Paying for infertility treatments

[BabyHopes1974]

I live in the United States and when I called to set up a preconception counseling session, the woman who scheduled the appt. said many insurance companies won't pay for inferility treatments. So, I don't know if that means I can't even get tests done or what. I am wondering if there is anyone who knows about what insurance pays for or doesn't.

I don't know if there is anything wrong with me or not. I am 38 and TTC for 6 months. I made the appt. to see what they say.

 

[donna noble]

Only your insurance co can tell you exactly what is covered. Can you possibly have your dr. refer you? Sometimes that helps. Isn't it wonderful here in the US you can get free contraceptives on any streetcorner but god forbid you want help having a baby...Otherwise you can pay out of pocket for a fertility clinic. Some can set up a sort of loan for you as well.

 

[BabyHopes1974]

I called my insurance today and was told that they do not pay for any kind of inferitlity treatment at all. this is terrible. If there is something wrong with me I might never know because I can't afford treatment or diagnosis even.

 

[donna noble]

That stinks! This is what is wrong with women's healthcare in this country. i don't know why those male politicians don't understand women's reporductive health involves more than contraceptives! grr. The one thing i would suggest is trying the ovacue. it is pricey, but in the long run cheaper than opks or the clear blue monitor which I think you have to buy sticks for? It will give you some basic insights into your hormone balance, cycle length and whether you are ovulating. I bought it for that more than anything since at my age I am scared my body will not work right anymore. I had insurance through the state when i was pregnant but here in Wi they take you off that and offer you free contraceptives and std testing when you lose a baby. Nice huh? I hope you will be able to figure somethig out. It is a horrible feeling to think you can't get pg or something may be wrong with your cycles.

 

[vermeil]

Well here in Canada all of the fertility related testing falls under general healthcare and so is 100% covered. Plus here in Quebec fertility treatments are also free - you can have up to 3 IVF attempts. Though drugs aren`t covered. Just started my first cycle and the drugs are 800$ - and that`s AFTER 80% is covered by my work insurance

I actually had the various tests done in a private clinic because I have such good insurance. It 'only' cost a total of 1000$ for both of us, which they paid back 100%. Of course I had all of the bloodwork done in the public sector, just the regular hospital, which is free. Else all of those might have added up.

Why is IVF covered here? In an attempt to control neonatal costs, which are expensive, the government passed a law limiting how many embryos you can have implanted during IVF. This is to reduce the number of multiple births, which often lead to costly nicu (neonatal intensive care) stays after birth. But it was decided it would be unfair to have a couple spend thousands of dollays for a try at IVF, to have their chances reduced by having only one embryo. Hence why those are also covered now. The idea is that longterm the government will save costs by reducing nicu stays. My own son was 105 days in the nicu so I know how complex it can be! Had I been in the states without insurance I would have had to sell my house to cover his care. Without starting a political debate... hurray for socialized healthcare.

 

[Rashaa]

Vermeil, while I agree it's great that Quebec offers IVF - it is not all-inclusive..if you are older than 42 - FORGET it! if you want to use your own eggs..unfortunately.

It is great for those who are 'younger' but really offers nothing to older patients who have been battling infertility and were not 'informed' until it was too late to be included in that IVF process .

 

[CaliDreaming]

You might want to check on your coverages again. While it is true that most U.S. insurance companies don't cover infertility, I am pretty sure that most do cover the diagnosis of it and they have to pay for the treatment of an underlying condition regardless. Infertility is a symptom of many covered conditions so just because they won't pay for stuff like clomid/iui/ivf doesn't mean that your insurance company is totally off the hook. For instance, if you have reason to suspect that you have a thyroid disorder, endometriotis, or fibroids, then your insurance company will have to pony up the cash even if your primary concern is your infertility. So there are ways of working around it to some extent.

 

[SabrinaKat]

babyhopes -- there are some tests that your GP/HMO must cover, e.g. iron, thyroid, etc., (am a transplanted american living abroad), so some preliminary stuff can be checked as part of well-woman stuff and therefore covered by insurance. I'd get the list of basic stuff from an IVF clinic as much of the pre-IVF stuff is blood tests, etc. In our case, my doctor (although am in Ireland) was able to do some stuff cheaper than the IVF clinic (where you do pay for everything (insurance doesn't cover anything but blood tests), and that helped us to resolve some basic stuff (ultimately, I DID get lucky naturally as we think it was the underactive thyroid that was the problem).....

(we also looked at the Shady Grove centre in the DC area in relation to possible egg donation and/or IVF with my own eggs as they have pages about insurance coverage, etc., and that might lead you in the right direction as well)....

best wishes (and don't give up hope!)