Navigating a family building journey can be overwhelming, but Progyny is here to provide support each step of the way. To kick-off the new year, we hosted a webinar on Your Family Building Journey with Progyny. Our expert panelists discussed the Progyny benefit, how it works, and the many ways individuals and couples can build their families.
The webinar featured:
- Victoria St. John, Account Manager, Progyny
- Karen Madsen, Manager of Member Services, Progyny
- Dr. Brent Hanson, MD, Fertility Specialist and OBGYN at CCRM Minneapolis, Progyny network provider
Your Progyny Benefit
At Progyny, we understand that the road to parenthood can be challenging, and we want to ensure members feel supported each step of the way. We designed our benefit to give each individual and couple the opportunity to fulfill their dreams of parenthood by removing barriers to care and partnering with the nation’s leading fertility specialists to bring a smarter approach with treatment options that support all paths to parenthood. The Progyny benefit includes comprehensive treatment coverage leveraging the latest technologies and treatments, personalized support and guidance from dedicated Patient Care Advocates (PCAs), and access to high-quality care through a premier network of fertility specialists.
For your specific benefit design and coverage details, please reach out to your dedicated PCA number or refer to your employer specific benefit member guide.
As a Progyny member, your journey will begin with your dedicated Patient Care Advocate (PCA), who will be there to support you each step of the way. Progyny’s PCAs are trained to support all treatment types and paths to parenthood, including surrogacy and adoption. In addition to providing guidance on available treatment options and outcomes, your PCA can provide logistical support such as coordinating and preparing you for all your appointments.
As a new member, your first step will be to call Progyny and activate the benefit. On that initial call, you will go through the onboarding process and your PCA will ask questions about your family building goals and medical history, and ensure you are registered so that our team can proceed with authorizations when you are ready to see a fertility specialist. During these calls your PCA will tailor the conversation to your specific fertility journey and educate you on the process so you feel comfortable with any next steps. We understand no two journeys are the same and some paths may be more complex, so it’s important to note that you have unlimited access to your PCA. Your PCA is available to you at any point in your journey and you can reach out to talk about your treatment, medications, or just for moral support. Your PCA can also connect you to our team of clinical educators, made up of nurses and embryologists, who can discuss more clinical questions in more detail.
Progyny designed our benefit to ensure members can customize their treatment for their unique journey. Progyny bundles each treatment into a currency called the Smart Cycle. The Smart Cycle includes all standard of care services and technologies needed for a treatment cycle, meaning members and providers are empowered to make the best care decisions and focus on the best treatment plan, eliminating cost-based treatment decisions. Each treatment or service type is valued as a portion of a Smart Cycle that deducts from your overall balance. Depending on your health plan, you may have financial responsibility such as coinsurance, deductibles, or an out-of-pocket maximum. PCAs are available to walk through your financial responsibility at any point.
When ready to begin treatment, your PCA can help you find the right fertility specialist and you can also search for in-network providers at https://progyny.com/find-a-provider/. Your PCA is available to discuss each appointment to ensure your treatment is authorized and that you feel prepared. Our provider team will contact the clinic and get everything arranged so you are taken care of by the time you step in the door for your visit.
Top Fertility Specialists
No two fertility journeys are the same and one of the first steps you need to take is finding a provider you like and trust. Progyny has built a provider network that is unmatched in the industry, allowing you to choose from over 900 of the nation’s top fertility specialists across 650 clinic locations nationwide. Your PCA can help you choose a clinic if you do not already have one in our network, or you can search for in-network fertility specialists, reproductive urologists, and in-network labs at progyny.com/find-a-provider.
A fertility journey can be physically, emotionally, and financially draining, so it’s important you find a provider and clinic that is right for you. When visiting your chosen clinic and fertility specialist, it is important to feel prepared and we recommend having a list of questions so you can get the information you need based on what you’re looking for and ensure you and your doctor are aligned. Some questions to keep in mind when meeting with your physician include:
- What are your outcomes?
- What types of treatments do you provide?
- What would happen if you needed to change treatments from the initial plan?
- How does my Progyny benefit come into play?
- What will my relationship with the nurses and physicians look like moving forward with treatment?
