Dealing with infertility or miscarriages is a painful/frustrating/maddening situation. What makes it even worse is how incredibly expensive it is to cover doctors’ visits, lab work, diagnosis, and treatment. I have gone through all of this (and we joke about our kids being our 100K dollar babies), so I know how little is covered. However, there are a few resources that could provide assistance.
Take a look at The American Society of Reproductive Medicine website www.ASRM.org. Here you will find a list of states’ insurance regulations: what each state requires an insurance carrier to cover for diagnosing and treating infertility. You may find that your state requires your carrier to cover diagnosing but not treating (as mine did), or you may find helpful information to take to your doctor. Doctors can use different insurance codes that will get certain things covered. For instance, if it is determined that your infertility is related to PCOS and your doctor codes all the testing due to painful and irregular menstrual cycles, rather than coding it to inability to conceive, your insurance company will have to pay for everything related to the PCOS because it is a recognized medical condition. (If for some reason your state isn’t listed, you can contact your state’s insurance commissioner’s office, and they will be able help).
Another website to try is www.IHR.com. Go to their homepage, under the Financial Options, you can find a list of clinics that offer “money back guarantees” for couples undergoing IVF (in other words, they give you your money back if they are unable to get you pregnant). HUGE caveat here: clinics live and die by their success rates, so in order for this type of “guarantee” to work, you will have to be a superior candidate for the procedure (young, tip top health, all lab work in perfect order, for both you and your partner…now, most people going through IVF would not BE dealing with IVF if everything were perfect, so it leaves an extremely small percentage of the population that can fit this criteria).
www.IHR.com also lists a number of places that offer low cost infertility loans. Banks don’t really have this service, (imagine walking into your bank and saying “Hi, I’d like a loan for sperm analysis…) so these are specialized loans.
Another website that I have referenced before, one of my favorites, is www.inciid.org. Go to their Insurance and Legal tab, then under that tab, you will find Programs, Carriers and Mandates. Here they have a list of what they call “Infertility and Adoption Friendly Employers”. So, if you were willing and able to switch jobs, or are looking for new job, this list might help you find an employer who would support your efforts in achieving your family.
I know one of our DS members actually asked her employer if he would add infertility to the company policy, and she offered to pay the difference that the employer had to shell out. As a corporation, he had decent amount of coverage for IVF available to the company’s policy, but he had never had a reason to pay for that coverage. He was willing to do it for her!
Under that same tab you will find a listing of insurance companies that have infertility riders available. You would obviously have to purchase a rider as an addendum to your regular policy, but it could end up costing a good deal less than paying for everything out of pocket.
Inciid also has it’s own “scholarship” program, called “The Heart Fund”. They give out scholarships each year, covering all the costs of infertility diagnosis and treatment. Please see their website for full details. (Also, Inciid lists a grant available if you are a resident of the state of New York).
Lastly, you can speak with the accounting department in your own doctor’s office. They will have a list of the companies that they bill who cover certain treatments. You can also ask your doctor if they work on a sliding scale. Some doctors and clinics will charge different fees for families with lower incomes.
Until our healthcare gets a major overhaul, we are all going to have to use all the resources we can find. If you know of anything I have left out here, PLEASE include it in the comments section so that everyone else reading this can share in the information.
- Sorry, in advance; This is a LONG post, but very important. Missouri has referred a bill for insurance infertility coverage, and in my MBA program, I just happen to be taking a course on Legal action, so have reviewed all of this with my professor/attorney. :) Non-Missouri residents ? check your state pending regulations ? there are a lot of states addressing insurance infertility coverage, and the information below and in the attached letter apply for any state that doesn?t cover infertility treatment. Posted on 03/21/09, 04:50 pm
- I know many of us have insurance, but infertility treament is not covered. Recently I saw a list going around of the companies that offer infertility treatment with insurance.
Yes I am sad to say it has gotten to that point that my husband & I are thinking about finding other employment that will cover infertility. What has this world come to? :( Posted on 08/18/08, 08:48 pm
- I know I asked this before...but it might be good to ask again for new people coming in... Does anyone remember those who offer infertility insurance (primary for IVF?) Also, do they cover costs for embryo donation? Thanks. Posted on 06/06/09, 08:58 am