Paying for infertility treatment can be an expensive undertaking for many. If Assisted Reproductive Technology (ART) like intrauterine insemination(IUI) or in vitro fertilization (IVF) is needed, it can cost into the tens of thousands. Risa Kerslake reports that she spent $55,000 on fertility treatments to have her two children. She writes, “Paying thousands of dollars for a chance at pregnancy is a little like playing Russian roulette. Either you’re going to be relieved when you find yourself still breathing at the end or your whole life will seemingly be over.” Her story points to the emotional distress and financial pressure families face who are ready to build families and are unable to do so without help.
Infertility not often covered
Most health plans don’t cover infertility treatment. FertilityIQ, a fertility information website, tracks employers who add infertility benefits. Their most recent survey of IVF patients paid for all or some of their treatment out-of-pocket. And despite infertility being a medical diagnosis, it is not considered an essential health benefit by the Affordable Care Act (ACA) health insurance plans purchased from the healthcare marketplace.
The U.S. government does not require insurance companies provide infertility treatment coverage as part of a comprehensive health plan. Similarly, it does not mandate that employers offer it as a benefit. According to RESOLVE, just 17 states have some infertility insurance coverage laws, but it doesn’t apply to every company. If you are self-employed, you are on your own.
Health Savings Accounts another way to save
Health Savings Accounts (HSA) are savings accounts that are paired with high-deductible health plans to save for expenses a health insurance plan does not cover. They operate much like an individual retirement account (IRA) in that contributions you make are tax-free and can be used exclusively for qualified health expenses including infertility treatments. These types of accounts were set up to encourage individuals to save for medical expenses.
HSAs can be offered by an employer, or an individual can access them by purchasing a high deductible health plan independently. According to Healthcare.gov, the balance in your HSA will roll over year to year, to give you a chance to save up for healthcare expenses and items needed later on. The annual contribution limits for 2020 are $3,550 for individuals and $7,100 for families. Expenses paid out for qualified expenses are tax-free, another benefit.
Flexible Savings Accounts offer options
Flexible Savings Accounts (FSA) are employer-sponsored accounts where employees may contribute part of their pre-tax wages that can be reimbursed for qualified medical and dental expenses. Both of these types of accounts work in similar ways in that they allow an individual to save up money to be used tax-free for medical expenses. The employee contribution limit is $2,750 for 2020 with the employer contribution capped at $500.
According to the Society of Human Resource Management, employers may adopt a carryover feature where participants may roll over up to $500 of their balance to next year. Alternately, they may offer a grace period to give employees an additional time period (2-1/2 months) to use their FSA balance before forfeiting remaining funds. “Plans can offer either the carryover feature or a grace period, but not both, or they can offer neither.”
Using FSA or HSA funds for infertility treatments
Saving money using an FSA and/or HSA is one that families can pursue to cover some of the costs of infertility treatment if they have access to them. But depending on the infertility treatments needed, it may not cover everything you need on the timeline you prefer. There are strict rules about receipts needed for qualifying expenses, so these plans require some planning and administration work.
These plans can cover medical expenses applied to the deductible, co-pays and co-insurance, and prescription drug costs. They can also cover other qualifying medical items, procedures and services. See HSA Store and FSA Store for a searchable list.
A supplemental health policy covering infertility
The CDC reports that 1 in 8 couples face infertility along their journey to become parents. And the emotional, financial and physical toll of treatment is difficult and long-lasting. But, we can remove the barrier of finances for future families by covering children today. A new supplemental health policy available for Texas children ages 0-13 provides a deferred benefit of $50,000 when that child and their partner are older and ready to start a family. Instead of worrying about how generous employer benefits will be and what health plans may available, this plan fills the gaps and can be used with no co-insurance and no deductible for infertility treatments including IUI and IVF. It can also be used alongside your regular health plan.
LifeSpring Insurance Services offers its Primary Infertility Assistance Policy for a one-time payment of about $2,000. A monthly payment options is also available. The policy covers a child and their future partner from age 18 to 35 in the event they need infertility treatments to become parents. Learn more about the plan which can be purchased online by any benevolent adult, such as a parent, grandparent, aunt or friend. We may not ever know if our child or their future partner will suffer infertility, but now we have a way to plan for their future.