Finding the right fit can really help set you up for success in your journey, and it’s important to remember that the patient/clinic/doctor match is highly individualized. A clinic that may be a good fit for your friend may not be the best for you. It’s always okay to get a second opinion and look at other options. The Progyny network provides access to clinics nationwide, so you always have options for your care.
Your Initial Consultation + Treatment
Once you’ve chosen a clinic, your next step is to set up an initial consultation to review your medical history and do some diagnostic testing. Your PCA can help you schedule and review what you can expect. While there are general guidelines for when to consider seeing a fertility specialist, each journey is unique and you can reach out to a PCA at any time to understand your options and what next steps might be best for you. If you have a condition that may impact fertility, such as endometriosis, PCOS, oncofertility, or male-factor infertility, it often makes sense to seek consultation early and undergo diagnostic testing to understand your treatment options. You can schedule an appointment if you are curious to learn more about your own health or want to understand options for the future like fertility preservation. Information is key and the more you know, the earlier you can intervene with treatment if needed, and the better equipped you will be to make decisions that make sense for your health.
Once a consultation has taken place, a couple or individual may have to do testing which typically includes blood work, uterine imaging to assess the uterus and then visualizing the ovaries. The male partner may have to do a semen analysis and blood work. After testing you will work with your provider to determine the most effective treatment plan for you. The Progyny benefit supports all paths to parenthood and includes treatments for same-sex couples or single parents by choice such as reciprocal IVF, donor tissue purchase or surrogacy services (based on your specific coverage). Our ultimate goal is to make any member’s dream of parenthood come true through a healthy, timely, and supported fertility journey. You can reach your PCA on our general PCA line at 888.597.5065.
- What can someone expect when getting started and having that first appointment with their reproductive endocrinologist?
We know it can be a little intimidating when you go to see your fertility specialist so it’s great to know what to expect. There will be a lot of questions about your history – fertility, sexual intercourse, family, genetics, as well as a physical exam to learn more about your overall health. It will be a very in-depth conversation, followed by the doctor going through initial diagnostic testing. Your doctor and PCA can walk you through each test and you will have a follow up meeting to walk through your results.
- How do I access a Smart Cycle? Is there a list of medical conditions that make you eligible?
In order to access a Smart Cycle, you need to be employed or a spouse or domestic partner of a person who has access to the Progyny benefit. In most scenarios, Progyny is integrated with your insurance carrier which ensures the financial responsibility is streamlined. You will need to coordinate with your PCA to understand the specifics around what the financial responsibility looks like and your specific benefit plan design.
The Progyny benefit is designed to be inclusive and removes barriers to care so you and your doctor can create the customized treatment plan that is best for you. Reach out to your PCA to confirm eligibility and learn more about covered treatment options.
- If I’m already in treatment, how can I start using the Progyny benefit?
This will vary depending if you are a new employee at a company that already has Progyny or at a company that has recently implemented Progyny. If your employer is new to Progyny this year, there may be transition of care documents in place that will describe the transition of that journey. This means there may be some crossover of coverage from the previous plan to the Progyny plan. If you are a new employee to a company who already has the Progyny benefit, we would want your start dates of the cycle to align with your start date of eligibility so you have coverage. You can always discuss your specific situation with your PCA.
- Are there any exclusions for diagnostic testing?
There are no exclusions as long as the testing is considered standard of care. Anyone who is eligible for the Progyny benefit has access to the initial consultation and the only exclusions that may occur are if a test or procedure isn’t considered standard, such as experimental testing. Your PCA can always discuss standard exclusions with you.
- Am I able to have genetic testing performed on embryos from a previous retrieval?
This will be specific to your employer’s benefit and Progyny members should connect with their PCA to discuss specific coverage.
- Does Progyny have any surrogacy agencies they can recommend?
Progyny is not formally affiliated with any agencies but can recommend agencies we work closely with, such as Circle Surrogacy and Growing Generations. Progyny members can also speak to their PCAs who can provide resources, answer questions about the surrogacy process, and connect you with a surrogacy coach.
- When going through treatment, what can I do to ensure the best possible outcome?
When going through the treatment process, we want to ensure you have the information and education necessary to feel prepared and empowered about your journey. Your PCA and our team of clinical educators are always available to make sure you have the information you need.
If you have any other questions related to this webinar, please don’t hesitate to reach out to email@example.com. If you are a Progyny member and have any questions about your fertility benefit or coverage, please call 888.597.5065.