Building a family by having children is a milestone that many couples desire. Our dreams of family bring up images of cuddles with small children, family vacations and quality time together. Fertility, however, is not guaranteed for everyone. This is why it’s so important to have the best insurance for fertility if it is needed. It may take medical intervention to diagnose the underlying reasons for a couple’s infertility. Lifestyle changes and the latest technology offer hope for many couples who want to pursue having their own biological children. But Assisted Reproductive Technologies, such as IVF and IUI, can be expensive and take more than one round of treatment to be successful.
Primary health plans leave gaps
It is an unfortunate circumstance that most primary healthcare plans do not cover expensive treatments like the various types of In Vitro Fertilization (IVF) and Intrauterine Insemination (IUI). The Kaiser Family Foundation reports that roughly half of Americans receive insurance from their employer (48% in Texas). A very small number of them offer these treatment benefits for infertility. One study found that 26% of larger companies in the U.S., those with 500 employees or more, offer benefits for fertility treatments. Companies such as Progyny make fertility benefits more cost-effective to employers who want to offer this health coverage to couples and single parents. Yet, half of Americans get their health insurance from sources other than an employer, if they are covered at all.
State mandates are incomplete
And, while roughly one-third of states mandate companies of a certain size to offer some type of fertility coverage according to RESOLVE, small employers are exempt from those rules. Companies who self-fund are also not subject to state mandates. Short of a federal insurance mandate for the specific diagnosis of primary infertility, it is likely that typical group, individual and public health insurance plan benefits mean couples must pursue growing their biological family in other ways. FutureFamily is one such company that provides fertility financing to offset the cost of IVF and egg storage.
Supplemental health policies are a promising alternative
The financial and emotional toll of pursuing treatment can mean that some families are unable to pursue having their own biological children. Some may decide to abandon their dream of family altogether or pursue building their family through adoption. A different type of insurance that covers an infertility diagnosis can provide vital health coverage without breaking the bank.
LifeSpring Insurance Services, whose founders have years of experience in insurance, examined the problem through the lens of insurance. They felt that it wasn’t fair that parenthood is pursued only by those with the means to afford fertility treatments. The solution they created is a supplemental health insurance product, the first of its kind in the nation. The Primary Infertility Assistance Policy is purchased for children under age 13 with a deferred benefit covering fertility treatment for a couple between ages of 18 and 36, so they can pursue their path to parenthood.
LifeSpring CEO and Co-Founder Jason Muesse explains why this policy is designed for children: “When families buy a supplemental policy before it is needed, that policy can be offered at the lowest possible cost with the most financial benefits. When you own a policy for a possible future infertility diagnosis, its premium is a fraction of its value.” That means the time to make fertility treatment affordable is years before treatment is needed.
The benefits of a supplemental health insurance plan for infertility
LifeSpring’s Primary Infertility Assistance Policy covers what most health insurance plans do not. This includes drug therapy, diagnostic testing, IUI, lab tests, IVF, surgical care, egg and sperm retrieval and storage and more. The policy covers both the beneficiary and his or her future partner because primary infertility is a couple’s diagnosis.
The cost of treating infertility is high and overwhelming for most. For a one-time payment of $2,000, which can be paid in monthly installments, LifeSpring’s Primary Infertility Assistance Policy for Texas children ages 0-13 offers a deferred benefit from age 18-35 that pays up to $50,000 for a whole range of infertility treatments including IUI and IVF for the beneficiary couple if they ever need it when they decide to have their own biological child.
LifeSpring Insurance Services innovative policy gives many more families a way to ensure their children have the financial resources they may need to start a family if they ever need fertility treatments. No longer will it matter who their employer is, what type of insurance they have and how much money they have in the bank. Coverage is offered without waiting periods, deductibles or coinsurance.
LifeSpring’s innovative insurance plan invites any caring adult, parent, relative, godparent or friend to purchase the coverage for any Texas child. The resulting gift will last long into the future with 18 years’ worth of benefits from age 18-36. This Primary Infertility Insurance Policy will give them what they need to pursue their own biological child if they or their future partner ever requires treatment for primary infertility. It gives today’s families the best chance possible to insure their future family.
LifeSpring Insurance Services was founded in Austin, Texas, by insurance executives Jason Muesse and Eugenie Shea. It took them five years to develop a plan that was affordable and delivered comprehensive benefits to remove the barrier of finances for infertility treatments. The resulting Primary Infertility Assistance Plan is an admitted insurance product in Texas, which means the insurance policy has been reviewed by state regulators at the Texas Department of Insurance to ensure the plan will be available for years to come. They plan to pursue approval for the product in additional states.
