Finding the means to fund your IVF treatment can add an extra layer of stress, which is the last thing you need when you are already struggling with the challenges of infertility. Highly specialized and sophisticated assisted reproductive technologies (ART) require substantial financial investment, and for many families the burden of paying for this type of treatment can seem out of reach.
Before you decide it’s impossible, make sure that you have explored all of your options. There are many different ways to pay for IVF, and most patients end up using a combination of sources. Here are some avenues to consider.
It’s “common knowledge” in some infertility circles that most clinics don’t take insurance and most insurance plans don’t cover fertility treatments anyway, but in reality this is not universally true. There are plenty of questions to ask about insurance before you assume that coverage is not available.
- Learn your state’s laws. Laws about insurance coverage for fertility treatment vary between states. Of the 15 states which currently offer some legislation around this issue, some have a “mandate to cover” which means that every policy must include some coverage for fertility treatment, while some have a “mandate to offer” which translates to a requirement that insurance companies have a policy among their offerings which includes coverage.
- Speak with your employer. Even if you are in a state with mandate to cover or offer coverage, the accessibility of insurance coverage will depend largely on your employer. In “mandate to offer” states, employers have the choice whether to opt into policies which cover fertility treatments. Self-insured policies are exempt from state law, and may not offer fertility coverage even in a mandate to offer state. Religious employers may also be exempt from offering coverage, while small companies with 10 employees or less are generally exempt from providing any health insurance coverage at all. Talk to your HR department about your insurance choices. If you have an open enrollment period coming up, you may want to switch plans before starting treatment. If they don’t offer a policy which includes coverage, you may want to ask if they would consider adding such an offering.
Talk to your HR department about your insurance choices. If you have an open enrollment period coming up, you may want to switch plans before starting treatment. If they don’t offer a policy which includes coverage, you may want to ask if they would consider adding such an offering.
- Talk to your insurance company. Don’t assume your insurance won’t cover anything, even if you get a “no” the first time. Get a full copy of your policy and go over it carefully. Keep it in front of you when you call your insurance company. Speak to more than one person and keep careful notes of who you talked to and what they said. You may find that even if your policy will not cover IVF or other in-depth fertility treatments, they may pay for more “grey area” items such as testing to determine the probable cause of infertility. Everywhere you can save or be reimbursed for some fertility-related expense allows you to put that money towards another part of your treatment. If your insurance company will pay for fertility treatment, make sure you fully understand the details of what’s covered and what’s not, as well as any caps or limits on the funds available.
Flexible spending accounts, health savings plans, or tax deductions
Make the most of your flexible spending account (FSA) or your health savings plan (HSA) in the months before you begin treatment. These savings plans allow you to use pre-tax dollars for medical expenses, and infertility-related expenses qualify. It is a great way to cut down the total cost of your treatment, but it requires some careful planning.
First, get a clear idea of how much your IVF treatment is going to cost, including testing, procedures, and prescriptions. Then find out how much you can contribute annually, and max out your contributions. If you and your partner both have access to an FSA or HSA, it may make sense for both of you to contribute, as your own account can be used for medical expenses incurred by a spouse or family member. While the maximum contribution to your account may not cover the whole cost of treatment, if you have a high deductible health insurance plan it can make things much easier.
Depending on your income and total medical expenses in a year, medical tax deductions may actually offer a bigger savings than an FSA or HSA. Speaking with a tax professional on this subject could open up further avenues for you to explore.
“Shared risk” or “refund” IVF programs
Some fertility clinics offer programs or packages which include several IVF cycles (often three to six) for one flat fee. Usually this fee is lower than the cost of the same number of cycles paid for individually, with the additional understanding that if you are unsuccessful at the end of these cycles you will receive a partial or total refund of the fee.
At first glance, this option may seem attractive. The fear of disappointment around failed IVF cycles is compounded by the worry that you may run out of funds without getting pregnant, and the prospect of a refund that might allow you to try again is comforting. In reality, not all of these programs are created equal, and there are several important factors to consider.
- Eligibility. Unfortunately, the people most likely to benefit from a shared risk scheme are often least likely to qualify for it, and those who do qualify are least likely to benefit. The necessary qualifications vary between programs, but most have an age cap, and if you have a poor prognosis or previous failed cycles in your medical history, there is a good chance that your application will not be accepted.
In the end, this generally means that the people who do qualify are usually younger patients with few complications who have a good chance of success on their first or second cycle. These patients end up paying more than they would have if they had paid for the cycles individually.
- Coverage. The fee for the package of cycles is unlikely to cover all the associated costs of IVF: prescreening, testing, prescriptions, advanced techniques such as assisted hatching or ICSI, anesthesia for egg retrieval, and sometimes even cycle monitoring can all be charged separately from the IVF cycle fee. These additional costs are generally not included in the refund, so you may end up seriously out of pocket after several cycles, even if you do get a refund.
- Guarantee. How the program defines “success” is very important. In some, a positive pregnancy test is enough, so if you get pregnant in your first cycle and then miscarry, you still pay the whole fee and do not get to use the rest of the cycles in the package. If you are exploring a program like this, make sure that success is defined as a cycle which results in a live birth.
There are “scholarships” and grants out there which can help defray the cost of IVF treatment and/or the cost of fertility medication. These programs tend to be very competitive, and most require application fees, which can add up if you are applying for several potential grants. Some have specific eligibility requirements, such as age limits, regional residency requirements, or specific cultural affiliations. Resolve, the National Infertility Association, has a list of some of the bigger IVF programs, but it is worth doing further research to see what other financial aid opportunities may be open to you.
The cost of fertility medication prescriptions can add a hefty sum to your overall IVF cost (sometimes thousands of dollars), and are not usually included in the price of a cycle. Some pharmaceutical companies and charitable foundations offer programs with significant discounts, like First Steps or Compassionate Care.
If you are seeking fertility treatment as a result of cancer treatment or want to preserve your fertility before undergoing treatment, you may be eligible for assistance from Livestrong and other cancer charities.
Loans are an option for many patients who wish to spread out the cost of their IVF cycles over a more manageable amount of time. Credit cards are not your only option here, and smart research can pay off. Some financial institutions offer medical loans or unsecured personal loans which can be used to pay for fertility treatment, and there are some companies which specialize in this type of lending: some are even non-profits which offer interest free loans in some cases.
Your fertility clinic may offer favorable financing options to its patients, whether you want to cover the cost of an IVF cycle, expensive fertility medications. For those who are looking ahead to the future, some clinics (including SCRC) even offer financing for fertility-preservation procedures such as egg freezing.
As with any aspect of fertility treatment, educating yourself about the many financial options available to you is empowering. Talk to your partner, to a financial planner, to your tax professionals, and to your clinic. Don’t be afraid to ask questions and advocate for what you want.
Some patients look even further afield to find financial help for IVF. Family loans, crowdfunding, and all types of fundraising have been successful avenues for many motivated families. The initial shock of discovering what will be required to start IVF can be discouraging, but paying for treatment is often more achievable than you might think.