Fertility Insurance Information for Hawaii
Understanding your health insurance coverage is an important part of planning your fertility care. While navigating insurance can feel complex, many patients are surprised to learn that fertility treatments, including IVF and diagnostic services, are often partially or fully covered, depending on their specific plan.
At the Fertility Institute of Hawaii (FIH), we work with most major insurance providers across Hawaiʻi and nationwide to help make fertility care more accessible.
Insurance Plans We Accept
FIH participates with a wide range of insurance providers, including:
- Aetna
- Blue Cross Blue Shield (including Out-of-State and Federal Employee Program)
- ChampVA
- Cigna
- Desert Mutual
- GEHA
- HMA and HMA/UFCW (Hawaii Food Employers Health & Welfare Trust Fund)
- HMAA / HWMG
- HMSA
- Hawaii Electricians Fund
- Hawaii Laborers Trust Fund
- Horizon Blue Cross Blue Shield
- Kaiser Permanente (Added Choice)
- Meritain Health
- PSWA
- Tricare (Select and for Life)
- TriWest VA
- UnitedHealthcare (UHC)
Fertility-Specific Benefit Providers
Some employers offer additional fertility benefits through third-party programs. We are in network with:
- Progyny
- WinFertility
- Kindbody
- Maven
HMO Plans
We are in network with the following HMSA HMO groups; therefore, no referral is needed for the following:
- Hawaii IPA
- Straub
- Hawaii Health Partners
- Castle Health Group
- Oahu Physicians Group
- Pacific Health Care Group
Referral Required
Some insurance plans require a referral before your visit. These may include:
- Kaiser HMO
- Tricare Prime
- HMSA HMO plans not listed above
Quest (Medicaid) Plans
The following Quest plans typically cover fertility diagnostic services only, but do not cover fertility treatments such as IVF:
- AlohaCare Quest
- HMSA Quest
- UnitedHealthcare Quest
IVF Costs
Most Hawaii-based insurance plans are mandated to cover IVF, and many will cover other infertility services. Please see our IVF Costs page for more detailed information about the costs of IVF treatment.
Hawaii State Insurance Mandate for IVF
In 1987, Hawaii became one of the first states to mandate insurance coverage for infertility treatment. Under Sections 431-10A-116.5 and 432.1-604 of the Hawaii Revised Statutes, qualifying patients are entitled to coverage for one cycle of IVF.
To qualify, patients must meet at least one of the following criteria:
- A documented five-year history of infertility
- A diagnosis of endometriosis
- Blockage or surgical removal of one or both fallopian tubes
- Abnormal male factor infertility
- Inability to achieve pregnancy through other covered fertility treatments
While Hawaii’s mandate is an important protection, some provisions reflect the era in which the law was written and may feel outdated. Coverage eligibility can also vary by plan, as most, but not all, Hawaii insurance plans extend some fertility treatment benefits to single women and same-sex couples.
Our billing team is here to help you navigate your specific plan and maximize your benefits. Contact us directly with any coverage questions.
At the Fertility Institute of Hawaii, we have been actively advocating for updates to this mandate to improve access and ensure more inclusive fertility coverage for all patients. The Hawaiʻi State Legislature is currently reviewing this law, and updates may be made in the future.
Frequently Asked Questions
Does Medicare, Medicaid, or Quest cover any infertility treatment or expenses?
No. While most Hawaii-based insurances will cover IVF and a few will cover other infertility services, Medicare, Medicaid and Quest insurances will NOT cover any infertility treatment services or treatments.
Do I need a referral to be seen at FIH?
This will depend on your insurance plan. Most plans do not require a referral, but Kaiser, Tricare Prime, and certain HMO plans typically do. Our billing team can help verify this for you at the time of booking your appointment. If a referral is required but not obtained, your visit may not be covered. If you are planning to pay out of pocket, a referral is not needed.
Does insurance cover intrauterine insemination (IUI)?
Some insurance plans offer partial coverage for IUI, while others do not. If covered, you may still be responsible for co-pays, co-insurance, or deductibles. If your plan does not include IUI benefits, our team will provide a clear cost estimate before starting treatment.
Does insurance cover IVF (in vitro fertilization)?
Hawaiʻi has an IVF insurance mandate, which means many local insurance plans provide some level of IVF coverage. However, benefits vary, and specific medical and policy criteria must be met. Our providers and billing team can help you understand your eligibility and coverage.
Are fertility medications covered by insurance?
Coverage for fertility medications varies by plan. Some medications may be partially or fully covered, while others are not. We work with specialty pharmacies and discount programs to help reduce out-of-pocket costs whenever possible.
Does insurance cover intrauterine insemination (IUI)?
Some insurance plans offer partial coverage for IUI, while others do not. If covered, you may still be responsible for co-pays, co-insurance, or deductibles. If your plan does not include IUI benefits, our team will provide a clear cost estimate before starting treatment.
How do I verify my fertility insurance coverage?
Our billing team assists with benefit verification once established with our clinic and will walk you through your plan’s specific coverage levels. Patients can also contact their insurance provider directly to confirm fertility benefits, including coverage for IVF, IUI, medications, and any referral requirements.
How much does IVF cost without insurance?
The cost of IVF varies based on your personalized treatment plan. In general, an IVF cycle without medications may range from $9,000–$13,000. A consultation with one of our providers is the best way to receive an accurate estimate tailored to your needs.
Do you offer cost estimates before treatment?
Yes. After your consultation and treatment plan are finalized, our team will provide a detailed cost estimate so you understand your financial responsibilities before moving forward.
Why am I receiving a bill after paying my co-pay?
Your co-pay is only one part of your financial responsibility. Depending on your insurance plan, you may also have a deductible and/or co-insurance, which are billed after your insurance processes the claim.
Do you offer financing options?
Yes. We partner with several reputable financing companies that specialize in fertility care. You can learn more on our Financial Options page, and our billing team is happy to walk you through available options after your consultation.
Have Questions About Insurance Coverage? Contact Our Team
Contact us and we’ll help you review your benefits and options.
Established Patients
If you are already a patient of FIH, please use the purple Klara message button in the bottom right corner of your screen or text 808-855-6932 directly for the quickest support.
New Patients
If you are new to our practice, you can use the contact form to request a consultation or ask about treatment options.
