Is IVF Covered By Health Insurance?

Most people never consider struggling with infertility. Luckily, the success rates of standard IVF and advances in fertility treatment options can increase your chances of a successful pregnancy. Women...
IVF Covered By Health Insurance
IVF Covered By Health Insurance

Most people never consider struggling with infertility. Luckily, the success rates of standard IVF and advances in fertility treatment options can increase your chances of a successful pregnancy. Women under the age of 35 who have tried to conceive unsuccessfully for at least a year should consider seeking fertility help. The same is true for women over the age of 35 who have tried to conceive unsuccessfully for at least six months. If your journey to parenthood will include IVF cycles you’ll need to find out if IVF is covered by your insurance provider.

Does your health insurance plan cover fertility treatments?

Most health insurance plans consider maternity and newborn care essential benefits, but infertility care usually isn’t. Some plans might cover in vitro fertilization but not the required injections, while other plans might cover both. Some plans might cover a certain number of conventional IVF cycle attempts, while other plans might not cover any aspect of IVF. Fertility treatment evaluates both partners involved, so insured men will want to see if their plan covers semen analysis and male infertility care.

Where should you start when asking about fertility treatment options?

If you are considering fertility treatment options, talk to your Ob/Gyn first. They can run diagnostic tests to determine what problems, if any, are making it difficult for you to conceive. Your Ob/Gyn will be able to offer you the least invasive, and least expensive, methods such as timing intercourse during ovulation and prescribing ovulation-stimulating drugs. The out of pocket costs will be less with a gynecologist than with an infertility specialist.

Minimal stimulation IVF, or mini IVF, is a more cost-effective alternative to conventional IVF provided at PFCLA. This type of IVF has lower costs, reduced risks, and qualifies more good candidates while relying on a reduced amount of fertility drugs to stimulate the number of eggs produced. Because mini IVF uses less medication than traditional IVF, the overall reduced mini IVF cost makes it a more affordable alternative for hopeful parents.

How many cycles of IVF treatment will be covered?

With IVF treatment, it may take more than one cycle to have a successful outcome. You’ll need to check with your health insurance plan about how many treatment attempts are covered. Create a strategy with your doctor about what treatment to undergo, how many cycles are recommended, and if there are any special considerations to increase the likelihood of successful IVF. One such consideration is the number of embryos to implant at once; some insurance providers have policies regarding the number of embryo transfers at a time.

Ask your insurer for coverage.

When in doubt, ask your insurance provider for additional benefits with an Exemption of Benefits. Write a letter about your personal experience with infertility, and include a letter from your doctor and thorough research to present to your insurance company. Show your insurance company that you are a qualified candidate with a high chance of IVF success and that IVF is your only option. Never assume your health insurance coverage is finite. It never hurts to request special consideration for additional benefits.

Purchase non-group insurance if necessary.

If your existing health insurance plan doesn’t cover IVF, purchase a non-group plan than provides IVF benefits. Non-group plans do have high monthly premiums, but they are far less expensive than paying out-of-pocket for treatment.

Health Quote Gurus can help you find affordable individual and family health insurance plans that provide innovative health coverage tailored to your individual needs. You can apply for ACA plans and group health benefits at any time of the year, even when it’s not open enrollment. Find prescription health care coverage, specialist visits, and Medicare supplement insurance plans at the best pricing with Health Quote Gurus.

There are many factors that contribute to the costs of IVF and the coverage that health insurance provides. Before you begin your fertility journey, do your research, and learn what to expect from your health insurance.

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