Fertility drug costs add up very quickly. The medications are very expensive to pay out-of-pocket, and many couples do not know how many cycles they might need before conceiving.
Fertility drug cost assistance is available to couples willing to think creatively, and act at the right time.
You do not need to break the bank just to get pregnant. Find two ways to get insurance companies to pick up much of the tab, and have the IRS pick up the remainder.
- Direct and indirect insurance coverage
- Two forms of discounts programs
Fertility Drug Insurance Coverage
When it comes to paying for prescription fertility drugs the best scenario is to pay with other people’s money. Health insurance is the ultimate form of fertility drug cost assistance.
There is no greater discount than a prescription drug card with a formulary listing one or more of your prescribed medications on the list, or having a plan that reimburses you when you deliver your baby.
Direct coverage pays off right away, while indirect coverage makes you wait.
Direct insurance coverage is the ideal form of fertility drug cost assistance. Nothing beats having a third party pick up most or all of your expenses.
Finding insurance that covers infertility treatments is possible, but not easy. You have to think differently, and be creative. If you find a plan, you may still face deductibles, and copays.
If your plan provides this coverage, keep in mind any deductibles you must pay. Sometimes there are both individual and family deductibles that must be met before benefits begin.
If a couple is taking medications for both the man and the woman you may face the individual deductible twice.
Most prescription drug plans have a three-tier co pay structure: generics, preferred, and non-preferred (or name brand). The co pay is smallest for generics, and highest for name brands.
Some express the co pay in terms of hard amounts: $20, $30, $50, etc. These designs work best for cost containment. Plans often come with percentage-based copayments, which may cost patients far more.
A fifty percent co pay on a medical therapy combination costing thousands really helps, but still leaves a gaping hole.
Supplemental health insurance for infertility treatments provides indirect fertility drug cost assistance. These policies cover the intended side effect of the medications – mom’s pregnancy.
Coverage must begin before getting pregnant. Purchase the two different policies before your next cycle.
Lost Maternity Income
Fertility drugs and getting pregnant is a happy outcome that may increase your medical expenses, while reducing mom’s income. Many women take an unpaid maternity leave, which may create hardship after spending so much money just trying to get pregnant.
Short-term disability insurance provides fertility drug cost assistance. The policy replaces a portion of mom’s income during her maternity leave. It may also replace income if she needs to stop working prior to her delivery because of pregnancy complications.
The most common side effect of many fertility drugs is multiple pregnancies. Many follicle-stimulating hormones promote extra egg production. More than one quality egg increases the chances that two or more eggs become fertilized.
Multiple pregnancies are often high risk, and deliver preterm. Mom may experience added expenses for hospitalizations, and additional lost income during an extended pregnancy leave. Preemies confined to an NICU leave many couples with unpaid medical bills.
Hospital indemnity insurance provides cost assistance with these negative aspects of fertility drugs.
Fertility Drug Discount Programs
Several different forms of discount programs provide fertility drugs cost assistance. Any form of discount keeps money in your pocket, and preserves resources for further treatment or adoption.
Offshore pharmacies often offer steep discounts relative to those regulated by the United States. Several countries have very different regulations, and often subsidize prescriptions medications. You can order your medications through one of these discount pharmacies.
Make certain that you take full advantage of IRS discounts, and specialized pharmacy discounts as well.
A Flexible Spending Account (FSA) provides tax savings discounts that work as a form of fertility drug cost assistance. Your infertility treatments are tax deductible per IRS rules.
An FSA provides you with first dollar discounts on your fertility drug purchases up to a set limit each year. You can double the limit by participating in the plan offered by both spouses’ employers.
You save federal, state, and FICA taxes when you use the pretax dollars in an FSA. Many couples can realize a discount of up to 33% or more. Many plans now come with a debit card, making it very convenient to purchase prescription medication online.
Schedule A provides federal income tax savings on expenses that exceed 10.0% of Adjusted Gross Income. Usually this option works best for couples taking these medications as part of a more expensive ART procedure.
Discount pharmacy cards provide fertility drug cost assistance.
Pharmacy discount cards are becoming more and more popular. They are not insurance plans, but provide couples with the opportunity to buy their medicine at wholesale prices, rather than retail.
Often times the cards are offered free to consumers, or as part of an employee incentive program. We offer a free card to anyone brave enough to introduce us to his or her employer in order to take advantage of supplemental health insurance.