Posts Tagged ‘health insurance’

Will infertility insurance cover IVF or IUI?

Understanding the Options

In the United States, infertility affects 12% of all couples wanting to conceive. It is a condition that can affect a couple, regardless of their race or socioeconomic status. 

A couple experiences infertility when they have not become pregnant after at least one year of having sex without using birth control methods. Couples who meet with a doctor regarding their infertility issues will discuss lifestyle issues and also determine what medical tests and counseling are needed as part of their infertility treatment.  Up to 30% of couples may not find a reason for their infertility.

Traditional health insurance coverage

Many health insurance plans and policies will cover some aspects of infertility diagnosis, but the tests and treatment coverage a couple can receive will vary from one insurance policy to another. This is the case regardless of whether a couple has insurance through their employer or purchased independently through a broker, the Healthcare Marketplace or through a public option.  

It is smart to check your plan for the coverage that you have. Many cover a diagnosis, but treatment for infertility is sometimes considered “voluntary” by some traditional health insurance plans. According to RESOLVE, 17 states mandate or require that insurance offer coverage of infertility treatment, such as IVF and IUI. In most cases, these mandates are far from complete or comprehensive.

Infertility as a medical diagnosis

The American Society of Reproductive medicine declared “infertility is a disease of the reproductive system that impairs the body’s ability to perform the basis function of reproduction” in 1993. But the American Medical Association did not agree with this until much later in 2017 said David Adamson, M.D. This explains why even though infertility is a medical diagnosis, traditional health insurance still considers expensive treatments elective or unnecessary.

Even the Affordable Care Act which was designed to increase access to healthcare for more Americans does not consider infertility treatment as an Essential Health Benefit.

Types of infertility treatment

A couple exploring treatment for infertility could undergo hormone testing, imaging, genetic testing, ovulation testing, or other initial tests, in order to determine their cause for infertility. According to the American Society for Reproductive Medicine, a standard workup includes a semen analysis, ovulation assessment, a hysterosalpingogram, and possibly, tests for ovarian reserve and laparoscopy.  Once a doctor has enough information needed, then he or she will put a treatment plan in place for the couple. Their treatment plan could include IUI to start and then add IVF later. 

What is IUI?

IUI (intrauterine insemination, formerly called artificial insemination) and IVF (in vitro fertilization) are two commonly prescribed treatments for infertility. Intrauterine insemination (IUI) describes the technique of placing sperm into a woman’s uterus when she is ovulating. 

This procedure is used for couples with unexplained infertility, minimal male factor infertility, and women with cervical mucus issues.

IUI is a more cost-effective solution and is often done in conjunction with ovulation-stimulating drugs; it is typically prescribed before a doctor proceeds with IVF treatments. 

What is IVF?

In Vitro Fertilization (IVF) is a type of assisted reproductive technology (ART) and it was introduced in the U.S. in 1981. It describes a technique where a woman’s eggs and man’s sperm are combined in a laboratory in order to create an embryo(s). Depending on the diagnosis and age of the woman, an embryo or embryos are transferred to the woman’s uterus through her cervix to enhance the chances of pregnancy.

One round of In Vitro Fertilization (IVF) can cost $12,400 according to the American Society of Reproductive Medicine. However, if the cost of medications, egg storage and genetic testing are included, the true cost can be much higher. FertilityIQ estimates it can cost $23,000 per cycle, and that couples pursuing IVF may need on average 2-3 cycles for a successful outcome.


A new type of coverage 

The cost of IUI and IVF treatments are covered under a new type of infertility insurance policy now. 

LifeSpring’s infertility insurance policy is a supplemental health insurance policy purchased for Texas children ages 0-13 that provides the beneficiary couple up to $50,000 of coverage following a diagnosis of primary infertility when they are older. It was designed to give the next generation of couples affected by infertility the hope and financial resources they need. 

The primary infertility assistance policy covers primary infertility treatments for the beneficiary couple, including medication, testing, doctor visits, IUI, IVF, anesthesia, egg/sperm/embryo storage and other related treatments with no deductibles or co-insurance. The one-time purchase does not need to be renewed. 

 If you’re looking for the best infertility insurance for your future family, we invite you to learn more about LifeSpring’s infertility insurance policy, see our frequently asked questions, and apply online from the privacy of your home or smart phone. In about the time it takes to order a coffee drink from your favorite coffee bar, you can receive a custom quote after answering a few short questions.