Pregnancy and
Fertility Support
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.
Maven
Meet Maven! Beginning January 1, 2027, Maven—your virtual partner for family-building and maternity support—will provide personalized, on-demand access to trusted experts, education and care guidance for fertility, pregnancy, postpartum and parenting. More information on accessing this benefit will be available in early 2027.
Fertility Benefits
RWJBarnabas Health’s medical plans include coverage for fertility evaluation and treatment services through participating providers. Member cost-sharing, including copays, deductibles, and coinsurance, varies based on the provider, place of service and the medical plan in which you are enrolled. Please refer to your plan documents for specific coverage details and limitations.
Note: Fertility coverage does not apply to employees of Trinitas Regional Medical Center due to its status as a Catholic institution.
Fertility Benefits FAQs
All coverage is subject to Aetna®/CVS Caremark® medical policy and authorization.
What is the fertility benefit in 2026?
In 2026, the fertility benefit includes a $30,000 combined medical and prescription maximum, made up of a $15,000 medical maximum and a $15,000 prescription maximum. The fertility benefit maximum currently does not apply to services rendered at IRMS/CCRM Fertility. All care is subject to Aetna®/CVS Caremark® medical policy, authorization requirements and applicable plan cost-sharing.
What is the 2027 fertility benefit?
Eligible fertility services incurred on January 1, 2027, or later are covered up to a $30,000 lifetime maximum, subject to Aetna®/CVS Caremark® medical policy, authorization requirements and applicable plan cost-sharing. The fertility benefit will be administered as a $20,000 medical maximum, administered by Aetna®, and a $10,000 prescription maximum, administered by CVS Caremark®. The fertility benefit maximum will apply to all in-network Aetna® providers including IRMS/CCRM Fertility.
Will fertility care I received before 2027 count toward the lifetime maximum?
No. The fertility lifetime maximum will apply only to eligible medical services and prescription medications received on or after January 1, 2027. If you received services from a non-IRMS provider in 2026 or earlier, those services will not be counted towards the new $30,000 maximum.
What kind of services are covered?
Covered advanced reproductive technology includes Invitro Fertilization (IVF), GIFT, ZIFT, Ovulation Induction, Cryopreserved embryo transfers and ICSI or ovum Microsurgery.
Is storage covered?
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?
Do I only see specific fertility providers?
Beginning January 1, 2027, you can see any in-network fertility provider. Services at IRMS/CCRM Fertility are in Tier 2 and will result in a lower out-of-pocket cost compared to other in-network fertility 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 drug 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 8 a.m. to 7 p.m. ET
Still Have Questions?
My Service Portal
Additional Resources
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