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Legacy is in-network with leading health insurance plans and fertility benefits providers.
What this means for you: You may be able to test and preserve your fertility for up to 100% off, depending on your plan.
Legacy is in-network with several leading insurance providers, including:
Your specific plan’s coverage will depend on your location and benefits details.
You may also want to explore coverage from fertility benefits programs offered by some employers. Legacy’s products and services may be covered by benefits from:
Not sure if you have access to these benefits? Ask your employer! The details of your coverage will depend on which plan is offered by your employer.
Most eligible insurance plans cover a “For Today” semen analysis kit plus one year of frozen sperm storage. Your insurance or benefits plan may cover additional testing or storage. Check your explanation of benefits document for clarity.
You can check your insurance plan’s explanation of benefits, typically mailed to you or available online, to understand whether fertility testing and preservation services will be covered, and if a deductible, copay, or coinsurance will apply. Your explanation of benefits should also specify if prior authorization is required for your plan.
Alternatively, you can call the Member hotline found on the back of your insurance card. Due to regulations around provider-plan communication, we can’t make this call for you.
Keep in mind that you’ll be responsible for any charges that are not covered by your insurance plan or fertility benefits (up to the full cost of the services purchased, or $440). Typically, claims are processed and fees assessed by insurance providers within 2 months.
The CPT® or procedure codes associated with Legacy’s testing and freezing services include:
89320 Semen analysis
89259 Cryopreservation, sperm
89343 One year storage, sperm
89353 Thawing cryopreserved sperm
Prior authorization is a process by which your insurance provider approves care in advance. Some plans require prior authorization, or a similar process, to assess medical necessity before they’ll cover a claim.
Legacy is not your medical provider, and does not have access to your medical history, records, or documentation. Therefore we cannot provide evidence of medical necessity or complete prior authorization requests.
If your plan requires prior authorization, we recommend that you see your own physician and discuss at-home semen analysis and sperm freezing with Legacy. Your doctor can submit the information required for prior authorization digitally.
If you already purchased a Legacy kit or bundle on your own, the easiest way to get reimbursed by your insurance or benefits plan is to submit an itemized insurance receipt. Then, your insurance will reimburse you directly for the covered costs.
To get an itemized insurance receipt, please email us at firstname.lastname@example.org.
Yes. Certain Legacy products and services are eligible for reimbursement via flexible spending accounts (FSA) and health savings accounts (HSA).
What may be eligible:
Temporary frozen sperm storage
If you plan to submit your purchase for reimbursement from an FSA or HSA, please contact us for an itemized FSA/HSA receipt. Email us at email@example.com.
Health insurance, typically offered by employers in the US, is a plan that provides financial coverage for some or all of your necessary healthcare expenses.
Flexible spending accounts (FSA) and health savings accounts (HSA) are additional employer-sponsored benefits. These accounts allow you to save tax-free or tax-deductible funds for eligible healthcare expenses.
Fertility benefits programs are separate, additional insurance or coverage plans that may bridge the gap in fertility coverage in traditional insurance plans. These plans may offer specific coverage, discounts, or funds for fertility care such as diagnostic tests, infertility treatment, and fertility preservation (like sperm freezing).
Examples of fertility benefits providers include:
The best way to understand if you have access to fertility benefits is to talk to your employer.