IVF Insurance – IVF Insurance Coverage Options
Currently there are 15 states which have “INFERTILITY INSURANCE MANDATE”. Compelling insurance providers to cover the cost of infertility including diagnosis and treatment. These states are:
Arkansas | California | Connecticut | Hawaii | Illinois | Louisiana | Maryland | Massachusetts
Montana | New Jersey | New York | Ohio | Rhode Island | Texas | West Virginia
The map below gives state specific information on laws pertaining to IVF Insurance it only has the information of the states mentioned above giving information on their state website regarding ivf insurance. Out of the 15 mentioned above, 13 states have made it mandatory for the health insurance companies to cover IVF treatment. Louisiana and New York are the only states where the coverage may be excluded for ivf treatment unless the medical condition otherwise covered results in the diagnosis of infertility. Each state might have it’s own definition for infertility under the law and self-insured individuals, certain HMO’s and religious employer’s might be exempted from covering infertility cost and treatment.
15 States Where Infertility Coverage Is Mandated For Group Coverage
There are three types of expenses associated with IVF cost. These are:
- Doctor consultation fees and testing expenses (In the range of $1,500 to$4,500 Your health insurance plan might cover this)
- Pre and post procedure medication expenses (Fresh cycle may cost around $12,000 and embryo cycle around $3,500, and
- Treatment procedure expenses.
What Is Actually Covered When It Comes To IVF Insurance
A lot of couples come across this dilemma of what does infertility insurance coverage actually cover. We hear the doctor saying this or you might have read somewhere “Coverage is provided for the diagnosis and treatment related to infertility”. But if we have to explain this in simple terms then it would be something life this:
- Fertility Drugs
- All treatment related to IVF
- Blood sample tests
- Radiology tests.
It is important to note than infertility coverage might not be providing cover for male reproductive systems.
IVF Refund Programs
There are numerous fertility medical centers offering IVF refund programs for patients to save money on the treatment of infertility. As an example, let’s consider IVF refund programs provided by Attain Fertility
The IVF refund program provided by attain covers up to six tried. Three fresh and three frozen. You have to meet the clinical acceptance criteria to be eligible for this program and would cost you around $24,000 for all six cycles. You can refer their website for further details.
Supplemental Maternity Insurance For Infertility Coverage
Including No Waiting Period
If you live in one of the states where there is no law regarding infertility insurance benefits then you don’t have to be disappointed. You can choose supplemental maternity insurancewhich is available in all 50 states.
Supplemental maternity insurance when purchased before conceiving a child can help you to some extent in covering infertility treatment cost. It would pay for normal delivery, pre and post natal care (NICU). Even if you are fortunate enough to live in state where you have ivf insurance mandated, it would still be a wise decision to consider supplemental maternity coverage to offset the cost.
Health Care Reform And IVF Insurance
New healthcare reform law which comes into effect in 2014 will be a great help to infertility patients. Starting in 2014, no health insurance provider can exclude or deny you coverage for any pre existing medical condition. Infertility coverage will become a part of essential health benefits. This means that, no insurer can deny you coverage due to infertility condition. Co-payments which are related to reproductive health services will also be eliminated effective 2014, which include:
- Immunization check ups
- HIV tests, and
- Routine well check up visits to your primary care physicians.
One major healthcare reform change which will make ivf insurance expensive is the FSA (Flexible Savings Account) limits being capped at $2,500. Earlier individual employers had the liberty of setting this limit as per their terms. Which was generally $5,000. This amount was deducted from your paycheck on pre tax basis to help you cover for medical expenses. As per the new limits, you will be financially constraint and might have to shell out more money from your own pocket.