Shared Risk Refund Program

Shared Risk Refund Program

Money Back Guarantee Package for In Vitro Fertilization (IVF)

‘SHARED RISK PROGRAM’

IN VITRO FERTILIZATION

SHARED RISK PROGRAM provides couples for whom IVF is medically necessary a chance to pursue their dreams of pregnancy with minimal financial risk! Qualifying patients may use their own eggs or donor eggs. If a pregnancy does not occur, all costs of the retrieval and transfer will be refunded at 80% of the package price for your age group. Please review the individual packages for pricing information and terms of each plan. We also have capable, caring financial counselors to help answer any questions you may have. The Medical Director will decide if you meet the medical criteria for each pricing package.

$13,500 3 cycles including all FETS egg provider < 34 years of age

$15,750 3 cycles including all FETS egg provider 35 – 36 years of age

$18,000 3 cycles including all FETS egg provider 37 – 38 years of age

IVF MONITORING PACKAGE & CYCLE MANAGEMENT $1750: includes ultrasounds and blood work done at NCCRM & management of patient’s cycle throughout monitoring phase per cycle. (non-refundable)

IVF CYCLE MANAGEMENT $500: management of patient’s cycle throughout monitoring phase per cycle – for outside monitoring patient’s. (non-refundable)

**All outside monitoring visits are subject to that facilities financial protocol**

If patient doesn’t pay for NCCRM monitoring package, patient is responsible for any charges incurred from ultrasound and blood work done at our facility.

Anesthesia $250 each cycle non-refundable.

ICSI

$3000 onetime fee non-refundable

Frozen Embryo Transfers (FET) Do not count as a cycle.(all embryos must be used before another fresh cycle is done)

EXCLUDED:

Medications $4-$6,000 each cycle  non-refundable & paid to the Pharmacy

 

SHARED RISK ADDITIONAL COST) (NOT INCLUDED IN PACKAGE PRICE) NON-REFUNDABLE

Medical Screening & Initial Work-up $1300 – $2500 (usually covered by insurance)

SCSA  (Sperm Chromatin Structure Assay) $350

Semen Analysis & Freeze $300

Patient Education Class $65 per Couple (Tuesday 10:30am & Thursday 1:30pm)

Embryo Cryopreservation $500 each cycle

PICSI- $100 (If deemed necessary by lab staff or physician)

Annual Storage Fee (after first year) $450

Blastocyst Culture $250

Confirmation of Pregnancy – Price Varies(not included in monitoring pkg)

All Treatment Associated with Hyper-Stimulation

 

*If you are interested in the Shared Risk Program, contact Schann at ext. 137 ASAP.*

Full fees vs. cash discounted fees. The full fees for this cycle is $11,900….$14,300….$16,750

All in vitro fertilization costs listed on this page reflect “cash discounts” and are paid in advance.

 

Who is Eligible for SHARED RISK PROGRAM

 

Medical Criteria: All Patients MUST be Approved by the Medical Director

o             Healthy uterine cavity

o             Prolactin & TSH within normal limits, Anti-Mullerian Hormone(AMH) 2.5 or more.

o             Cannot be pre-menopausal.

o             Male–sperm must be present in ejaculate at a level greater than 5 million total motile count.

o             Donor sperm can be used.

o             All medical and psychological evaluations (if applicable) must conclude the patient is healthy enough to undergo treatment & pregnancy.

o             The patient/couple must follow all medical protocols, schedules and directions given by an NCCRM doctor or nurse.

o             Some surgeries may exclude patient from plan.

o             SCSA must be done-the results of the SCSA will determine if patient is eligible.

 

Eligibility:

o             All medical criteria must be met.

o             IVF cycles performed outside of NCCRM do not apply, BUT, if you have undergone previous unsuccessful IVF cycles at NCCRM, the terms are as follows

o             *If you have had two (2) or more unsuccessful cycles at NCCRM you are not eligible to enroll in the refund plan.

o             No Pre-implantation Genetic Diagnosis- PGD or PGS

 

***You may enroll in the SHARED RISK PLAN one time ONLY***

Terms:

o             All three cycles and all FETS must be completed within one (1) year.

o             All monies must be paid before medications are called to pharmacy.

o             SCSA required.

o             Intracytoplasmic Sperm Injection (ICSI) & Assisted Hatching.

o             Contract is terminated, when reached 26 weeks of pregnancy on the 1st or 2nd cycle, and 12 weeks on the 3rd cycle.

o             Age of female is based on age at end of plan duration.

o             The patient/couple must follow all medical protocols, schedules and directions prescribed by or ordered by NCCRM doctors or nurses.

o             All consents and/or legal agreements must be signed by all parties involved.

o             Any services provided outside of NCCRM are NOT eligible for refund, nor is NCCRM responsible for any services provided outside of our office.

o             Packages apply only to self-paying patients.

 

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