Supplemental health insurance for infertility treatments is often the only option available to families who are trying to conceive. Most medical plans choose not to cover infertility for a simple reason: the cost of providing such a benefit may far exceed the premium most policy holders are willing to pay.

Most people end up self-paying for infertility treatments without direct coverage, and need help finding alternatives to better afford getting pregnant. Supplemental health insurance for infertility treatments is the best alternative.

  • How supplemental policies work for infertility treatments
  • Employers that offer infertility coverage
  • Infertility treatments without a policy

Supplemental Health Insurance for Infertility Treatments

Supplemental health insurance for infertility treatments allows you to bet that your efforts will work. Purchase the additional policies while you are still trying to conceive. Couples seeking help with infertility treatments don’t have this problem. They are not pregnant yet. Coverage must begin prior to conception.

Getting insurance to cover infertility treatments is very hard to do, but it does happen. Benefits are paid when you deliver your baby. Your benefit for normal delivery may greatly exceed the premium you pay. Use the surplus to offset some of your costs.

Financing security

Couples who are trying to conceive often finance infertility treatments to get pregnant, and then experience a high risk pregnancy, and then pre-term delivery associated with high order multiple births, followed by an unpaid maternity leave. Supplemental health insurance protects your family finances by replacing income, and filling holes in hospital plans.

Lost income

Couples undergoing artificial reproductive treatments often experience high-risk pregnancies. Some couples are starting later in life, while others choose a fertility procedure that results in multiple pregnancies. Supplemental short term disability programs may replace mom’s income during bed rest if she misses work prior to delivery, or needs to be confined to the hospital prior to her due date.

Multiple pregnancies

Many infertility treatments are associated with multiple pregnancies. Multiple pregnancies often are delivered pre-term. When this happens your infants may spend time in the Neonatal Intensive Care Unit (NICU). You may be left with extra hospital bills. Supplemental hospital policies may also make payments upon the hospital stay for mom’s normal labor and delivery, and may pay additional benefits for each infant confined in the NICU for medical reasons.

Covering Infertility Treatments Directly

Supplemental health insurance for infertility treatments requires making premium payments while trying to conceive. This adds an additional burden in the beginning, but pays off when treatments succeed. Finding a healthcare plan that directly covers infertility treatments makes the purchase decision easier.  If you understand the economics and laws you can increase the odds of affording the supplemental premium payments.

Bad Economics

Any healthcare plan must pay for the cost of the Artificial Reproductive Technique (ART), medical treatment of the resulting conception, extra monitoring of high-risk pregnancy, and NICU confinement of premature infants connected with high order multiple birth. As a result most carriers resist covering infertility treatments – doing so makes poor business sense.

Savvy couples understand that insurers don’t want to take on this risk, but state laws require they do in specific instances. By understanding how state regulations work, who must comply, and where the loopholes are, you may be able to find a policy that pays benefits for your ART and/or IVF.

State Infertility Mandates

Fifteen states mandate that medical plans include infertility and/or IVF. Each state mandate is different. Mandates vary based upon who is required to comply, what treatments are included in the mandate, and who is excluded. Regulations apply based upon In Situs status – your key to finding coverage no matter where you live.

IVF coverage is even more difficult to find than programs for many first line infertility treatments – except for those who work for an employer based in a mandate state that stipulates in Vitro Fertilization exclusively. Without the right plan costs can be staggering. IVF refund programs offer an interesting choice for many couples.

Employers that Offer Infertility Insurance

Most people get their health plans through their employer. Finding employers that offer infertility insurance may be your best bet. The state mandates referenced above apply mostly to employers rather than individuals.

Supplemental health insurance for infertility treatments are also employer based with a twist. They are offered as a voluntary employee benefit program. This means an employer can offer this valuable option without adding to direct costs.

Only a handful of states have mandates, but you only hear people complain when they live in a mandate state, but their employer does not have to comply because they are headquartered in a non-mandate state. Turn that complaint around. Many employers are headquartered in mandate states, and provide employment in other states. If one spouse has the flexibility, changing jobs may be the best answer.

Companies that Offer Plans

Many people ask “which insurance companies cover infertility treatments?” If that is your question, your odds of success rise by reframing the question. As mentioned above most companies will refrain from addressing infertility unless required to do so by law. Follow through on the logic.

Federal Employees

The Federal Employees Health Benefit Program is exempt from the fifteen state infertility mandates. If you are a federal government employee, you may need to consider your spouse’s employer sponsored plans, or look more closely at the option for people without a policy.

Limits and Approvals for Infertility Treatments

Those lucky enough to have a healthcare plan covering infertility treatments directly will need to understand policy limits and seek approvals before beginning any treatments. Every policy has limits in terms of the types infertility treatments, number of cycles allowed, age of the mother, and more.

Consult with the finance advisor at your fertility clinic for advice on what procedures will be included, and at what level. The advisor can also help you get approvals from the carrier in advance of any treatment. Nobody wants like unpleasant surprises.

Lost Income Limit

Supplemental health insurance for infertility treatments covers the most common limit. Traditional healthcare plans are not designed to replace income. Remember that infertility treatments often result in a pregnancy, which nine months later results in an unpaid leave from work. Don’t miss out.

Infertility Treatments without Coverage

Getting a denial letter from your carrier can be deflating. Most people will find they have to self-pay for infertility treatment without insurance. You have plenty of company if you say, “my insurance does not cover infertility.” Most couples have limited resources and need to make every penny count, but there are some alternatives to help make things more affordable.

Infertility treatment costs when paid for out of pocket can cripple many couples financially. The cost of getting pregnant can vary widely. The cost of treatments and fertility drugs are multiplied by the number of attempts needed to get pregnant. Accurately forecasting expenses is a key to keeping more of your money via the tax code.

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