If you are looking to get fertility treatments, you are not alone. It’s important to understand your fertility coverage to see what your insurance covers.
More and more people are seeking treatment for infertility to successfully conceive and have the family of their dreams. Of course, fertility treatments don’t come cheap, which means you may have to shell out a lot of money in order to receive them. However, your insurance might cover a portion of some treatments.
What Can You Expect From Fertility Treatment?
Fertility treatment involves a number of steps. You can expect to have bloodwork performed to check your hormonal levels, for starters. From there, you may receive intrauterine insemination or IUI, which involves your partner’s semen being inserted directly into your uterus. If that is not successful at leading to a pregnancy, the next step may be taking fertility drugs either alone or concurrently with in-vitro fertilization (IVF).
While these treatments are extensive, they can also be very expensive. You may only undergo fertility testing in the initial stages to determine the root of your struggles in getting pregnant. However, at this point, you will want to ask the fertility clinic or doctor about your payment options and whether your insurance will pay for any of the treatments.
Understanding Your Fertility Coverage With Insurance
First and foremost, you must read your insurance policy closely and carefully to determine whether you have fertility coverage. While it is definitely tedious and takes some time, it’s worth doing. Be as thorough as possible and make sure you understand the terminology. Go through it with your significant other and use Google to look up any medical terminology you don’t understand. Take notes that simplify things for you as well.
Of course, you can also go a step further to learn whether or not you have fertility coverage. If your insurance is through your employer, speak with someone in your company’s human resources department. You can also call the insurance company directly by dialing the phone number on your insurance card.
What Might Insurance Actually Cover?
Unfortunately, depending on the state in which you reside, you may or may not have fertility coverage. At this time, only 17 states have laws related to fertility insurance coverage. Only seven states have coverage for medically induced infertility. Due to these variations, you may qualify for some treatments through your insurance in spite of some limitations to your coverage.
Interestingly, some insurance policies may cover IVF but not the medications that are required as part of that type of fertility treatment.
In some cases, fertility coverage may include a specific number of IUI or IVF treatments. Some insurance may even cover donor sperm or donor eggs.
On the lower end of the spectrum, in some insurance policies, you may get coverage just for a consultation and testing like bloodwork. Others may offer coverage only for a vaginal ultrasound or a sperm analysis for your significant other.
State Mandates and Fertility Coverage
There has been a rush of state mandates across the country lately. These are making it mandatory for insurance companies to include coverage for at least some aspects of fertility treatments. However, it’s worth noting that some of these have strict requirements, such as the age range for women who are eligible. For example, in New York, women are eligible for some fertility treatments if they are between the ages of 21 and 44. This means women older than 44 may not qualify for the treatments if they need assistance in getting pregnant.
No matter what your insurance, it’s important for you to get in touch with a representative from the company to ask questions. If you are unsure about whether fertility coverage is included and what types of treatments are covered by your policy, this is the best way to know for sure. At the end of the day, knowing ahead of time what your insurance will pay for can be helpful to your wallet as well as your peace of mind.
