One of the most pressing concerns for anyone exploring fertility treatment is the cost and whether insurance can ease the financial burden. This leads to the central question: Can I purchase infertility insurance? The straightforward answer is: No, you cannot purchase infertility insurance as a separate, standalone product in the United States. Instead, coverage for fertility treatment is always included, if at all, as part of a larger, comprehensive health insurance plan.
It is essential to recognize that the Affordable Care Act (ACA) does not require all insurance providers to cover infertility treatments. Instead, coverage relies on where you live. Several states have passed laws requiring insurers to cover specific infertility treatments, such as in vitro fertilization (IVF). For example, Arkansas and Hawaii currently have such mandates.
Average cost of IVF
For many women exploring their options, the price tag on IVF is the single biggest roadblock. In the United States, the average cost for a single IVF cycle can range from $20,000 to $25,000, and sometimes even more. This massive number typically includes the base procedures and necessary monitoring. Still, as Carrot Fertility points out, this often excludes essential costs like medications, which can add another $3,000 to $7,000 per cycle.
Since most people require two to three cycles to achieve a successful live birth, the total out-of-pocket cost can easily reach $50,000 or higher. This financial burden is a huge contributor to the persistent disparities in fertility care access for Black families. While it’s a huge lift, knowing the actual cost is the first step toward finding grants and financing options designed to help.
With insurance
As a Stanford Health Policy study reveals, dealing with infertility can be devastating. Anne Kamwila, a healthcare policy analyst at the African Health Economics & Policy Association, explains, “IVF, an assisted reproductive technique, can help you, your partner, or a surrogate get pregnant.” This is a procedure in which eggs and sperm are combined in a laboratory to create an embryo. Of course, the cost of treating infertility can be a burden and overwhelming for a couple who wants to get pregnant.
Generally, IVF is costly. This can push many women out of reach of fertility treatment options, especially those with limited financial resources. IVF includes procedures, imaging and medications, and a single cycle can cost, on average, about $12,400, per Forbes. The cost ultimately depends on the center and your individual medication needs. If you happen to go through more than one IVF cycle, you can expect to be met with an even higher treatment expense.
Without insurance
Insurance typically plays a crucial role in helping to reduce the burden and cost of treatment for individuals who may not be financially stable. Without insurance coverage, a full IVF cycle can cost you anywhere between $15,000 and $20,000, the Mayo Clinic notes.
The cost typically includes:
- Facility fee: This covers clinic charges for the work of healthcare experts and laboratory services.
- Lab work and imaging: This includes check-ups and monitoring at the clinic during the ovarian stimulation phase, when hormone medications help your ovaries produce eggs.
- Anesthesia: While retrieving eggs from your ovaries can be painful, this procedure helps to reduce pain.
- Egg retrieval: Where mature eggs are carefully collected from the ovaries.
- Embryo creation: Where the collected eggs are fertilized with sperm in a lab setting to develop embryos.
- Embryo transfer: Where one or more viable embryos are placed directly into the uterus for potential implantation and pregnancy.
The overall cost will likely be higher when medication is included, as well as other optional procedures, such as genetic testing.
Factors that affect the cost of IVF
In most cases, the cost of IVF treatment refers only to the charges levied by the fertility center. Other expenses will arise from prescription fertility medications and genetic testing for embryos. The following factors affect the cost of IVF:
- Medications: Fertility medication can cost about $2,000 to $7,000 or more for every cycle. But what you pay mostly depends on the prescribed drugs, which are influenced by treatment duration and specialty pharmacy.
- Clinic location: In the U.S, costs vary by state and region. Costs can be higher in urban areas, such as New York or Los Angeles.
- Number of cycles: If you have more than one IVF cycle, expect the costs to shoot up. The good news is that some clinics offer discounts when you commit to multiple cycles upfront.
- Testing: IVF can sometimes include genetic testing of the embryos before they are implanted, as explained by the UCSF Center for Reproductive Health.
