Supplemental health insurance covers infertility treatment results. It is one important option available to families who are trying to conceive. These programs may make additional claims payments when treatments work. Benefits are paid directly to the policyholder, rather than the medical provider.

Secondary health insurance works slightly differently for infertility and requires some poetic license to explain the implications. Understand how the two different types work for couples trying to conceive.

  1. Supplemental infertility insurance plans
  2. Secondary coverage of treatment results

Supplemental Infertility Insurance Plans

Supplemental health insurance for infertility treatments allows you to bet that your efforts will work. The plans cover mom’s pregnancy. They cover the treatment results, rather than the treatments themselves. They make infertility financing programs viable, by securing mom’s income during maternity leave and reducing your exposure to pregnancy-related medical expenses.

These are not traditional programs. They supplement or add to your primary healthcare program. Rather than making claims payments directly to medical practitioners, they make the payments directly to the policyholder instead. Use the claims payments to offset your costs of getting pregnant.

Understand how the two different programs work, and how they provide additional support.

Short-Term Disability

Short-term disability works as a supplemental infertility insurance plan by covering one likely treatment result. Mom might miss work prior to delivery, and while she recovers from delivering her baby. Postpartum disorders may delay her return to work.

Traditional healthcare does not replace income. Most employers do not provide paid leave. Lost income during pregnancy leave is very common. A policy that replaces income while unable to work takes this exposure off the table for couples.

Coverage must begin prior to conception. You are not pregnant yet, so take advantage of the opportunity before it is too late.

Hospital Indemnity

Hospital indemnity is another supplemental infertility insurance plan that also covers treatment results. The policy makes claims payments when mom admits herself to the hospital for normal labor and delivery. It may make an additional payment if her infant spends time in a Neonatal Intensive Care Unit (NICU).

On average, one in eight babies delivers prematurely. Infertility treatments increase those odds. Some couples are starting later in life while others choose procedures that increase the chances for multiple pregnancies. Multiple pregnancies often deliver prematurely. When this happens, your infants may spend time in the NICU.

Hospital indemnity may make additional claims payments for each infant confined to the NICU.

Secondary Health Insurance for Infertility Treatments

Secondary health insurance for infertility treatments works differently. To explain the concept we define these as traditional healthcare plans that make claims payments directly to medical providers. Couples sometimes consider purchasing an extra policy in the hopes of directly covering an incremental portion of their out-of-pocket costs.

This strategy seldom works. Private health insurance covering infertility rarely occurs in nature for three reasons.

  1. The treatments are elective and do not address any life-threatening medical conditions.
  2. The premium costs are very high relative to the expected benefit – if any.
  3. Carriers view infertility as a preexisting condition.

Rather than fight this uphill battle choose a secondary objective. A secondary objective focused on mom’s pregnancy does not involve elective procedures, returns more in benefits than it costs, and is not a preexisting condition.

Beef up the actuarial value of your plan design, and find one with ideal in-network medical providers.

Increase Actuarial Values

Pick a secondary health insurance program that maximizes coverage for infertility treatment results. When mom becomes pregnant, she will need prenatal care from her obstetrician. When she delivers her baby, she will incur significant hospital charges.

Many maternity health insurance policies leave couples with unreimbursed expenses from deductibles, coinsurance, and copayments. Individual plans have four different actuarial values. The actuarial value defines the percentage of expected medical expenses covered.

Metal Level Actuarial Value
Platinum 90%
Gold 80%
Silver 70%
Gold 60%

Women giving birth generate much larger medical expenses than the average member does. Choosing a platinum plan during open enrollment may lower overall costs the most. The premium costs are much higher, but so is the benefits level.

Focus on Networks

Secondary objectives for health insurance covering infertility treatment results also suggest closely examining the network of doctors participating. Many carriers keep premiums low by narrowing the list of participating doctors and hospitals.

Utilizing an in-network doctor or hospital dramatically lowers costs. Participating physicians agree to pre-defined reimbursement levels. Those out of network are free to charge well above the predefined rate for each medical service. They often do charge much more.

Make certain that your obstetrician, choice of hospital, and local level 4 Neonatal Intensive Care Unit (NICU) is listed as in-network. Your out-of-pocket costs could be much higher if any one of the three does not participate.

Infertility treatments often spawn high-risk multiple pregnancies which frequently deliver preterm. High-risk complicated pregnancies often require specialized care. The need for specialized care increases the chances you may need out-of-network care. Choose a policy with the most robust list of in-network providers to reduce this exposure.

Supplemental health insurance for infertility treatment results makes the exact same claims payment regardless of provider participation. Since the programs make payments directly to you, in-network status does not matter. Combine these programs with your secondary objective to maximize your healthcare benefits from infertility treatment results.