Infertility insurance is not a common coverage among the millions of families worldwide who have had children via IVF. While some traditional health plans will cover infertility diagnosis and treatment, the coverage is often incomplete. Many families are still paying out of pocket to cover the costs. And some decide to forgo having their own biological child, building a family in other ways.
Some companies offer fertility treatment benefits such as IUI and IVF, but it’s a small number as compared to the number of U.S. businesses (18,500) with 500 or more employees. ABC News reported, “Over 400 U.S. companies offer benefits for fertility treatments…[but] Even with some employers adding infertility benefits, the majority of IVF patients treated last year paid for all or some of their treatment out-of-pocket, according to Fertility IQ.”
Treatment for infertility has long been thought of as a women’s issue or a lifestyle choice for those who can afford it. Change is coming though. In 2017, the American Medical Association declared infertility a disease for the first time. For the world of insurance, this distinction makes a world of difference.
However, insurance as a industry is slow to change. Immediate past president of the American Society for Reproductive Medicine Dr. Richard J. Paulson explains that just 30 years ago “most insurance companies didn’t even cover obstetrics [childbirth]. It was all out of pocket.”
Why don’t employers offer infertility insurance?
One reason employers don’t offer infertility insurance is that is is too expensive. The cost of fertility treatments is still too high. To cover it would require insurance companies to raise the cost of health insurance premiums overall. Combine this with the escalating costs of healthcare and it is even less likely that employers will add infertility coverage in the future.
Another financial concern is that the cost of infertility treatments often incentivizes couples to seek higher risk treatments in the hopes of a quicker return. The American Society of Reproductive Medicine and American College of Obstetricians and Gynecologists advise against the transfer of multiple embryos during an IVF cycle for most women. They favor elective single-embryo transfer (eSET) using IVF, a type of Assisted Reproductive Technology, because of the risks of multiple birth, which can lead to much higher healthcare costs for patients and insurance companies.
Why can’t the states require fertility coverage?
Out of the 50 states, 18 have any type of required infertility coverage according to RESOLVE, a fertility advocacy nonprofit. Advocates from RESOLVE and the American Society for Reproductive Medicine are currently working in the hopes that states will be able to create/pass laws that mandate insurance coverage for infertility. This, however, will be a long road because even if states pass similar laws, like Delaware, which has one of the most comprehensive bills concerning infertility, not everyone would still have access to the same coverage.
State laws can only mandate or require that employers of a certain size and those with a certain type of insurance cover specific health benefits. Employers who are smaller and those are self-insured are exempt from state regulations. Only a federal law can require that infertility be covered, and the Affordable Care Act already does not consider it part of the Essential Healthcare Benefits.
How can I find insurance that covers fertility treatments?
While primary health insurance plans are not equipped to deal with all the expenses that fertility treatments incur, a supplemental health insurance policy is filling that need.
Supplemental health insurance is designed to fill any coverage gaps left by a traditional health insurance plan. This insurance can cover a variety of conditions that your traditional plan does not cover or does not cover completely. Often supplemental health insurance plans cover eye care/glasses, dental care, hospitalization, accidents, major illnesses and other medical conditions, including infertility.
Where can I buy infertility insurance?
Infertility insurance is now available as a supplemental health policy for future families. At LifeSpring, we cover children today so that families of tomorrow don’t have to worry about what health insurance they have or who their future employer will be. They can have the freedom to be an entrepreneur or business owner without the worry of not having the financial resources to cover treatment for primary infertility.
Change is taking place in insurance and health care reform, but that doesn’t mean you have to wait to see what options your child or grandchild may or may not have access to. By covering children today, we can make coverage more affordable for many more families. It’s a fantastic way to preserve a family legacy by planning ahead. Learn more about LifeSpring’s innovative Primary Infertility Assistance Policy and see if it might be right for a Texas child in your life.