Easy and Private
It’s quick and easy to apply. The insurance application, quote and payment can be finished online in about 10 minutes. When a beneficiary reaches age 18, the insurance ownership will transfer to them, so they can access it and file a claim when they and their partner are ready to start a family. Supplemental health insurance policies cover medical expenses that traditional health plans may not cover. There’s a good reason for that. If a comprehensive health plan covered everything possible, it would be difficult for most people to afford it. This is why the Affordable Care Act covers 10 essential benefits and part of why fertility treatment isn’t one of them.
A supplemental health insurance plan that covers infertility is a way to plan ahead to care for future family before they need it. This gives the investment in the one-time insurance premium time to grow, so it will be ready for those couples who need it to pursue having their own biological child. As parents and grandparents begin saving for their child and grandchild’s future education, wedding and home, this policy becomes an investment to help them build their future family — a precious gift.
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.
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?
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.
Whether you are a new parent, a soon-to-be empty nester or a grandparent, the desire to see your children flourish and grow will always be a part of your life. Trying to prepare your children for their future is a lifelong challenge. There is a balance of letting go. For instance, when they try to ride a bike without training wheels for the first time and pulling children back when they forget to watch for cars in a parking lot. No matter the age of your child or season of life, your role as a parent or grandparent brings its own challenges.
Your family’s legacy
Between teaching children valuable lessons and planning for their future, it is easy to get caught up with the hopes and dreams of their future families. Many of us wonder who our child’s future partner may be. We also wonder if we may become grandparents or great-grandparents one day.
Many of us would like to leave our family a legacy to help them long into the future. By making plans now, we can help prevent financial hardships caused by unexpected medical diagnoses like infertility.
Why choose infertility insurance?
No one knows if their child/grandchild or their future partner will be affected by infertility. Even now, there is still much that isn’t known about infertility and the causes of infertility.
What we do know is that infertility impacts 1 in 8 couples. The cost of infertility treatments is expensive. Cofertility, a blog that aims to inform and connect families dealing with infertility in a compassionate way, shares that pricing can vary from $800 for intrauterine insemination (IUI) to $8,000+ for IVF for just the basics. FertilityIQ documents how much IVF costs by city and region.
The fact is: High costs of treatment keep families from pursuing their own children. Cofertility published a survey that found that 86% of those undergoing infertility treatment said “they have forgone a fertility treatment option recommended by their doctor…due to cost.”
What about health insurance from your employer?
While we can’t predict who a future employer will be or even what type of healthcare insurance coverage our children will have access to, we can provide our children protection from the costs of infertility now.
Not only that, fertility treatments are generally not included in traditional healthcare coverage. Currently only about 26% of the top 500 employers provide any type of infertility coverage. This is mainly due to the high cost of infertility treatment.
A supplemental health policy/coverage, however, can fill the gaps and complement the health insurance your child may have in the future. It can pick up where other health coverage stops. It can give them the financial resources they need to treat infertility and pursue having their own biological children when they are ready.
Can a supplemental health policy cover infertility?
Yes. LifeSpring Insurance Services has a Primary Infertility Assistance Policy that provides an affordable insurance solution for infertility treatments in the future. Unlike a traditional health plan, LifeSpring’s innovative policy is geared towards children and their future. By providing coverage early in life, we can offer a one-time premium around $2,000 or less for a policy that provides $50,000 worth of benefits for your child and his or her partner. The policy is designed to cover infertility treatments, providing access to all of the common treatments from IVF, IUI, medicine and storage. This way couples can pursue their own child without the crippling costs that so often compromise their hope.
How can an insurance policy preserve my family’s legacy?
LifeSpring’s innovative supplemental health insurance policy, approved by the Texas Department of Insurance, was designed in the hopes of creating a future where children wouldn’t have to decide between a mortgage payment or fertility treatments. With a LifeSpring Insurance policy, you can give a gift that continues to give over time, one that will ensure that your family will have a lasting legacy.
Your desire to protect your children is part of what makes you a great mom, dad, grandma and grandpa. Family is one of the most precious parts of life. Consider the lasting impact you can have to preserve your family’s legacy by giving a LifeSpring policy today. Contact us if you have any questions
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.