IVF Rates - Will My Insurance Pay?

Let's face it, no one likes to read all the health insurance company's fine print to try to decipher just what is and is not covered, but with IVF rates as high as they are, couples who are struggling with infertility should definitely see exactly what their insurance covers before proceeding with any treatment plans. While it's impossible to say without looking at your actual insurance policy, there are a few things that you should know in general about insurance and paying for IVF.

Maybe, Maybe Not
First off, some insurance plans will cover some infertility treatments but not others. There may be a section on your health insurance policy that talks about whether or not you are covered for certain infertility treatments, but if you can't find it, you can either call your insurance company or your employer's human resources department, which will be able to walk you through the ins and outs of your policy. If your insurance will cover some infertility treatments or at least diagnostic appointments, you should definitely take advantage of that before jumping right in to IVF.

State Laws for IVF Insurance
Some states have laws in place requiring employers of a certain size - usually they have to have more than fifty employees - to offer insurance plans that cover at least some infertility treatments; even if you live in one of these states, though, you may not be covered for actual IVF treatments. The states with laws like these are Arkansas, California, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia. Some couples actually move, especially if they live close to the state and can find jobs there, in order to get infertility coverage before trying treatments.

The requirements in these states can vary greatly. In Arkansas, for instance, the couple must be infertile for two years before using the infertility coverage, and the benefits - copayment, limit, and deductible - for IVF are the same as those for other maternity coverage; insurers can limit coverage to a maximum of $15,000, which covers, on average, one cycle of IVF. In Illinois, on the other hand, couples only have to be infertile for a year, and the law requires insurance to cover IVF and more complex treatments like ZIFT and GIFT.

If you don't live in one of these states, though, don't give up hope. Some employers offer insurance plans with infertility benefits even if they aren't required to. The main thing is that you have to check with your provider. Before you get any treatments done, be sure you know the requirements such as how long you have to be infertile to use your insurance for infertility treatments, what types of clinics you can go to, and what types of treatments you can have. Also, ask about the lifetime limit for infertility treatment, since this can also vary greatly from one plan to the next. Knowing this information about your insurance beforehand can help you team up with the infertility clinic's financial department to determine the course of treatment that is most likely to get you a baby without breaking the bank.