For couples who want to have their own children and who have struggled, insurance benefits may mean the difference between completing one round of fertility treatments or four. For most Americans, infertility insurance is not a required healthcare plan benefit. While the Affordable Care Act (ACA) changed health care coverages, currently it does not require coverage for fertility treatments. Let’s take a look at the costs of infertility and how infertility insurance measures up.
How is infertility defined?
Primary infertility occurs when a couple is unable to become pregnant after one year of continuous trying without birth control. While infertility is about as common as diabetes, impacting about 12% of couples, treatments can be expensive, involved, and last for months and up to years. Treatment for infertility is unique because it is a couple’s diagnosis, so both must be diagnosed and treated. It can be an expensive condition especially if Artificial Reproductive Technology (ART) such as IVF and IUI are needed.
What does fertility treatment cost?
Fatherly’s Patrick Coleman explains: “Traditional IVF will generally top out around $14,000. However, expect that figure to nearly double if electing to use donor eggs, which can cost up to $25,000.” Even without ART, medications like injectable hormones can cost hundreds per month. An Intrauterine Insemination (IUI) runs $300 to $800 per cycle, but IUI are often paired with drug therapies and costs can increase if you use donor sperm (Source). Additional fees for medications, storage, genetic testing and diagnostic exams can be extra.
According to FertilityIQ a cycle of in vitro fertilization or IVF will cost about $23,000 per cycle. And the“average IVF patient will cycle multiples times (2.3 – 2.7 times), which brings the actual cost closer to $50,000.”
Why is treating infertility often not covered by health insurance plans?
One of the reasons traditional health plans fail to offer comprehensive coverage for IVF is because it would drive overall insurance premium costs higher. Given that the average couple spends upwards of $50,000 on treatments, excluding cost of labor and delivery, insurance would have to cost enough per person to be able to provide the coverage to everyone. These are the factors that drive up the cost of primary health insurance and why it has been such a difficult problem to solve. In many states, employers also have the choice to reject fertility treatment coverage.
Assuming that an employer did offer coverage, what type of coverage could you expect to receive? ModernFertility’s Chanel Dubofsky completed an informal survey regarding infertility insurance. She found people’s experience with current fertility insurance plans coverage for treatment ranged from nothing to paying for some of the medications to paying for all of the medications and even covering one IVF cycle. There was quite a variety of experiences that she documented. FertilityIQ reports that “less than 27% of Americans have a fertility treatment paid for by insurance.” Of those, only a small percentage have the majority of the infertility treatment covered completely by insurance. Basically, it’s rare to be covered by a primary health plan you purchase individually or from an employer.
How to make fertility affordable?
There is a way to make treating infertility affordable by purchasing supplemental health insurance early in life for children who may need it as adults. In this way, we can cover this diagnosis for more couples and future families without having to rely on legislators, healthcare policy changes, employers and what primary health plan your child may have in the future.
LifeSpring offers the nation’s first Primary Infertility Assistance Policy for children ages 0-13, now available in Texas. For a one-time payment of about $2,000, which can be paid out monthly, the policy covers the insured and their future partner if they ever need infertility treatment. For relatively small investment, it pays up to $50,000 – covering the couple for 18 years from age 18-35 when they are ready to build a family. It covers all the procedures couples typically need to resolve an infertility diagnosis up to $50,000, including IVF and IUI, storage, medications and minor procedures.
If you or someone you care about has been through treatment for infertility, you know the stress and financial hardship it brings. We may not be able to remove the emotional weight an infertility journey brings, but a LifeSpring policy can relieve the financial hardship that causes many couples to abandon their dream of having their own biological child. Learn more about the product and contact us if we can answer your questions.