Benefits Handbook

For questions related to infertility prescriptions, contact WIN at +1 844 446 2329.

WIN infertility pharmacy coverage is available to you and your eligible family members (spouse/domestic partner and children) enrolled in the Plan with a diagnosis of infertility. A diagnosis of infertility is solely determined by WIN, the Claims Administrator.

All prescription drugs related to infertility treatments will be provided by WIN's pharmacy network. Any prescription drugs related to infertility treatments must be filled by WIN's pharmacy network in order to be covered as well as accumulate to the deductible and out-of-pocket maximum under the Aetna medical plan in which you are enrolled.

There is NO out-of-network infertility-related prescription drug coverage under the WIN program.

Your WIN Nurse Care Advocate will discuss the prescription process with you, as well as any preferred formulary drugs and treatment authorizations needed prior to processing any associated prescriptions. You can reach WIN at +1 844 446 2329, Monday to Friday, 9:00 am to 9:00 pm, ET. You can also download the WINFamily App on the App store or Google Play using app code: MMC18 to view and manage your prescriptions directly in the app, including a cost-estimator tool to help you locate where the medications can be dispensed at the lowest price.

There is a combined lifetime maximum of $40,000 per eligible plan participant for eligible medical care and prescription drug expenses related to infertility treatment and related infertility medications.

Prescription drug benefits are subject to the prescription drug cost share of the Aetna medical plan in which you are enrolled in, meaning plan deductible and coinsurance (coinsurance listed below). The coinsurance below represents the portion of the costs that the plan pays for covered infertility prescriptions.

Note: all prescription drugs related to infertility treatments must be filled by WIN's pharmacy network in order to be covered as well as accumulate to the deductible and out-of-pocket maximum under the Aetna medical plan in which you are enrolled.

Infertility medications will fall under the "Formulary Brand" 30-day supply tier.

Contact WIN. All prescription drugs related to infertility treatments will be provided by WIN's pharmacy network. Your WIN Nurse Care Advocate will discuss the prescription process with you and treatment authorizations needed prior to processing any associated prescriptions.

You can reach WIN at +1 844 446 2329, Monday to Friday, 9:00 am to 9:00 pm, ET.

You can also download the WINFamily App on the App store or Google Play using app code: MMC18 to view and manage your prescriptions directly in the app, including a cost-estimator.

Yes. All prescription drugs related to infertility treatments must be filled by WIN's pharmacy network. WIN's pharmacy network will provide all prescription drugs related to infertility treatments.

There is NO out-of-network infertility-related prescription drug coverage under the WIN program.

For prescription drugs related to infertility treatments, visit https://managed.winfertility.com/mmc-2, download the WINFamily App on the App store or Google Play using app code MMC18, or call +1 844 446 2329 for more information.

To locate an in-network pharmacy for your infertility prescriptions:

All of the pharmacies listed can mail the infertility prescriptions to your home, but there are retail pick-up options available in many areas as well.

Once your prescription order has been received by WIN, in the Review Rx screen, the "Select Best Pharmacy for Selected Drugs" tool will help identify the pharmacy closest to you (when retail pick-up is available) and match you with the best priced in-network pharmacy that has the infertility medications in your order in stock.

Your WIN Nurse Care Advocate will discuss the prescription process with you, as well as any preferred formulary drugs and treatment authorizations needed prior to processing any associated prescriptions. Your WIN Nurse Care Advocate also has access to the "Select Best Pharmacy for Selected Drugs" tool to help you find the closest pharmacy to you (when retail pick-up is available) with the best prices for your prescription.

Download the WINFamily App on the App store or Google Play using app code: MMC18 to view and manage your prescriptions directly in the app, including a cost-estimator tool to help you locate where the medications can be dispensed at the lowest price.

You can contact WIN for infertility prescriptions claims at +1 844 446 2329, Monday through Friday from 9:00 am to 9:00 pm Eastern Time and ask to speak to with a WIN Nurse Care Advocate. Alternatively, you can download the WIN app and schedule a Nurse Care Advocate consultation in the Find Care section.

Infertility prescription claims through WIN are in-network, therefore, you do not have to file a claim form. The WIN provider will file a claim directly with the Claims Administrator, WIN. Once the claim is processed you will be billed for the appropriate coinsurance amount and/or deductible.

Yes. A WIN ID card can be found on the WIN App in the Benefits section under Patient ID.

For questions related to infertility medications, contact WIN at +1 844 446 2329.