming appointments, view account and claims information, and communicate directly with your PCA.
From PCA to Provider: Understanding Your Initial Consultation and Treatment Plan
After onboarding with Progyny and selecting a clinic, you’re ready for your initial consultation. If you have already started your journey but are new to utilizing the Progyny benefit, our Patient Care Advocates are here to support you through the transition of care process and ensure there are no disruptions. No matter where you are at in your journey, the initial appointment with your provider is an opportunity to build that relationship and align on your family building goals. Every clinic and doctor conducts their consultations differently but there are a few topics that you should be prepared to talk about.
- Your family building goals: Your provider will be interested in understanding your overall family building goals, such as family size and what you may not be open to, to tailor a treatment plan for you. Once they understand your goals, they can help you understand what your options are moving forward.
- Patient and family history: Whether you are new to the family building journey or are trying out a new clinic, these records will be needed to understand what to recommend for your next steps.
- Your treatment plan: After learning more about your family building goals and clinical history, your doctor will come up with a plan for you. You and your provider will discuss the plan together to ensure you’re aligned and comfortable with the path forward.
At the end of your initial consultation, you should walk away with an understanding of your different treatment options, success rates, and timeline expectations. Your PCA is there to discuss any questions you may have following your appointment and make sure you keep them looped in on all future appointments to provide needed authorizations. In addition to helping with authorizations and understanding your financial responsibility, your PCA is also there for emotional support. PCAs can help discuss how you can continue to advocate for yourself throughout your treatment and how to keep open communication with your provider.
Continued Support Throughout the Journey
We understand the fertility journey can be overwhelming and emotionally draining, so it’s important to lean into your support systems and know that Progyny is here to support you across each aspect of your journey. In addition to speaking with your PCA, Progyny also provides a wide range of resources that can help you through your journey whether that is through our podcast, This Is Infertility, which shares real life stories and different perspectives on a family building journey, or on our YouTube channel which features experts in the field to provide education to support you on your journey.
Outside of Progyny, be on the lookout for other amazing resources that are available for you along your journey. Check in with any employee resource group your company is offering to see if there’s one that aligns with what you are looking for. If you are more comfortable finding support outside of the office, your provider can help you find support groups in your area or direct you to online support groups that are connected to their clinic. Having people around you who are going through the same experience as you can create a great resource to rely on during the journey.
Questions From The Audience
- Can you explain what a Smart Cycle is?
Unlike traditional fee-for-service carrier models, everything needed for a comprehensive fertility treatment is bundled within the Progyny Smart Cycle. The Progyny Smart Cycle is designed for comprehensive coverage, and all standard of care services and technology needed for a particular type of treatment cycle are covered within the Smart Cycle. Each treatment or service is valued as a portion of a Smart Cycle and expressed as a fraction, so you always know your benefit balance. That means you won’t run out of coverage mid-cycle, and you can focus on the most effective treatment. Please note, covered services include financial responsibility depending on your medical plan and some treatments may have tax considerations.
- What’s included in my Progyny benefit?
Your Progyny benefit includes comprehensive fertility treatment coverage for every unique path to parenthood, access to a premier network of fertility specialists, and personalized emotional support and guidance from dedicated Patient Care Advocates (PCAs). Under your Progyny benefit, a Smart Cycle can be mixed and matched to cover the fertility treatment that is right for you. You may pursue treatments such as timed intercourse (TIC), intrauterine insemination (IUI), in vitro fertilization (IVF), etc., or any combination that you and your doctor think is best.
- What happens if I start treatment with Progyny from my employer and then I change jobs mid-treatment? Am I still eligible to continue with the treatment even if I lose my current Progyny coverage?
If you receive treatment after you have left your employer, you must enroll in COBRA. The process of enrolling in COBRA may take time. Contact your HR department directly for more information regarding your specific COBRA coverage options. Advise your PCA of any coverage changes. You forgo any remaining Progyny benefits if you choose not to enroll in COBRA and are subsequently responsible for any further treatment expenses.
- After the initial consultation, how long does an individual have to start treatment? Can there be a large time gap between the initial consultation and starting treatment?
Typically, the recommendation is to start as soon as possible, but labs are usually good for up to twelve months. There are some tests that would need to be repeated if six months elapses between initial consultation and treatment. On the Progyny side of things, authorizations are valid for 90 days so it’s best to ensure your request for an authorization is timed according to when you start treatment.
- When going through treatment, what can I do to ensure the best possible outcome?
It is important to have a healthy lifestyle overall when going through treatment. This includes eating well, good sleeping habits, consistent exercise, and having a strong village around you. If you are interested in learning more about taking charge of your reproductive health, check out this helpful resource that outlines different steps to consider when prioritizing your wellness: Wellness and Taking Charge of Your Reproductive Health.
- What is an authorization and why do I need it?
A Patient Confirmation Statement (authorization) is a document that confirms your Progyny coverage for a specific treatment. An authorization is required before your first appointment and again before you begin each treatment cycle. Contact your PCA when you schedule each appointment to generate an authorization and to help ensure there are no billing errors or delays in treatment.
If you have any other questions related to this webinar, please don’t hesitate to reach out to firstname.lastname@example.org. If you are a Progyny member and have any questions about your benefit or coverage, please call 888.597.5065.
Additional Resources to Support Your Progyny Journey
- Progyny Article, What Should I Expect at an Initial Consultation with a Fertility Specialist?
- Progyny Article, Frequently Asked Questions During a Fertility Journey
- Progyny Infographic, Patient Fertility Treatment Timeline
- Progyny Video, Meet Progyny’s Clinical Educator Team
- Progyny Article, Starting Your Fertility Journey: What to Expect and When to Seek Care | Progyny
- Progyny Article, 8 Tips To Getting Started with Fertility Treatments | Progyny
- Access resources across Progyny’s family of benefits on our Education Site