Infertility Treatments

Many couples seek infertility treatment to help them have children. Insurance for fertility treatments is complicated. Many policies cover some treatments and not others. Unfortunately, fertility insurance is only available in some state in the United States. However, there are several major insurance companies that offer fertility insurance.

When you consult a specialist for fertility testing and treatments, the doctors should help you with looking into insurance coverage. They can pre-screen a couple to find out if either has an insurance that covers their procedures. Many specialists have financial counselors that help with the process of financing fertility treatments. You can talk with your insurance company directly to find out what’s covered before you proceed with fertility treatments.

Insurance Plans In Certain States and Coverage

Some insurance plans cover procedures like IVF, testing, and artificial insemination. Other plans do not cover anything at all.  About 15 states have mandates that insurances companies that provide pregnancy coverage should have some coverage for fertility testing and treatments.  Some of the insurance companies that offer fertility coverage are Aetna, United Healthcare, Blue Choice, Blue Cross, Cigna, Humana, and Optus Health.

Many plans only cover doctors in their network and the costs to patients that use out of network doctors are higher. Many plans pay for testing of infertility but not for procedures to treat it.  This is because diagnostic testing does not cost as much as treatment for the condition.  Some states have mandated laws that the insurance must pay for certain fertility treatments. The problem is that many treatments are not covered.

The states that have fertility insurance are Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia.  Each state offers coverage for different treatments, testing, and medications and does not cover all procedures.  Many insurance companies offer coverage of fertility drugs and testing. It varies from company to company and from state to state.  Some private insurance and supplemental policies cover fertility treatments. Your doctor should be able to provide you with information about this.

Medicaid does cover fertility testing and a consultation with the doctor. However, it is very limited.  VA insurance for veterans will cover some fertility treatments in 2016. Check to see if this is only for active military veterans through Tricare or non-active too. The senate recently passed this amendment.

Options when Insurance Coverage is Limited or Not There

Some doctors have lowered the cost of treatments for some procedures or offered a refund if  a couple does not get pregnant. Many offer discount programs for couples without insurance or good coverage. Or discounts to military families too. There are specialized loan companies that offer loans just for fertility treatments for couples. The companies offer a variety of loans to help make the treatment affordable and easy to pay on. One of these companies is Fertility Finance. Each loan is designed to fit a couple’s situation.

The ARC Fertility Program is a network of facilities offering discounted treatments and financing.  Another program The ARC Reproductive Insurance Program run by the New Life Agency tries to help couples get insurance coverage and a refund when pregnancy is not achieved. Compassionate Care is an income assisted program that provides couples with discounts on fertility medications.

Eggbanx provides loans and discounted rates for egg freezing.  The Fertility and Reproductive Program run by Prosper Healthcare Lending helps couples with financing for medical treatment for fertility. There are many other organizations that help with infertility treatments costs located around the US.

Another option is opening up a saving account to save for treatments and testing. Some insurances have medical savings accounts that help with this type of savings. This idea is better for a younger couple than older.

Grants and Scholarship and Discounts for Military Families

Grants for fertility are competitive and hard to get. But organizations like The Baby Quest Foundation offer grants twice yearly with amounts between $2,000 to $16,000. Other organizations that award grants are The Cade Foundation, The International Council on Infertility, The JSCF Fertility Fund, Lederer Life Foundation, and Pay It Forward Fertility.

Many of the organization listed with loans and discounted costs give military couples discounts on testing and fertility treatments. These are insurance and other financial options for covering fertility cost. Infertility insurance coverage is complex and often limited by many companies. Patients should work with clinics and doctors to help them find solutions to financing these treatments.  A good source of information is Resolve The National Infertility Association. 

By Joan Russell