Progyny: how Smart Cycles work and which employers use it

“The Smart Cycle is Progyny’s unique benefit currency. All of the individual services, tests and medications needed for a particular type of treatment are bundled together and assigned a Smart Cycle value.”

“We currently offer 20 different Smart Cycle treatment bundles, which may be used independently or in combination depending on a member’s need. Each Smart Cycle has a separate unit value (i.e., some have fractional values and some have whole values). Our clients contract to purchase a cumulative Smart Cycle unit value per eligible member. These can range from one to unlimited cumulative Smart Cycle units.”

“She then undergoes an IVF Fresh cycle. One fertilized embryo is transferred to her uterus and the rest are tested and frozen for later use. This uses 3/4 of a Smart Cycle.”

“She then undergoes IUI, where her spouse’s sperm is inserted directly into her uterus. This uses 1/4 of a Smart Cycle.”

“Nora undergoes egg freezing and stores her eggs until she is ready to use them. This uses 1/2 of a Smart Cycle.”

“In this example, Jessica and Letitia will purchase sperm (1/4 Smart Cycle), complete an IVF Frozen cycle to retrieve and fertilize Jessica’s eggs (3/4 Smart Cycle) and transfer to Letitia (1/4 Smart Cycle). In total, their treatment path utilizes 1¼ Smart Cycles.”

“They purchase a cohort of donor eggs (1 Smart Cycle) and create embryos with Mike’s sperm (1/2) Smart Cycle. Because their employer also offers a surrogacy reimbursement, they can use those benefit dollars to cover eligible costs for their surrogate.”

“Our Smart Cycle design ensures that members always have coverage for a full treatment cycle as their access to treatment is not limited by a dollar maximum that could be exhausted mid-treatment.”

“When you have used your full Smart Cycle allowance your lifetime benefits are considered exhausted.”

“Every aspect of a member’s comprehensive fertility treatment is contained within the Smart Cycle, including diagnostics, testing, lab services, treatment and medications.”

“Everything needed for a comprehensive fertility treatment is contained within a Smart Cycle treatment bundle, including all necessary diagnostic testing and access to the latest technology (e.g., in the case of IVF treatment, preimplantation genetic testing).”

“Your Progyny benefit includes coverage through your first positive pregnancy test.”

“For example, cholesterol, Pap smear, HPV, and other tests that are not specific to fertility are not covered under Progyny but may be covered under your medical insurance.”

“Our clients can expand the benefits they offer their employees in a number of ways, including by adding egg freezing, increasing the number of Smart Cycle units, and adding our Progyny Rx solution or any of our other solutions and services.”

“We also offer an assistance services program where certain services can be offered through a reimbursement program, including adoption, surrogacy, doula, and travel reimbursement when travel is required to receive medical services.”

“For these programs, employers designate a specific lifetime dollar amount toward the elected assistance service for their employees.”

“Progyny Rx is our integrated pharmacy benefits solution that can be added by clients that utilize our fertility benefits solution. This solution provides our members with access to the medications needed during their treatment.”

“Your clinic will submit your prescription to a Progyny Rx pharmacy, and you will receive next day delivery of your medication and access to concierge support from pharmacy clinicians.”

“Currently, 92% of our clients under contract are utilizing our Progyny Rx solution, including 97% of the clients we signed in fiscal year 2025.”

“Our members have access to our selective Center of Excellence network of high-quality providers that includes over 1,100 fertility specialists who practice at over 690 provider clinic locations throughout the United States and over 1,190 specialists in total when including reproductive urologists.”

“Your REI and RU must be in-network with Progyny to use your benefit.”

“Progyny is available through your organization to individuals enrolled in an eligible plan. There is no cost to you to claim your benefit and access unlimited support from a PCA. For applicable programs, if you see a physician or receive treatment, you will have financial responsibility according to your plan (e.g., copays, deductibles).”

“Yes, Progyny’s family building benefit was specifically designed to support everyone, including single parents by choice and LGBTQ+ individuals and couples.”

“Your Progyny benefit does not cover services for you to act as a donor or gestational surrogate for another person.”

“Each general treatment authorization is valid for 60 days (90 days for initial consultations) and covers all services listed for the associated treatment cycle found in the Explanation of Covered Treatments & Services section of this Member Guide.”

“Cycles cancelled after fertilization due to no embryos available for biopsy, freezing, or storage will deduct 1/2 Smart Cycle.”

“Cycles converted to IUI or Timed Intercourse deduct 1/4 Smart Cycle.”

“You have the option to opt out of the use of your Smart Cycle benefit and pay out-of-pocket for a service to save your Smart Cycle balance.”

“Please contact your dedicated PCA for more information regarding your Smart Cycle balance and to discuss your options for utilizing your benefit. You can also view your Smart Cycle balance in your Progyny member portal.”

“Today, we have grown our current base of clients to more than 590 employers, each with at least 1,000 covered lives.”

“We currently have contracts to provide coverage to approximately 7.2 million employees and their covered dependents (known in our industry as covered lives, and to whom we refer to as our members)”