Progyny Fertility and Family-Building Benefits (with Cigna)
What you need to know
Starting April 1, 2025, the Health Plan is partnering with Progyny to offer in-network only fertility and family-building, pregnancy and postpartum, and menopause and midlife care benefits. Progyny is a leading fertility and family building organization that specializes in this type of care. Progyny provides a strong combination of support, and guidance. The Progyny benefit will be available to participants enrolled in the Health Plan with Cigna in either Tier 1 or 2. Dependent children though up to age 26 are not covered by these benefits, except in instances for fertility preservation necessitated by cancer or gender dysphoria treatment.
You must use a Progyny provider, which will be considered in-network, in order for these benefits to be covered under the Health Plan. There will be no coverage for these benefits if obtained from an out-of-network (i.e., non-Progyny) provider. In addition, this coverage is not available to those enrolled in HMO coverage with any of the Kaiser Plans. Please review the plan of benefits of the HMO you selected for coverage for more information to determine if fertility benefits are offered through that HMO.
Benefit Overview
The Progyny benefits go into effect on April 1, 2025.
Your benefit includes coverage for:
- Fertility & Family Building: Access top fertility specialists, personalized guidance, treatment coverage for fertility care (e.g., IUI, IVF, and more), and surrogacy and adoption resources. Once treatment begins, you will have to pay coinsurance of 10% up to the maximum out-of-pocket limit (currently $4,550). No other deductibles or copayments will apply, except for the applicable copay of $35 for any initial office visits.
- Pregnancy & Postpartum: Connect with certified coaches, L&D (labor and delivery) nurses, doulas, and lactation specialists, plus access a library of education & checklists. This benefit will be fully paid by the Health Plan, with no cost to you.
- Menopause & Midlife Care: Receive virtual care and personalized treatment plans from menopause specialists to feel relief. There is no cost for access to the patient care advocate or resources on the app. Any medical services (such as office visits or prescription medications) will be subject to the usual in-network copay or coinsurance.
Fertility & Family Building Benefit
The Fertility & Family Building benefits are specially designed to give you the best chance of fulfilling your dreams of family. Whether you just want to learn more about your options, are trying to conceive, or are exploring fertility treatment, we are here for you.
You can access comprehensive coverage through the Progyny Smart Cycle, which covers all the individual services, tests, and treatments you may need. Connect with top fertility specialists across the U.S. and lean on your Patient Care Advocate with unlimited concierge support.
Your coverage includes:
- 3 Smart Cycles per family per lifetime for fertility treatment coverage
- Progyny Rx fertility medication coverage
- Fertility preservation coverage for egg and sperm freezing
- Donor tissue coverage for egg and sperm tissue purchase
Pregnancy & Postpartum Benefit
The Pregnancy & Postpartum benefits include support and guidance for a healthy pregnancy and beyond. You’ll receive ongoing one-on-one support from a dedicated Pregnancy and Postpartum Coach (PPC). You’ll also have access to resources that empower you with knowledge and confidence for the many milestones to come, including personalized coaching and digital tools at no cost.
- Progyny offers personalized support
- Your Pregnancy and Postpartum Coach (PPC), who will be a labor and delivery nurse, will provide you with personalized education and support.
- You’ll receive advice at key stages of your pregnancy and postpartum journey, including return-to-work.
- You’ll be able to connect with lactation consultants and baby feeding experts.
- Progyny also offers digital tools
- Progyny offers curated content, education, and checklists to support each milestone.
- You can access health trackers to monitor your pregnancy (i.e., blood pressure, mood, and weight).
- You can access tools to track your baby’s diapers, feeding, and growth.
Menopause & Midlife Care Benefit
The Menopause & Midlife Care benefits provide relief and a specialized team by your side. Progyny helps you access expert menopause providers and coaches so you can develop a holistic plan that meets your unique needs.
You’ll be able to:
- Connect with a dedicated Patient Care Advocate for coaching
- Access virtual care from menopause specialist MDs/NPs
- Take advantage of content from top menopause MDs
- Explore hormonal and non-hormonal treatment options
- Learn lifestyle tips for sleep, nutrition, mental health, and more
Contacting Progyny
You can contact Progyny directly by calling them at (833) 233-0029 so you can get information about these benefits before the coverage begins on April 1.
Progyny Patient Care Advocates are available Monday through Friday from 9AM-9PM EST.
You can visit Progyny’s website for more information about your benefits and to access Progyny’s tools and resources.
You can also download the free Progyny app on your mobile device.
You must be enrolled to access the tools.
For any other questions about eligibility or other topics, call the Fund Office at (212) 869-9380 or toll-free at (800) 344-5220, Monday through Friday. A representative from the Benefits Service Department will be able to assist you between the hours of 9:30 AM and 5:30 PM Eastern Standard Time. You can also send us an email.