Why Should Insurance Cover Infertility Treatment?!?

Dawn Davenport


Why Should Insurance Cover Infertility Treatment?!?

Why Should Insurance Cover Infertility Treatment?!?

Infertility treatment is expensive—very very expensive. Especially once you move into assisted reproduction and in vitro fertilization. It feels all the more expensive to those suffering from this disease because few insurance companies in the US cover the cost. Many of us in the infertility advocacy world have argued that we need all insurance companies to cover fertility treatment, but it feels like we are shouting in the dark. And really, if you think about it, insurance is ultimately a method of cost sharing and why should the majority help defray the cost for the minority–albeit not a small minority at one in eight US couples? Beyond basic human decency and the fairness of not discriminating against one specific disease, the reason insurance should cover infertility treatment is that it makes hard economic sense—it saves money!

You know me—nothing excites me more than the words “research” or “study”. So my geeky heart started to race when I saw this study out of Canada on the significant cost savings resulting from insurance coverage of fertility treatment. The study was focused on public funding/insurance in one Canadian province, but the basic findings are applicable to the private insurance system in the US as well.

The study was funded by Generations of Hope (GOH): The Fertility Assistance Fund with the purpose of determining to what extent the cost of public funding of IVF could be offset by a savings in medical and social costs as a result of a reduced rate of multiple births. They found that insurance coverage (in the form of public financed insurance) for in-vitro fertilization (IVF) treatments would improve health outcomes and save the health care system millions.

Specifically, the researchers found that over the first five years insurance coverage for IVF would result in:

  • An overall 60% reduction in the rate of multiple births through IVF
  • 44% fewer twins and 90% fewer triplets 585 fewer premature babies born
  • A reduction in prenatal, delivery and neonatal costs of about $29 million
  • A reduction in long term disability costs of approximately $156 million
  • A net savings to the healthcare system of $78 million

I find this research fascinating. For the record, I think the infertility medical community in the US needs to do more to reduce the twin rate with IVF, but even with a higher than ideal twin rate for IVF, it is still better than the alternative of medicated artificial insemination.

We all need to push for each US state to mandate that insurance companies that sell insurance in that state include coverage for infertility treatment, including a specific number of cycles of IVF. And even easier, and perhaps more effective, each and every one of us who is lucky enough to be on a group insurance plan through our work should ask our employers to add fertility treatment to their group plan. For more information on this issue, listen to this great Creating a Family show where we talked about this issue and go to the Resolve Advocacy page for more on what you can do.

Image credit: Aiden Blizzard

24/05/2012 | by Dawn Davenport | Categories: Blog, Infertility, Infertility Blog | 8 Comments

8 Responses to Why Should Insurance Cover Infertility Treatment?!?

  1. Avatar Laura says:

    Infertility treatments should NOT be covered by insurance. It is not a medical necessity. It should be looked at like cosmetic surgery, Gender reassignment should NOT be covered either. It may not be fair that your body does not work in the way necessary to conceive but life is not fair in general.My 29 year old died of a rare cancer- NOT FAIR. My 13 year old has a deadly peanut allergy- NOT FAIR. I suppose what my girls live with and died from is God’s will for some reason. just like infertility is God’s will for some reason.

    • Avatar Hannah says:

      Didn’t you just say life wasn’t fair? So you deal with it. It’s not more fair that we can’t conceive naturally than it is that you’re children that you were naturally able to bare have issues..

  2. Avatar Mina says:

    I struggled with inttierlify for three years before doing IVF and having a baby boy, who is now three. There is no one way to cope. I found talking about it very helpful, but you have to talk to people who went through it. I did not want to hear that I should go on vacation and relax, I did not want to hear about adoption, I wanted to hear that someone understood how unfair it was and that it was an unbearable feeling of having no control over something in your life. You have to stay positive and tell yourself with all the technology today that you will have a baby, maybe not so quickly ( wanted one yesterday) but you will be a mom. I stayed away from events with babies and children only because it was hurtful for me because I thought I may never have the same. Just be patient and keep positve, I hear there are some excellent books out there written by women who went through this too and they are helpful. I am thinking of getting them myself, because no one can understand it unless they’ve experienced it, and sometimes its nice to know you’re not the only one(although you wouldn’t wish it on anyone.) There is also a website I used everyday, http://www.tryingtoconceive.com, it was comforting to read others experiences. Good luck, and remember that you will be a mom. Also, I fould that no one understood the huge financial part of it, it would depress me so much that I had to pay so much for it when others just got to have sex. It is so much money, we are just about ready for number two and we have been saving for three years. It is a huge expense, that is very stressful, I hope knowing that I understand helps you cope a little better.

  3. Avatar Annissa says:

    Great post …

    Happy ICLW from #3

  4. Avatar Robyn says:

    So, I’m curious: Does infertility count as a pre-existing condition? Could insurance companies refuse to insure infertile individuals? (At least until 2014, when, theoretically, they have to insure everyone.) When I’ve applied for health insurance (which I can’t get due to a pre-existing condition), I don’t recall seeing anything on the apps about infertility, just pregnancy.

    BTW, did you know that adoption is a pre-existing condition? If you’re adopting, you “count” as an expectant parent and can be denied health insurance. My husband was denied for this reason.

    Personally, I think every person in the US should have health insurance, and that health insurance should cover pretty much everything. But then, I guess I’m a socialist.

    • Avatar Dawn says:

      Robyn, I wish I were more knowledgeable about insurance. I find it all so depressing and impenetrable. We are in the process of trying to find an expert on insurance as it applies to infertility for an upcoming Creating a Family show.

  5. Avatar AlleyRose says:

    That would be wonderful! I’m Canadian, but I’m a full on advocate for fertility treatments to be covered everywhere. Not only does it make financial sense, but just imagine how many families can finally afford to grow.
    Excited to do some site browsing – you’ve got a ton of info here!
    ICLW #26

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