According to the National Survey of Family Growth by the Centers for Disease Control and Prevention, one in eight couples have trouble getting pregnant or sustaining a pregnancy and more than 85,000 women in the U.S. undergo in vitro fertilization each year.
Unfortunately, such fertility treatments often require out-of-pocket costs and can be a tremendous financial burden for those dealing with infertility. According to 2017 data from Progyny, a fertility benefits management company, the average cost of IVF treatment, including cycle costs and medication, is $25,000. And considering it takes most couples an average of 2.2 cycles to achieve a successful pregnancy according to 2015 data from the CDC, aspiring parents must often pay a high price to get treatment, especially since insurance rarely covers the full cost.
[Read: 7 Ways to Keep Your Health Care Costs in Check.]
“Financial reasons are the biggest barrier for couples to receive fertility treatment,” says David Schlanger, CEO of Progyny. “Patients typically exhaust their traditional coverage and or savings before achieving a successful pregnancy.”
According to a 2015 study about the sentiment, costs and financial impact of fertility treatments in the U.S. by Prosper Marketplace, a peer-to-peer lending marketplace, nearly half of those polled said that prices impacted the level of treatment they sought. Almost 34 percent of those women surveyed had to stop treatment due to the financial burden. Meanwhile, 70 percent of participants reported acquiring some degree of debt in their quest to conceive with more than 26 percent taking on over $30,000 of debt. The cost of treatments was also the single largest factor for those respondents who initially decided to delay fertility treatment at nearly 82 percent.
The financial implications of infertility are often as stress-inducing as the emotional and physical strains. If you’re struggling to conceive and you’re contemplating IVF treatments, don’t let the expense deter you. Follow these step-by-step, expert-approved strategies to overcome the financial burden of infertility.
Educate yourself. The perceived costs of fertility treatments keep many people from visiting a doctor to learn more about their options, says Barbara Collura, CEO of Resolve: The National Infertility Association, a nonprofit organization that provides free support groups in more than 200 communities.
“Take the first step to educate yourself by going in for a consultation and getting diagnosed regardless of financial worries,” Collura says. “Ask as many questions as possible about treatment plans, associated costs, payment options and financing alternatives.”
The fertility clinic’s finance department can guide you through complex and confusing cost and coverage questions. In fact, most providers know which insurance companies and employers offer coverage, and can also recommend loan programs or may offer payment plans, she adds.
Understand and leverage your insurance coverage. It’s important to review your health care benefits and state laws to understand what type of coverage you qualify for. According to a 2016 study by the International Foundation of Employee Benefit Plans, a nonprofit organization that provides the employee benefits community with objective, solution-oriented education, research and information, 24 percent of employers with 500 or more employees offer fertility services as part of their health care benefits. On the down side, the study found only 4 percent of employers with fewer than 50 employees offered fertility services.
Even if your company is based in one of the 15 states with laws that require insurance companies to offer or provide coverage for infertility, some of these states do not require insurers to provide fertility treatment coverage or may not require employers to include it in their insurance plans for employees. Even more troubling, California, Louisiana and New York have laws that specifically exclude coverage for IVF. Keep in mind, an employer plan that is self-insured is exempt from state law and does not have to offer fertility benefits and companies with fewer than the set number of employees may not have to provide coverage either, Collura explains.
[Read: 8 Ways to Get Help Paying (or Cutting) Medical Bills and Drug Costs.]
You can review coverage by state at Resolve’s website to understand which laws apply. Keep in mind, there are eight states that have passed laws mandating companies to offer IVF, including Massachusetts, Rhode Island, Connecticut, New Jersey, Maryland, Illinois, Hawaii and Arkansas.
Even if IUI, also known as intrauterine insemination, or IVF is not covered under your plan, diagnostic tests and some medications may be included, so leverage any coverage you may have to help lower the overall out-of-pocket cost of your fertility treatment, Collura says. “If you get a denial letter, appeal it. Often times, denials are mistakes,” she adds.
If your company offers a h ealth savings account, also known as an HSA, Ryan Firth, CPA at financial planning and investment management services company Mercer Street, says this is the best way to pay for treatment when using your own money.
“Contributions to an HSA are tax deductible or are made with pre-tax income, interest earned is tax-free and withdrawals for qualified medical expenses, such as those for IVF, are tax-free,” Firth says.
Make a request for fertility benefits. When coverage for fertility treatments isn’t available, employees are urged to speak with a representative in their human resources department and ask for it to be added as a benefit.
The main reason an employer adds a comprehensive fertility benefit is because their employees ask for it, Schlanger says. “Employees often don’t realize the impact they can have, especially when it comes to health care coverage. If one employee speaks up about their infertility, there may be others who are also dealing with it. One voice can really make the difference and we really encourage employees to be vocal about asking for a fertility benefit.”
Consider cost-saving alternatives. For people whose elective medical procedures aren’t covered by insurance or fall below the deductible, meaning they are responsible for paying 100 percent of claims since they haven’t met their annual deductible for insurance to kick in, financing alternatives are available. Most often, the fertility clinic will be able to walk you through the various options available, such as taking out a loan or applying for a grant or scholarship, Collura says. For instance, several nonprofit organizations provide financial assistance to select infertility patients and you can find a list of options along with application instructions and requirements at Resolve.org.
Those who do not qualify for a grant or scholarship, or those who may already have incurred debt for previous IVF cycles and don’t want to take out another loan, should consider borrowing money from friends and family. Otherwise, setting up a fundraiser through sites such as GoFundMe.com, the world’s largest social fundraising platform, which has a page specifically designed for IVF crowdfunding campaigns, is another option for raising money.
Beware of low-cost clinics. Low-cost fertility clinics may offer a less expensive IVF treatment, an enticement for budget-conscious patients, especially those who have already exhausted their insurance coverage and savings, but the cheapest treatment is not always the best option. Poor practice methods may result in a low success rate and wind up costing couples more money for multiple cycles in order to achieve a healthy pregnancy.
[See: 10 Things You Need to Know About Medicare.]
It’s important to research treatment centers and go in for consultations to make sure the clinic is right for you. You can locate fertility clinics, learn about the services and their success rate on the CDC website.
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How to Cope With the High Costs of Infertility originally appeared on usnews.com
