Is Infertility a Rich Man's Disease to Treat?
October 10, 2012
© Sarah Preston Gorenstein
I get a lot of personal emails from readers, about everything from miscarriage to IVF, and by far the most common theme among them is what a big role the cost of fertility treatments plays in their decision to seek more advanced fertility care. Namely, IVF is a very costly procedure, yet it yields the highest success rates in infertility patients. Depending on your company’s insurance plan, or your own health insurance, your policy may not cover in vitro fertilization or multiple embryo transfers, or your coverage can be very minimal.
Through my last company’s health insurance policy, I was covered for up to four IVF procedures, with a 30 percent co-pay on everything, including the drugs. My first shipment of medications cost me $1500 out of my pocket, even with the coverage I had—I had sticker shock (it was the first of several shipments). I was grateful I had the coverage I did—at my clinic, IVF costs $11k out of pocket. I had one IVF, a canceled frozen embryo transfer, and two unsuccessful FETs while I worked at Playboy—if I didn’t have any coverage, that would’ve amounted to about $30,000.
When my company relocated its headquarters to Los Angeles earlier this year, our fertility coverage changed without my knowledge: I was still insured through them when I was about to undergo my second FET, and found out two days before I only had a $2k allowance for fertility coverage (FETs cost $3050, which includes the pre- and post-transfer appointments but not the drugs). Since I was already in the middle of this cycle when the policy changed, I contested it—thankfully, in the end, my company did cover the cycle based on our previous plan.
I changed companies a few months after that, so my fertility coverage changed again: Now I only have one IVF or FET, covered fully, over a lifetime. One. My health benefits are great otherwise (I’m covered for unlimited IUIs), but many companies don’t want to pay for fertility treatments because they’re expensive, or perhaps they don’t see infertility as a disease to treat, who knows.
It can be worth talking to your HR department about changing these policies. I recently learned that Illinois law requires that companies of 25 employees or more cover four IVF or FET cycles, over a lifetime, per the Illinois Department of Insurance: “Coverage for such treatments is limited to four completed oocyte retrievals per lifetime of the individual, except that two completed oocyte retrievals are covered after a live birth is achieved as a result of an artificial reproductive transfer of oocytes.”
Cost being such a prohibitive factor in couples' decisions to seek more fertility help saddens me: I know too many people who’ve spent their life savings trying to have a baby. I’ve worried about this happening to us—I didn’t exactly plan on spending my savings this way, but I’d do whatever it takes. This is why people have started crowdfunding to help them pay for fertility treatments, which stirred a heated debate among readers when I wrote about it in May. Then there’s the cost of elective procedures like PGD (pre-implantation genetic diagnosis), which insurance does not pay for, and can run between $5k-$7k. I think it's the future of IVF, and will become a mandatory part of the process, but few people will be able to afford it on top of all the other costs.
Has the cost of IVF, surrogacy, or other alternative methods, and/or your insurance limitations on fertility coverage, impacted your decision to keep trying to have a baby? Sometimes I think infertility is a rich man’s disease to treat, but unfortunately it doesn't discriminate between household incomes.