Cost of IVF: How do people pay for fertility treatment?
As if struggling with infertility isn’t hard enough. Add the frustration for navigating paying for treatments that may or may not give you the family of your dreams and you’ve got a recipe for frustration and confusion. Continue reading if you want to learn the real cost of IVF, whether your state mandates infertility coverage, and how you can make a strategic plan to move forward.
The World Health Organization (WHO) defines infertility as a disease of the reproductive system, yet many Americans lack insurance coverage for the treatment of this disease.
Whether you are just starting to think you might need to see a fertility doctor for a consult or you have decided on a treatment plan – don’t make assumptions about coverage, ask questions, and make a strategic plan before you start.
Why is IVF so expensive?
IVF is expensive because IVF IS EXPENSIVE. Every piece of the process from the medications, the ultrasounds, the surgical procedures, the technology and equipment needed to care for eggs, sperm, and embryos in the lab are all expensive. It requires experts with years of training, expensive equipment, time, and many resources.
The average cost of IVF across the United States is most commonly quoted as $12,000.00 per cycle but this is not the full story. This number typically includes the stimulation cycle (sometimes called simply the IVF cycle or the fresh cycle) in which the woman takes gonadotropin hormone shots to mature eggs for about 2 weeks (ultrasounds, bloodwork), the egg retrieval procedure, the creation of embryos in the lab, and typically an embryo transfer. This $12,000.00 does not include the cost of medications (average $3,000-5,000.00 or optional treatments like ICSI (intracytoplasmic sperm injection) an active form of fertilizing the egg and sperm or genetic screening of embryos called preimplantation genetic testing for aneuploidy/chromosome imbalance which add thousands of dollars to the cost.
In many IVF stimulation cycles or fresh cycles – more embryos are created than transferred and are frozen for future family building. A typical frozen embryo transfer (FET) cycle cost is drastically lower than the stimulation cycle because the embryo(s) have already been created. There is cost in medications, monitoring of the cycle, the lab work to thaw the embryo, and the embryo transfer procedure but a typical cost for a frozen embryo cycle is approximately $3,000-6,000.00.
Why is IVF not covered by medical insurance?
Most medical coverage in the United States is provided by people’s employer. Each business negotiates coverage and cost with insurance providers and infertility is often excluded from coverage. It’s not considered essential and can be higher cost to include in packages for the employees.
Which states require coverage?
The majority of states do not require businesses to provide insurance benefits to their employees but some do. The states that do require coverage are included in this list from The American Society of Reproductive Medicine. The amount of coverage varies widely between states from a mandate to cover IVF in Massachusetts to states that only require IVF coverage in for fertility preservation for cancer patients. Each state has limitations and restrictions to their requirements like age limitations for women or exclusions for companies with small numbers of employees..
Which companies provide fertility treatment benefits?
There are several companies that offer fertility treatment and adoption benefits. The most buzz about employee fertility benefits recently includes large technology companies like Microsoft, Amazon, Facebook, and Google but other companies like Starbucks and Bank of America. Fertility IQ has a comprehensive list from 2016 for companies with fertility benefits and found that employees with fertility benefits felt grateful, felt more loyal to and stayed longer at the company that helped them build their family.
How do people without coverage pay for IVF? The short answer is that people get creative.
Borrowing from savings, retirement, family.
Crowd funding sites like GoFundMe.
Using credit, including medical loan programs.
What about fertility grants?
There are several non-profit organizations that provide fertility grants for patients that need to pay for treatment out of pocket. The process typically requires submitting financial information, an application, and working with patients’ clinics to coordinate. Unfortunately, not everyone that applies receives a grant, but these programs are can be wonderful:
Babyquest Foundation – A non-profit organization providing grants twice a year and over 100 babies born through this organization to date. I have been on the board of Babyquest since 2015 and witnessed first hand how hard founder, Pamela Hirch, and her team work tirelessly to help recipients meet as much of the cost of the cycle as possible.
The Tinina Q Cade Foundation (Cade Foundation) is a non-profit organization that was started in 2005 to provide information support and financial assistance to help needy infertile families overcome infertility.
Hope for Fertility Grants This group established their National Grant to help couples overcome the financial difficulties that come with infertility treatments. The frequency and amount of grants is based on the availability of funds raised throughout the year. Typically grants are awarded twice a year but may be more or less frequent. Grant amount typically range from $250 to $5,000.A $50 application fee is required, and is considered a donation which may be tax deductible. All application fees help fund the National Grant so we can continue to provide grants.
Parental Hope Grants have a mission to Parental Hope’s mission is to raise infertility awareness and provide emotional and financial support to hopeful couples battling infertility. They have grants for different types of treatment.
Aneden Gives is a non-profit organization that believes fertility treatment should be accessible to all and they are helping one family at a time.
Tips for Paying for Fertility Treatment
Do your research – think through what options are available to you and make the right choice for you moving forward.
Ask questions – your fertility clinic should be your ally in this process and help you think through strategy, ask the right questions of your insurance coverage, and work with you to make it work for you.
Do not make assumptions – patients can make assumptions both ways – they can assume fertility treatment is covered and shocked when it’s not and patietns can assume they do NOT have coverage and miss out on financial help with the process. Talk to your Human Resources department at your company about your coverage AND talk to the financial team at your clinic. Learn, ask a lot of questions and do not make assumptions.
Don’t assume that coverage for fertility evaluation and testing means coverage for treatment
Don’t assume coverage for IVF means all services and options are covered. Sometimes IVF is covered but NOT genetic screening of embryos.
Don’t assume that since your employer has fertility benefits that YOU will be eligible for them. There can be a pre-approval process and limitations to use of benefits like your age, you ovarian reserve test results, and more.
Navigating insurance coverage and payment for services in the midst of building your family can be frustrating. Take it one step at a time and ask for help along the way. My personal opinion is that infertility is a disease and medical insurance should cover treatment for any disease. Until the rest of the world agrees – you can find the right way to move forward with what you need.
Learn more about infertility and miscarriage with more blog posts at drlorashahine.com.
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