Financial Wellness and Your Progyny Benefit FAQ

Progyny is here to help you every step of the way as you navigate your fertility and family building journey, including understanding your financial responsibilities. We want to ensure you have the tools you need to make informed decisions around your care and have compiled the most frequently asked financial questions to help you best prepare for your next steps. If you are a Progyny member, you can always reach out to your dedicated Patient Care Advocate and our team of Clinical Educators for more information, guidance, and support.  

What is my financial responsibility with Progyny?

Your employer may offer Progyny benefits through several eligible health plans. Your financial responsibility will be determined by the specific health plan you are on. Please reach out to Progyny at 888.597.5065 for more information on your specific coverage.

When will I start receiving bills for services?

You can expect to see invoices from Progyny for covered services including tests, office visits, and treatment. Invoices can take up to 45+ days to process at the completion of your treatment cycle and will explain your cost share for that service. If you have Progyny Rx coverage, invoices will also be sent for medications, which can take up to 45+ days to process after medications are dispensed.  

What will happen if I have already reached my out-of-pocket maximum or deductible?

For most plans, at the start of each plan year, your deductible and out-of-pocket maximum may reset. This means you will pay out-of-pocket for your all-medical services (in most instances, including fertility services) until you reach your deductible or out-of-pocket maximum. Once you reach your out-of-pocket maximum, your insurance company pays a hundred percent of your covered services until the end of the year.

Does Progyny offer payment plans for treatments?

You are able to set up an interest-free payment plan with Progyny. Please reach out to your PCA to learn more.

Can I use my HSA or FSA while using the Progyny benefit?

Yes, when you receive your Progyny invoice, you may submit payment using your HSA or FSA.

What if my partner and I both have access to the Progyny benefit?

Services will be processed through your primary Progyny benefit until it is exhausted. Prior to the primary benefit being exhausted, you may request that any out-of-pocket responsibility be deducted from your secondary Smart Cycle balance, subject to your member responsibility, as applicable. Your PCA can provide you with more detail on how this will impact your secondary Smart Cycle balance. Once your primary Progyny benefit is exhausted, your remaining Smart Cycle balance under your secondary Progyny benefit can then be utilized for coverage of services. Please reach out to your PCA to learn more about your specific plan options.

How do I get started?

To get started, contact your PCA at 888.597.5065, who will be there to provide clinical and emotional support throughout your entire journey. Progyny PCAs are fertility experts trained to support all paths to parenthood, including surrogacy and adoption. Your PCA can provide guidance on available treatment options and outcomes, coordinate and prepare you for all your appointments, and answer any questions you might have about your benefit – including those related to finances.

Progyny recently held a webinar, Financial Wellness and Your Progyny Benefit, that discussed the financial aspects of fertility treatment and what to expect when using the Progyny benefit. Tune into the conversation and reach out to if you have any additional questions.