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 the number of cycles needed to get pregnant in unknown. How do you afford paying for multiple cycles, getting pregnant, and having a baby without going broke?
Find steps to minimize your spending, lower risk, and preserve income.
- How to find a policy
- Supplemental plans
- Assistance with self-pay
- What treatments are included?
Finding IVF Health Insurance Coverage
As mentioned IVF health insurance coverage is very rare. There is much debate about ethical issues, and other concerns. Most carriers will deny your request to pay for any artificial reproductive treatments unless compelled by law. You can find some strategies here.
Finding IVF health insurance coverage is more involved than just looking up the laws in the state where you live. These 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.
IVF Mandate States
There are nine IVF insurance mandatory states. The mandates apply to certain groups. 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.
Six states specifically exclude In Vitro Fertilization but may require payments for supporting treatments.
Supplemental Health Insurance for IVF
Supplemental health insurance for IVF reimburses some of your expenses when you conceive and deliver a perfectly healthy baby. This is your objective after all, right?
Remember that IVF success often translates into lost income for mom during her maternity leave, along with a stay in the hospital. Short term disability reimburses a portion of mom’s income if she needs bed rest, and while recovering from childbirth.
If you need to finance IVF costs make sure you secure the income needed to repay these loan.
In Vitro Fertilization 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.
Hospital indemnity 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. Any couple thinking about IVF should consider purchasing supplemental coverage before starting their next cycle. Once you become pregnant it will be too late to get a policy.
Paying for IVF without Insurance
The vast majority of site visitors may find that have to pay for IVF without insurance. If that describes your situation you may find some assistance in several areas.
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 refund plans that every couple should know that lowers costs, and provides financial security.
IVF Costs and Success Rates
Sometimes you have to make an informed bet to make IVF more affordable. The federal government provides tax breaks, but you have to know how to take advantage. Supplemental programs are a great way to play the odds, but you have to be able to accurately project results.
Find IVF cost breakdowns. 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.
Factor in IVF success rates to project what you might spend and make difficult choices about how to spread your premium dollars.
ICSI increases costs and success rates. 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. Your medical plan may not pay for this procedure even if IVF is listed as a covered benefit.
What Insurance may pay for IVF?
If you are one of the lucky few that has health insurance that covers IVF treatments you will find that there is a great deal of inconsistency. Each state mandate differs in terms of qualifying criteria, waiting periods, number of cycles supported, and more. Below are some of the issues you may encounter, along with some alternatives to explore.
Insurance may cover the cost of IVF medications. It depends upon the mandate which applies, and whether the drug can be used to treat an underlying health condition. Be sure to get approvals before beginning a cycle.
Most health plans will not provided benefits for genetic testing. However that does not mean you can’t make a compelling business case. Learn how to get insurance to cover pre-implantation genetic diagnosis.
Other forms of testing needed to determine the underlying medical cause of infertility may be covered by most plans. Work with your clinics financial advisor to submit the appropriate codes to improve the chances that testing is included.
Health insurance for IVF surrogacy has recently improved dramatically. Previously it was difficult to find a plan that would cover the resulting pregnancy. Maternity insurance under Obamacare provides two new angles: maternity, hospitalization, and newborn care are essential health benefits, and the surrogate may qualify for government premium subsidies. Many surrogates may have lower incomes, which allow them to qualify for a larger government contribution.
Couples sometimes choose to leave the country to find lower cost options. Book your trip with a rewards credit card, and get free travel insurance that covers trip cancellations. Read your healthcare plan documents carefully to verify that international care is included before traveling out of the country.