Does most insurance plans at jobs cover IVF?
My sister in law doesn't seem to be able to get pregnant. She wants to know if her husband gets insurance at work do they pay for IVF. She doesn't want to go to the doctor and try anything else she wants to get pregnant right away.
She is 24 been trying for 5 years
- Tina has TwinsLv 79 years agoBest Answer
Where do they live? - it is more about where you live and what your state mandates. MOST insurance companies do not cover anything related to fertility. Currently ONLY 15 states in the US mandate some sort of fertility coverage and not all cover IVF. For example, I live in Massachusetts and our treatments including IVF were covered 100% with just our co-pays through BC/BS Massachusetts but BC/BS in Florida covers nothing.
You also need to consider that insurance companies that do cover it require that you meet the criteria. We had to go through all the testing and when our diagnosis was unexplained infertility, we had to try IUI a minimum of 6 times before our plan would cover IVF. It is not as simple as "hey, we've been trying without success, give me IVF so I can get pregnant right away" - it has to be the right course of treatment. Even with IVF, there are no guarantees of success.
I recommend that she contact Fertility Life lines - they have a free hotline that you can call and have someone help you to better understand your current coverage and to do an analysis for you. Perhaps you can get your prescriptions covered or something like that with your current coverage. They were great - gave them my policy info and they researched it, got me all of the info on what was and was not covered and explained it to me. They also have information on prescription programs and shared risk programs.
If they cannot find insurance coverage here are some other suggestions:
1) Start with the RE - most doctors have a team that can help you with finding ways to pay for your treatment - they are amazing at figuring out your insurance benefits, coming up payment plans and may even be able to recommend medical studies / clinical trials that you may be able to participate in.
2) Grants -there are groups out there that fund raise for fertility treatments - you need to apply and cross your fingers.
3) Loans - banks and credit card companies (my friend used Capital One) offer fertility loans with fair interest rates and payment plans. Maybe see if you can borrow from a family member.
4) Serious budgeting - I also know couples who have taken part time / seasonal jobs to save up for treatments, sold things on ebay etc . . .
5) See if your employer as a flex spending account - you can set aside money tax free for medical things - everything from IVF to prescriptions to eye glasses etc . . .
Here is a great link:
Good Luck & best wishes.
PS - do NOT respond to anyone who says "I recall my plan covers it" and go to this random website for a quote . . . it is a scam, identity theft.
ETA - To Doodlestuff - unfortunately there is still a lot of ignorance in this world. Infertility is a medical condition and should be treated as such. Studies have also shown that including fertility coverage does NOT increase rates (unless your employer or your insurance company is ripping you off). Including coverage helps people make better decisions - such as transferring one or two embryos as opposed to shoving a litter into the uterus. It decreases costs associated with high-order multiples, NICU care & long term care for a child with disabilities associated with extreme prematurity and other issues seen with high order multiples. Better to invest the $15,000 on IVF than the millions a sick child could cost long term.Source(s): Mom to IVF twins
- CarbonDatedLv 79 years ago
He would have to check with HR and get a copy of the plan. Many companies will not include IVF because it raises the rates for all their employees. I agree. I agree that testing to determine a cause of fertility should be and often is covered, but IVF is your own cost.
I think your SIL also is unrealistic. What makes her think that IVF will solve all her problems? Doctors have to determine WHAT is wrong before they can fix it and IVF is not appropriate treatment for many.
If she's been trying for 5 years, she should have plenty of money saved up for the procedure. She's had 5 years to do so.
- 5 years ago
Now everyone can cure infertility using this natural remedy http://pregnancyhelps.info
infertility can run in the family and one of the first things the doctor asks you when you go to a fertility clinic is your family history regarding cases of infertility or other reproductive issues.
If infertility is caused by genetic disorder then it's not unusual that one of the kids (your mom) doesn't have it and another does (your aunt).
two months of trying is still to early to be concerned about the fact that you might be infertile and it's also quite early to go to a fertility specialist. Go to a regular Obgyb to get a closer insight and see what ways there are are to improve your fertility rate.
Also remove alcohol, caffeine and cigarettes from your life because they might influence your chances too. Stress is also a risk factor when it comes to infertility.
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- ?Who Am I?Lv 49 years ago
From what I've heard- no. I've had a few friends have difficulty conceiving and their insurance (decent insurance through very good jobs) does not cover any fertility treatments. My S-I-L spent over $15,000 on fertility treatments (Clomid, hormones injectiosn, IUIs) - nothing worked... and when she asked about IVF they quoted another $20,000! She is now using that money to adopt :)
HOw old is your SIL? Does she have any issues that might be preventing her from getting pg?Source(s): almd
- 9 years ago
It depends on he company and also what state you live in. There are 15 states that require different amounts of coverage. Here is a link to find out if your state requires it. Her husband should be able to request a booklet about the insurance and what it covers and doesn't cover before he signs up for it.
- 9 years ago
Idk about now but i knw before they didnt accept insurance u have to pay outta pocket so i know someone thats doing that now and they still dont take insurance u have to pay and they only charge for the treatment u need so she has to do consultation fiirst and than she will find out good luckSource(s): Me and my hubby thinking about doing ivf also i hope it works for the both of us
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