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Is in-vitro covered under my health insurance?

Keep in mind...
  • In-vitro fertilization treatments are for couples who are unable to conceive naturally
  • All health insurance companies view IVF differently
  • Fertility treatments can cost between $10,000 to $15,000 dollars

In-vitro fertilization is an alternative many people use to have a family, but (IVF) may not be covered by your health insurance. Every health insurance plan is different and how health insurance companies view in-vitro fertilization will vary between providers.

The only way to know for sure is to read your policy details or call your insurance company to find out if you have coverage. If you do have coverage, they can also help you understand exactly how much and what procedures they cover.

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What is in-vitro fertilization (IVF)?

adobestock_101816845-1600x1600In-vitro is used to help parents have a baby when certain forms of infertility have made it impossible naturally. Cases involving blocked fallopian tubes, low sperm count, or surrogacy have the highest pregnancy success rates for in-vitro.

In-vitro fertilization (IVF) is a process manually fertilizing an egg. The fertilized egg is allowed to grow for a few days then placed inside the uterus.

Once the embryo is inserted, doctors wait a few weeks to allow implantation and then check to see if the pregnancy has taken.

If my health insurance does cover in-vitro what is usually covered?

While not all health insurance providers and plans cover IVF, many do. Exact coverage will vary between providers. Always carefully read your policy so you will know exactly what to expect. Most insurance companies will have a lifetime cap on the amount they pay or may only cover one round of IVF.

Sometimes health insurance companies will cover certain aspects of the treatments, but not everything. Examples are that they may cover testing or labs but not procedures. If this is the case, most doctors will break services down so that you only have to pay for services not covered.

Fifteen states require insurance policies to have some form of coverage for IVF. Many other states are also working on legislation to mandate IVF provisions.

Some insurance companies also offer infertility supplemental insurance. These policies simply offer a partial rebate if you fail to conceive. If you are at high risk for not conceiving, they can refuse to write a policy, though.

If you do conceive, you will have expenses related to maternity and birth. IVF also increases your chances of having a multiples birth. Supplemental maternity insurance can help with these costs and lost income but you will need to purchase before you start trying to conceive.

How much does in-vitro cost?

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One round of IVF will cost you around $10,000, but could cost as much as $15,000 or more depending on the doctor, where you live, and other factors. This fee should also include all drugs, procedures, and labs needed, but you certainly want to get a breakdown of what is and is not covered before choosing an IVF doctor.

Some clinics may quote a price that is below $10,000 and although this may seem very tempting its often the case that these companies are not including the cost of these additional items.

There also may be some additional costs associated with your treatment. These are treatments used in conjunction with IVF, not hidden costs.

Doctors will be able to let you know if these treatments are needed after your screening and test results.

ICSI is another procedure where a single sperm is injected directly into the egg. It can increase the chance of fertilization. ICIS costs around $1000-$1500.

Sometimes genetic testing of the embryos is also needed. Doctors will sometimes recommend this if the mother has already had several miscarriages. This type of testing can cost about $3,000.

Many parents will have embryos that are not implanted during the first round. Freezing and storage may be expensive, but it is advantageous if second rounds of treatment are needed.

Using frozen embryo transfer will cost around $3000 and is quite a savings over an entirely new round of IVF.

If you need to use an egg donor, your cost will be significantly higher. Donor eggs can cost as much as the treatment itself. Eggs range in price from $13,000-$15,000. Donated sperm is much less expensive. You should only expect to pay $200-$3,000 for this.

If you need both egg and sperm donors, you may want to consider embryo donation. These are embryos that have been frozen, and the cost is often considerably less. Donor embryos usually cost $5,000-$7,000.

Where can I find help paying for in-vitro?

adobestock_95966077-1600x1600If you do not have enough health insurance to cover IVF treatments, there may be options to help you afford treatments. Shop around and consider all your options. The average woman may need three cycles to successfully conceive a baby.

  • Many facilities will offer finance plans allowing you to finance the cost of in-vitro treatments, but these are hardly ever interest-free so budget in the interest cost of the loan.
  • Also ask your employer if they offer a payment plan. Sometimes employers will offer interest-free loans to employees for medical expenses.
  • Some people opt to use proceeds from a home equity
  • line due to the low interest cost and possible tax deductions.
  • You may also want to consider a personal loan.

One important fact to remember is that in-vitro is never guaranteed. No matter how you decide to pay for treatments, you will be responsible to pay even if you do not conceive.

Start planning for your new family today. Use our FREE tool to compare health insurance quotes!

Free Health Insurance Comparison

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