When a couple hears the devastating news that they are dealing with the inability to conceive unless there is medical intervention, one of the many thoughts they will have is how to pay for the treatment. Infertility treatment can be as minor as medicated cycles which assist the woman in developing and releasing an ovum, or as complicated as IVF with ICSI. Medicated cycles can be as inexpensive as a couple hundred dollars, plus doctor office visits, and lab work, to the truly expensive IVF cycles with ICSI costing between $12,000 and $17,000 plus medications, and lab work. For most Americans that is a lot of money to spend on a chance to get pregnant. However, if you find yourself faced with the expense of IVF, there are things you can do to afford this expensive medical procedure.
The very first thing you need to do is read your health insurance policy and find out what procedures and medications are covered and to what extent. Sometimes the difference between having a procedure or a test covered or denied is based solely on how it was coded by the doctor's office and nothing more. Talk to your doctor about how things are coded, as well as your insurance company. Some, but not all, insurance companies have patient advocates that you can talk to and find out what is and is not covered. A few phone calls can save you hundreds to thousands of dollars in out-of-pocket expenses if you know what to expect and what is covered before you have a procedure done.
A few states do require some form of infertility coverage, but what is covered varies among these states, and any employer that "self-insures" is exempt from the law. A self-insure health plan is when the employer operates their own insurance plan instead of purchasing it from an insurance company. You can easily find out if your employer's health plan is self-insured by just asking or reading your plans benefits information. To see if your state has mandated infertility coverage, and if it does what must be covered, visit Resolve's State Information on Insurance Coverage at http://www.resolve.org/family-building-options/insurance_coverage/state-coverage.html.
If you find that little or nothing is covered by your insurance, don't panic. There are options out there, and they do not require you to max out your credit cards or get a second mortgage on your house. The first thing you should do is talk to the billing department of the fertility clinic that you have been to, or that your doctor has referred you to and find out what kind of payment options are available through them.
Some fertility clinics offer low cost loans, reasonable payment plans, and some offer what is known as shared risk plans. A shared risk plan requires a couple to commit to a series of IVF procedures, usually 3, for a set price. If the first IVF procedure does not take, the second is performed, and the same with the third. If the last IVF procedure does not result in a pregnancy, the couple gets a portion of their money back. Because the first IVF procedure can be successful, this can be a very expensive procedure, usually costing about $26,000 to $30,000 dollars for three possible procedures. A couple also has to qualify for the shared risk program, and could be disqualified due to age or other factors that they won't know about until extensive medical tests have been performed.
Another option is to budget for the procedure and medications that will be needed. Drastically cut back on all non-necessary spending, and put every last penny into a savings account so that you can walk into the fertility clinic, cash in hand, and not have to worry about your credit rating, interest rates, or the possibility of a shared risk being too successful. Budgeting may seem like a crazy idea, but if you were to track your spending for just a week, you could probably find ways to save at least $50, and possibly a lot more. Yes, it would take a while to save up the money needed to pay cash for the treatments, but in the long run, you won't have the burden of a successful procedure as well as the medical bills of giving birth and caring for a baby piling up either. There are options out there, and you need to do your homework and find out what is available to you either through your health insurance, fertility clinic, medication assistance through drug companies, or just by saving every penny.
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