Pregnancy and
Fertility Support

The 1095-C forms for Year 2025 have been distributed. If you have opted in to electronic forms from WEX, our Benefits administrator, you may access your 1095-C form in the Benefits Enrollment Portal.

Planning for and having a baby can be an exciting, happy and overwhelming time in your life! RWJBH has designed benefits to ensure you have the resources needed for you and your baby to stay healthy.

BHealthy Mom App

Provides health tips and trackers for moms-to-be, new parents and those planning for pregnancy. Click here or search “BHealthy Mom” in your device’s app store to get started.

Fertility Benefits

RWJBH partners with The Institute for Reproductive Medicine and Science (IRMS) as a Center of Excellence for fertility coverage under our medical plan. IRMS is one of the nation’s leading fertility centers, providing patients with state–of–the–art fertility treatment, supported by the latest scientific advances and laboratory techniques. IRMS has several locations throughout New Jersey and one in New York.

Your copay and deductible for fertility services depends on the place of service and the plan you are enrolled in. There is an unlimited benefit amount for services rendered by IRMS.
Note: As a Catholic institution, Trinitas Regional Medical Center may not cover certain reproductive services for health plan members.

Fertility Benefits FAQs

All coverage is subject to Aetna®/CVS Caremark® medical policy and authorization.

What is the Medical fertility benefit?

For care rendered at IRMS, there are unlimited number of fertility cycles. For care rendered by non-IRMS providers, there is a 1 cycle lifetime benefit. (A fertility cycle includes but is not limited to ovarian stimulation, egg retrieval, fertilization and embryo transfer). Benefit is subject to the Aetna® Medical Policy.

What is the Prescription fertility benefit?
For fertility medications prescribed by IRMS, the fertility prescriptions benefit is unlimited. For fertility medications prescribed by non-IRMS providers, there is a lifetime $15,000 maximum allowable benefit. All prescription coverage is subject to CVS Caremark® prescription guidelines.
Where can I fill my fertility prescriptions?
Fertility Prescriptions must be filled with CVS Specialty®.
What kind of services are covered?
Covered advanced reproductive technology includes Invitro Fertilization (IVF), GIFT, ZIFT, Ovulation Induction, Cryopreserved embryo transfers & ICSI or ovum Microsurgery.
Is storage covered?
Yes. Egg/Embryo storage is covered for up to 12 months.
What about IUI coverage?
Intrauterine Insemination is covered without an infertility diagnosis and regardless of the patient’s sexual orientation, or partner status.
Do I pay when I see a fertility specialist?
Yes, you will pay a copay when you see your provider in the office. Deductibles do not apply to in-network Tier 2 fertility specialist office visits. Procedures performed at an RWJBH facility are covered at 100%.
Are there deductibles for office labs or office imaging?
No, deductibles do not apply for in-office diagnostic labs or office imaging at IRMS.
What happens if I meet my lifetime benefit maximum with a non-IRMS fertility provider?
You can choose to continue your care with IRMS if you’ve met your lifetime maximum benefit with other providers.
For more questions about the fertility benefit, who do I call?
For Medical coverage questions, call Aetna® Concierge at (855) 546-5415. For Prescription coverage questions, call CVS Caremark® (833) 290-5676.

Questions?

IRMS (Appointment Scheduling)
Call: 973.548.9900
Website: IRMS Website

Care Navigation
Call: 844.424.2628
Monday – Friday from 8am to 7pm ET

Still Have Questions?
My Service Portal

Additional Resources

BHealthy Mom App​
Click here or search “BHealthy Mom” in your app store