Where to Turn if Your Insurance Doesn’t Cover Fertility Treatments

We grow up with the misconception that getting pregnant is easy; and for some it is. But for 25 percent of us, myself included, that simple path to a family we think about so often as kids, is not the reality. And we end up needing fertility treatments. Fertility treatments that cost thousands of dollars. Fertility treatments that aren’t always covered by insurance. 

To date, less than half of all US states have a mandate to provide fertility insurance benefits, Even when the coverage is available, it often excludes specific needs or has stipulations that not all patients will meet, or it runs out very quickly, still causing the massive stress of figuring out the finances of fertility treatment.

Resentment runs deep, and so do our pockets when pursuing Assisted Reproductive Technology (ART). And fertility treatment benefits are not something most of us think about when looking into insurance options offered by employers; it’s not something I thought about. 

Looking to budget for fertility treatments or another major expense? Look no further than our 8-week Money Makeover program, FinanceFixx. Learn more here, and join our community of financially empowered women today! 

So where do we turn when we’re running low on financing options? Here are some ideas.

Insurance Coverage for Diagnostic Procedures: Even if your medical insurance doesn’t cover more in-depth fertility treatment, diagnostic procedures are often covered. Examples include: Ovarian Reserve Assessment, Hysterosalpingogram, and Hysteroscopy. You sometimes have to confirm with your clinic that they are coding the bills to insurance as such (diagnostic).

IVF Grants & No-Interest Loans: There are a multitude of charitable grants and scholarships out there, as well as no-interest loans. Including:

• Worth The Wait Charity – Fertility & Adoption Grants for Cancer Survivors
• Fertility IQ – Gives grants at random a few times a year simply for reviewing your doctor or clinic
• Cade Foundation – Grants a few times per year for infertility or adoption
• JFLA – Los Angeles-based patients can seek an interest-free loan through the Feit Family program at JFLA

Medication Price Savings: Medication prices vary from pharmacy to pharmacy. You are not required to use the pharmacy your clinic recommends if you can find a less expensive option. Insider scoop: RescriptedRX is a platform that finds the cheapes fertility meds available and delivers them to your doorstep (when available!).

Flexible Spending Account (FSA): You can use your FSA dollars for some fertility treatments, including egg and embryo storage, but only if the storage is “temporary” and “for immediate use.”  (In other words, you cannot use your FSA dollars for egg and embryo storage that may last for years, for “potential future use.”) Note that a Letter of Medical Necessity (LMN) will also be required to redeem this benefit, and you can also use HSA dollars for this type of expense.

Medical Tax Deduction: The cost of most fertility treatments and medications qualifies as a medical expense under section 118.2 of the Income Tax Act. This means that costs relating to your fertility treatment may be claimed as a medical expense credit on your income tax return.

Open Enrollment or Additional Part-Time Job: If your employer doesn’t cover fertility treatments, you can look into getting secondary insurance during the open enrollment period. Open enrollment usually opens in November and goes through the end of the year. Additionally, if your employer doesn’t cover fertility treatments, you can look into other companies that do. Many of them only require you to work part-time for eligibility and getting a second, part-time job specifically for fertility treatment coverage is a trend we are starting to see. 

Egg/Sperm/Embryo Storage: If not offered, ask your clinic if you can pay your storage fees monthly, instead of annually. That way, as soon as you use (or discard or donate) what you have stored, you can discontinue payment. If the clinic requires annual payment, ask if you can be reimbursed on a prorated basis once you have used (or discarded or donated) what you have stored.

And perhaps the single most important financial tip: ASK

It is important to ask your clinic how you can save money and/or whether you can establish more manageable payment plans. Some examples:

• Do you offer any scholarships, payment plans, or packages? (many do!!!!)
• Can I choose to pay per visit or to pay monthly or even quarterly?
• If your clinic is asking for a certain amount of money upfront, try and negotiate. 

Have your own creative idea for an alternate payment plan? ASK. 

Asking for insurance coverage from an employer can also be helpful. Believe it or not, some employers simply don’t recognize how expensive treatment is, or that their plans aren’t covering it. You can learn how to discuss this with your employer via resolve.org resources. Self-advocacy in all realms of fertility treatment is key. 

Lastly, while this may be an unpopular opinion – especially from those wanting you to save, save, save money – my personal experience, theory, and what I always tell my clients: money is renewable, embryos are not. Taking out a no/low-interest credit card to pursue what you need now ideally ensures no regrets down the road. Fertility treatment is a miracle, and building your family is too. I took out loans and did everything I could to cover the multiple rounds of treatment. It was not easy, and we are still paying it off but it’s something I will never regret.

READ MORE:

• Making Your Work Schedule Work With A New Baby
• Why the Cost of Surrogacy is So Expensive for LGBTQ+ Couples
• How Much Does It Cost To Raise A Child? How Parenthood Changes Your Finances

SUBSCRIBE: For your regular dose of money tips, advice, opinions and more, subscribe to HerMoney today!