Infertility Insurance

If you are facing fertility difficulties, you and your partner may be considering visiting a fertility clinic for treatment. Fertility treatments, including fertility drugs, IUI, and IVF, can sometimes help to significantly increase your chances of becoming pregnant. Unfortunately, these fertility tests and treatments are very expensive and therefore are out of reach for many couples. However, fertility insurance is now offered by a number of different insurance providers. So before you give up on those treatments, find out whether or not your may be covered by infertility insurance.

What is Infertility Insurance?
Infertility insurance is a type of health insurance that can help you to pay for your fertility treatments. For a monthly premium, insurance providers will supply you with a health care plan that will cover a range of fertility treatments, including diagnostic fertility tests, artificial insemination, and other types of assisted reproductive technology. If you are ever faced with the need to have fertility treatments, your infertility insurer will pay for these treatments, up to a specified maximum amount. Infertility insurance is now mandated in certain states and available for private purchase throughout the United States.

Why Buy Fertility Insurance?
Insurance is becoming increasingly popular among couples and families, particularly as health care costs continue to rise. You can now receive health insurance, dental insurance, life insurance, and even pet insurance, in order to ensure that you and your family have financial security in times of need. Infertility insurance is also becoming more and more popular as demands for fertility treatment increase. With more than six million Americans facing fertility issues, fertility treatment is being seen more as a necessity than as a luxury.

Fertility treatments are completely out of the price range for most couples. With fertility medications costing upwards of $1,000 a month, and some ART procedures costing over $4,000, many couples simply can’t afford to finance fertility treatments on their own. Fertility insurance can provide you with a way to get the treatments you need without going bankrupt.

Types of Infertility Insurance
There are three main types of infertility insurance:


  • Standard Health Insurance: Standard health insurance requires that you pay a monthly premium in exchange for specific fertility coverage.
  • Refund Programs: With these types of programs, you pay up front for your fertility treatments. If you do not have a baby, between 70% and 100% of the money is paid back to you.
  • Financing: Loans can be taken out to cover infertility procedures. If you do not have a baby, these loans do not have to be repaid in full.


What Does Infertility Insurance Cover?
Every infertility insurance plan is different, so it is important to look around before you buy in to one. You want to make sure that all diagnostic tests, medications, and fertility treatments are covered by your insurer. Typical infertility insurance plans cover the most inexpensive treatment that is suitable for you and your partner. They also generally only cover treatments for a certain number of cycles, typically between three and five. Infertility insurance may cover one or all of the following treatments:


  • IUI
  • IVF
  • ZIFT
  • GIFT


Infertility insurance may also cover diagnostic test procedures, including laparoscopic surgery. Moreover, your infertility provider may cover medications, though some injectable medications are not covered. Typically, the use of donor eggs and donor sperm is not covered by infertility insurance.

Who Can Get Fertility Insurance?
Unfortunately, not everyone can get fertility insurance. Though it varies from insurer to insurer, there are normally certain qualifications that you have to meet before being approved for fertility insurance. To qualify for infertility insurance, couples who already hold an insurance policy usually need to be:


  • under the age of 40
  • struggling with fertility for a specific period of time (ranging from one to five years)
  • policy holders for at least one year


Couples that do not already have insurance coverage and are currently undergoing investigation for infertility issues will most likely not be approved for fertility coverage. In these instances, it is a good idea to look into whether your fertility clinic offers any kind of refund program or financing option to their clients,/p>

Laws Governing Fertility Insurance
Depending upon where you live, there are different laws regarding fertility insurance. Some states have a mandate that requires all employers with more than 50 employees offer health care coverage that includes some type of fertility insurance. These states include:


  • New York
  • New Jersey
  • Ohio
  • Montana
  • Massachusetts
  • Arkansas
  • California
  • Rhode Island
  • West Virginia
  • Texas
  • Maryland
  • Conneticut
  • Hawaii
  • Illinois


Other states have no mandate requiring employers to offer fertility insurance.

Are You Covered?
Before undergoing fertility treatments, it is important to check your insurance policy to see if any fertility treatments are included with your plan. Be sure to ask your employer for a copy of your full insurance policy, listing all inclusions and exclusions.

If fertility treatment or testing is not specifically excluded in the policy, your provider is required to pay for the treatments. Write a letter to your insurance provider asking for detailed information regarding your infertility insurance or speak with your insurance broker. If you are not covered, you may be interested in investing in an infertility insurance policy. Call your local providers and ask for an insurance quote.


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