Family Planning – Fertility Insurance, Costs and Options
Fertility insurance is health insurance that covers the diagnostics and treatments needed to help prospective parents who are struggling to conceive or to carry a child to term.
Family Planning – Fertility Insurance, Costs and Options
Seventeen States currently have mandated fertility treatment coverage
Arkansas, California, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Hampshire, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia.
If you reside in one of these States, you are in luck! You can learn more about the laws and coverage on the RESOLVE: The National Infertility Association website as well as access financial tools, scholarships and grants for family building.
Fertility insurance is not a separate plan, so often you may not even be aware that you are covered. The first step is to review your employee health benefits and/or talk to your HR Manager before you book any appointments with your doctor — and be stuck with a large bill!
If you are not covered, you will need to start researching your options and this can be a daunting task! We are here to help you navigate through your fertility journey with these helpful tips and resources.
No coverage? Check out one of these notable fertility insurance providers!
Investopia does a good job outlining the pros and cons of companies with affordable premiums and reasonable deductible options. Their list of best fertility insurance providers includes United Healthcare, Cigna, Aetna, WellCare and Progyny.
When shopping for insurance, here are a few things to ask and consider:
Is there coverage for the type of treatment and tests you need and how much of it — insemination, surrogacy support, ovulation induction, storage of eggs/sperms and embryos, drugs, etc.?
How large is their network of providers? For out-of-network plans, doctors can still accept the patient, however, this usually means you have a higher amount of co-insurance (what you are expected to pay) as compared to a doctor that is in-network.
Is the policy affordable to meet your budget?
Do they reimburse Assisted Reproductive Technologies (ART) including intracytoplasmic sperm injection, cryopreservation of gametes or embryos, and/or the use of fertility medication? Often in vitro fertilization (IVF) and intrauterine insemination (IUI) are not included or are limited because these are such expensive procedures.
What additional resources do they provide to help you determine your success rate and/or support you through your pregnancy journey?
What is the age range covered — some treatments may be excluded for those under 22 and over 40.
Participate in a fertility clinical trial
Ongoing research happens at hospitals and larger fertility centers where you can participate in clinical studies. The ClinicalTrials.gov website currently has over 300 clinical trials worldwide that are actively recruiting participants with various fertility issues. Some interventions involve taking dietary supplements, others are procedures that can be more invasive.
As always, due diligence is important. You and your partner (or a friend) should review the fine print and have a thorough understanding of what is expected, the time commitment and if there is any associated costs (or sometimes you can get reimbursed) before you sign-on.
This is a viable option if your place of work doesn’t have fertility coverage, or you are unable to afford out-of-pocket expenses. You will also be contributing to future healthcare advancement so it’s a win/win!
Fertility insurance consulting (including financing advice)
Fertility Within Reach is an advocacy non-profit organization founded in 2010. Their mission is to increase access to health benefits for fertility treatment and preservation while alleviating emotional, physical and financial stresses as couples strive to build their family.
In addition to a plethora of valuable information, they also offer insurance consulting to those who would like assistance in their efforts to gain coverage for infertility treatment or fertility preservation, but don’t have the time to research it themselves.
Options and cost for LGBTQ+ parenthood
Family planning in itself is already a confusing and costly endeavor but when you are in a same sex or gender fluid partnership, there is an added layer of complexities and a whole different set of costs (and legalities) if you go the route of surrogacy or adoption. This article does an excellent job of breaking down your rights and options so that you can be emotionally and financially prepared.
If one or both partners is able to conceive, then intrauterine insemination (IUI) may be a less costly solution. Some families also arrange to have extra vials of sperm frozen and stored if you are planning to have more than one child from the same donor.
Obtaining fertility care is a very personal experience and cost is definitely a top barrier to parenthood. Since policies vary so much by State and employer, we can’t cover it all but hopefully we pointed you in the right direction.
Medical Disclaimer:
The information provided in this blog is intended for general informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider or qualified medical professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this blog.
