Sometimes infertility can be a difficult subject to talk about, especially with your health insurance provider. Unfortunately, finding the answer to health care coverage may be difficult, too.
Infertility is more common than you think. At least 1 in 10 women between the ages of 15-44 have difficulty getting or staying pregnant. Unfortunately, the federal government doesn’t require health insurers to cover for infertility treatments (unless you’re in one of these 15 states). If you’re part of a group plan with an employer, it’s possible that some treatments may be covered.
Infertility treatments include a wide umbrella of procedures and services, so don’t assume that “some health plans cover infertility treatments” means that they cover all treatments. Treatments include:
- Fertility Drugs: Common medicines that help treat infertility such as Clomid or Repronex.
- Intrauterine insemination (IUI): Also known as artificial insemination, where a woman is injected with specifically prepared sperm.
- Assisted reproductive technology (ART): A group of different methods to assist infertile couples by removing the eggs from a woman’s body and mixed with sperm. Some common methods include In Vitro Fertilization (IVF), Zygote Intrafallopian Transfer (ZIFT), and Frozen Embryo Transfers (FET).
Oral medications could cost between $5-$20 per month, while hormonal injections could be $1000-$3000 per month. IVF can cost at least $12,000 per cycle, up to $25,000 with an egg donation. If you pursue multiple treatments or cycles, these costs can become overwhelming.
Do I Have Coverage?
The best way to figure out if you have coverage is to talk to your insurer. Here are some questions you should ask when you have that discussion:
- Does my current plan offer infertility treatments? If so, which ones?
- Are fertility drugs covered with my plan? If so, which ones?
- Are there restrictions or limitations related to the coverage? For example, is there a number of attempts that need to be made? Is my age a factor? Will I need a referral?
- Is there a limit on the number of cycles covered?
- Will I need to take specific tests before I’m covered for other treatments?
If you talk to your insurer and find out that you’re not covered for infertility treatments, here are some options you can take:
- If you offer to pay in cash, some clinics may offer financing or discounts.
- If you have a health savings account (HSA) or flexible savings account (FSA), this may help with paying for treatment.
- See if there are any pharmaceutical discount programs for fertility drugs.
- On average, embryo adoptions are more cost-effective than infertility treatments like IVF.
Only the medical portion of your embryo adoption costs will potentially be covered by a health plan, not the adoption agency fees.
If you have not investigated what your health plan might cover, it’s worth your time and energy to do so. If your current plan does not offer coverage, ask about your options. There may be an individual plan that can help with the cost and grow your family.
To learn more about embryo adoption and donation, visit EmbryoAdoption.org.