Infertility insurance coverage details
You cannot buy a separate infertility insurance policy directly. However, many employer-provided and some individual health plans include fertility coverage, particularly in certain states. States with mandated fertility coverage include:
- Arkansas
- California
- Connecticut
- Delaware
- New York
- Ohio
It’s essential to note that while some states mandate fertility insurance coverage, the coverage typically varies. Some plans may only cover diagnostic testing, while others cover multiple IVF cycles. To verify your coverage, ensure you:
- Review your coverage plan’s summary of benefits.
- Contact your insurance company.
- Ask for coverage concerning IVF, medications and genetic testing.
How to save money
If you are uninsured or underinsured, there are smart ways you can apply to save extra costs. These include:
- Applying for IVF grants. Some nonprofit organizations, such as Resolve.org, offer financial assistance to individuals who are unable to meet the treatment costs. This enables individuals from low-income families to access quality treatment.
- Facility financing companies like CapexMD can offer flexible payment plans.
- Programs like ReUnite RX offer medication discounts. This helps to reduce the cost of prescriptions.
Which insurance is best for fertility?
When it comes to the best fertility insurance in the U.S., there is no single best option. Coverage varies based on several factors, including location and plan. However, there are some insurers with years of reputation that have been deemed to offer the best fertility insurance across the country. To name a few, they include:
- Aetna: Offers IVF infertility services.
- Cigna: Includes IUI and IVF comprehensive fertility treatment.
- Progyny: A fertility benefits company that provides generous coverage through employers like Google and Amazon.
What is the cheapest way to do IVF?
There are several cost-saving options for IVF coverage. You can choose a budget-friendly clinic with the most affordable options that cover standard procedures, such as anesthesia. This helps significantly reduce the cost of treatment. Since the cost of stimulation medications can be high, you can import fertility medication to reduce the cost. However, it’s essential to conduct thorough research on safety and logistics promptly, and also consult your healthcare provider for informed guidance.
You can look for financial assistance, like grants and scholarships, from organizations like Resolve.org to help reduce your financial burden. Contact your company to determine if it offers any employer benefits for fertility care, including IVF coverage.
Bottom line
While you cannot buy infertility insurance as a standalone product in the U.S, many health insurance plans do offer partial or full coverage, especially if you live in a mandate state or work for an employer offering fertility benefits. To get the best financial assistance, check your current health insurance benefits, apply for grants and discount programs and compare clinics and financing options. Obtaining coverage may require effort, but the savings are often well worth it.
Frequently Asked Questions
Who is not eligible for IVF?
Eligibility for IVF varies, but factors like advanced age and severe health conditions can be common disqualifying factors. Always consult your fertility specialist to evaluate your specific situation.
Can you choose gender with IVF?
Yes, in some locations you can choose your baby’s gender through preimplantation genetic testing for aneuploidy (PGT-A), which identifies the sex chromosome of embryos.
Citations
Duff-Brown B. Striking Costs of Infertility Point to Importance of IVF Access and. Stanford.edu. Published July 11, 2024. https://healthpolicy.fsi.stanford.edu/news/striking-costs-infertility-point-importance-ivf-access-and-affordability
Conrad M. How Much Does IVF Cost? Forbes. https://www.forbes.com/health/womens-health/how-much-does-ivf-cost/. Published August 14, 2023.
Mayo Clinic. MiST IVF offers less expensive, easier treatment for motivated parents – Mayo Clinic. www.mayoclinic.org. Published 2021. https://www.mayoclinic.org/medical-professionals/obstetrics-gynecology/news/mist-ivf-offers-less-expensive-easier-treatment-for-motivated-parents/mac-20525097
UCSF Center for Reproductive Health. Genetic Testing (PGT & PGS) | UCSF Center for Reproductive Health. UCSF. Published 2024. https://crh.ucsf.edu/fertility-treatment/preimplantation-genetic-testing-pgt