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Health Insurance Coverage for IVF | In Vitro Fertilization
IVF health insurance coverage is hard to find. Most medical plans don't provide an allowance. In Vitro Fertilization can cost $12,000 or more, and who knows how many cycles you will need. How do you afford paying for multiple cycles, getting pregnant, and having a baby without going broke?
Follow four steps to minimize what you spend, lower risk, and preserve income.
- Find Options – fifteen states mandate infertility coverage
- Funding Choices – your employer is an easy source of interest free financing
- Stick Uncle Sam – leverage the tax code to cut expenses
- Make an informed bet – find the hidden advantage of refund programs
Key IVF Insurance Topics
Finding Coverage for Infertility Finding IVF coverage is more involved than just looking up the laws in the state where you live. Infertility insurance laws mostly regulate group health plans issued in the state. Know your employer headquarter state, and how to find employers subject to mandates. Some will succeed, but most will not. Find ways to keep your spending low. Plan for success, and buy a plan that protects you during pregnancy and maternity leave instead.
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State Infertility Mandates Fifteen states mandate infertility insurance coverage for certain groups. Some specifically include coverage, while others exclude an allowance for In Vitro Fertilization. Mandates apply mostly to group health plans issued in the state. Large multiple state employers headquartered in these states must offer the same options to employees in all states.
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Finding Health Insurance That Covers IVF
Finding health insurance that covers IVF is the holy-grail for couples undergoing in vitro fertilization. Insurance that covers IVF is rarely offered unless compelled by state law. Know which states have infertility mandates, how each work, and who they apply to. If you live, work, or work for an employer headquartered in one of the mandate states, you might be one of the lucky few. Even if your state mandates infertility coverage you need to know the law thoroughly.
Sometimes In Vitro Fertilization will be covered, and sometimes not. Some mandate that medical plans cover IVF, but no other infertility procedures. While other times it’s the opposite: IVF is covered, while other infertility treatments are not. Other mandates apply across the board.
IVF involves complex treatments including testing, fertility drugs, and other therapies. The inconsistencies in laws make it hard to determine what portion of these therapies will or will not be covered. So get educated to avoid surprises.
If you live in an area without a mandate, remember that insurance laws apply in the state where a policy is issued. If you have job flexibility, the key to finding the ideal plan sometimes means finding employers who do offer what you need. Remember that a plan that covers three cycles could be worth $45,000 in after-tax income. Is that worth changing employers? Everyone's answer will be different.
Supplemental Insurance for IVF: Refund on Delivery
IVF is often associated with multiple pregnancies, as several fertilized eggs are often inserted to improve your odds of conception. Multiple pregnancies are often high-risk, and deliver pre-term. Your infant(s) may spend time in the neonatal intensive care unit (NICU), and you may be left with extra medical bills.
Supplemental maternity insurance is an ideal health plan for couples in this situation: it pays benefits for normal delivery, complications, premature birth, with an added bonus for multiples born pre-term. Follow the link to see how this works.
Supplemental Maternity Insurance Any couple thinking about IVF should consider purchasing supplemental coverage before starting their next cycle. Once your IVF is successful and you become pregnant it will be too late to get a policy. IVF pregnancies are often high risk because multiple embryos are implanted to improve the odds of conception. Supplemental insurance covers normal pregnancy and delivery, but shines the most when a high risk multiple pregnancy translates into a long bed rest before delivery, and/or premature birth.
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Hidden Advantages of IVF Refund Programs If you are unable to find a medical plan that covers In Vitro Fertilization, you may need to utilize a refund plan. These programs provide you an opportunity to purchase multiple cycles at a discount, and receive most or all of your money back if you fail to take home a baby. There are two hidden advantages of these plans that every couple should know that lowers costs, and provides financial security.
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Self Pay IVF Costs Without a medical plan that covers infertility, costs can be staggering. There are fees for the In Vitro Fertilization, plus fertility drugs, testing, monitoring, and more. The biggest variable will be the number of cycles needed to get pregnant and bring home a baby. Odds go down as your age goes up. Keep more of your money by leveraging the tax code. Protect your finances from the risks of multiple pregnancy and pre-term delivery with supplemental programs.
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Cost for ICSI - Intracytoplasmic Sperm Injection Intracytoplasmic Sperm Injection (IUI) is an additional procedures many couples utilize in conjunction with IVF to improve the odds of conception. Your embryologist will take a single sperm and inject it directly into an egg. Each cycle will add $1,500 on average to the cost of each cycle. Your medical plan may not pay for this procedure even if IVF is listed as a covered benefit.
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No Health Coverage for IVF? Financing Options
Health coverage for IVF may leave you with leftover expenses: if you can find it. Some plans will place limits on the number of cycles covered, while others will require you to utilize other infertility treatments for several years before approving benefit payments. The whole process is draining emotionally as well as financially.
IVF financing can get you started, but is hard to come by, and presents risks. Borrowing money in advance of losing mom’s income during maternity leave is scary enough without contemplating a high risk pregnancy often associated with the implanting of several viable embryos.
If a lender is willing to loan you money under these circumstances, it must be coming with a hefty interest rate to cover the obvious risks. If you are contemplating a loan make sure you protect your ability to repay using supplemental insurance.
Paying for IVF
No In Vitro Coverage? Stick Uncle Sam
Without In Vitro benefits you have to cut spending at every corner. Your unreimbursed medical expenses associated with getting pregnant are tax deductible. These deductions may cut your spending depending upon your income, and your level of unreimbursed expenses.
But there are many limitations and different vehicles to use.
IVF Insurance Coverage: Make an Informed Bet
Individual IVF insurance that directly pays for your procedure do not exist. Individual IVF coverage will refund a portion of your costs for a certain number of cycles. The "in vitro fertilization insurance" rebates a portion of costs if you fail to conceive or delivery a baby.
On the surface, an individual plan like this has appeal. Who wants to make all these additional medical payments, only to come up empty? But did a little deeper, and you might change your thinking.
The carrier is betting that you will deliver a baby, but only if you qualify medically. That means they will offer you this program only if their underwriting experience suggests that your treatments will succeed. You are betting the opposite.
Does this make sense? Not to us! Also consider which costs you more: IVF treatments that succeed or fail?
* You fail to get pregnant - You are refunded a portion of your investment
* You conceive and deliver - Your spending is just beginning. First, you are responsible for the full price of your cycles. Then you may experience a high risk multiple pregnancy, incur additional medical expenses, and/or miss unplanned time from work. You then will lose mom's income during her maternity leave. Then there is the cost of raising your child(ren).
If you can't afford IVF treatments that fail to work, how can you possibly deal with the extra expenses and lost income? Plus, you will be betting against the infertility clinic armed with better information, more experience, and deeper pockets.
If you qualify for the rebate, make an informed bet: buy supplemental maternity insurance.
