How to Get Infertility Insurance
Health coverage with infertility benefits is very hard to find. Most plans cover little if anything - unless compelled by law. Infertility treatments are expensive by themselves, and they often result in pregnancy, which is more expensive still. Know how the rules work to maximize your chances of getting coverage. Find ways to minimize costs in case you can't.
We suggest navigating through your options by following these steps:
- Learn the laws in where you live - your odds are best if you live in a mandate state
- Know where employers are headquartered - most laws apply to employer plans
- Switch employers - find local employers that provide infertility insurance
- Find coverage in every state - receive benefits with supplemental maternity insurance
IVF Refund Programs Many couples will not find coverage that pays for infertility or IVF directly. Many clinics offer refund programs to couples without insurance coverage or those who have exhausted benefits. Find several hidden advantages that many couples overlook: tax savings and a way to make a smart bet.
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State Infertility Insurance Laws Where You Live
If your home state mandates infertility insurance you odds are best for finding coverage, but does not provide guarantees. An individual mandate is best, but mandates for group coverage are most common.
Three states mandate plans in the individual market: Connecticut, Hawaii, and Rhode Island. But some laws apply only to plans providing maternity coverage, which many do not. You will need to know the state maternity insurance laws for these states.
Most mandates apply to group coverage. If your employer is headquartered in your home state then these rules might apply, unless they fall into a loophole:
- Many states limit the mandate to employer groups by employee size
- Companies that self insure are not subject to the mandates
- Religious organizations are often exempt
If your state does not mandate coverage, don't stop looking.
Look at Employer Headquarter States
Most state infertility insurance laws govern insurance plans issued in that state. For group products, the location of the employer’s headquarters, or situs, dictates which insurance regulations apply – not the resident state of each insured, as is the case with individual insurance. For example, if the employer is sitused in New York, New York State insurance regulations will apply to those employees who live in New Jersey, as well as those that live in New York.
Pay attention to where your employer is headquartered and the laws in that state. Make sure you investigate the laws pertaining to both spouse's employer.
Several states with infertility mandates have a large amount of corporate headquarters that may be subject to the laws and export those benefits to employees in all fifty states. Those states are California, Connecticut, New Jersey, New York, Massachusetts, and Texas.
On the flipside you may live in a state with a mandate, but work for an employer headquartered in a non-mandate state. Hopefully that does not describe your situation as you probably won't have infertility coverage in your employer plan.
Finding Local Employers with Infertility Benefits
Because most laws apply to employers headquartered in a certain state, the branch office employees of these employers benefit from the home state rules. You might consider looking for a new job: at a branch location of a company headquartered in a state with favorable laws.
If one spouse has career flexibility, changing employers may make sense. The average cost of an IVF cycle is about $12,000, and on average it takes three cycles to conceive. An employer that offers IVF insurance coverage may pay significantly better than one that does not.
But how do you find these employers? Look at the mall! Most large retailers are headquartered in mandate states, and employ workers in all 50 states in multiple locations. Be creative!
Coverage Available in Every State
Insurance coverage ideal for infertility is available in every state regardless of any mandate. You just have to think creatively and remember that your objective is to get pregnant and deliver a baby.
Supplemental maternity insurance is available in every state - regardless of any mandate requiring direct payment for infertility treatment. Provided you purchase coverage before getting pregnant, your normal labor and delivery may be a covered benefit. The benefit for normal delivery may be several multiples of what you pay in premium. These plans provide coverage for the most risky part of any infertility treatment - getting pregnant.
Supplemental maternity insurance is available in every state - regardless of any mandate requiring direct payment for infertility treatment. Provided you purchase coverage before getting pregnant, your normal labor and delivery may be a covered benefit. The benefit for normal delivery may be several multiples of what you pay in premium. These plans provide coverage for the most risky part of any infertility treatment - getting pregnant.
When you get pregnant often your costs are just beginning. There may be lost income during mom's maternity leave, or there may be left over medical bills for a hospital stay. Don't lose sight of your objective. Plan for good things to happen and get a nice payoff when they do. Get extra security just in case your pregnancy encounters difficulties.
