Is IVF Covered by Insurance?
While starting your in vitro fertilization (IVF) journey is exciting, there are many potential stressors that come along with the process. For most couples, the cost of infertility treatment can be the first challenge. This leads many people to wonder, is IVF covered by insurance? The short answer is it depends. Here’s what you should know.
Is IVF covered by insurance?
Insurance and IVF coverage is a complicated topic. Every insurance plan is unique, which means you’ll have to do some research to find out if yours provides coverage for IVF. Put simply, it depends on your insurance provider, your location, and a host of other factors.
However, with a little time and effort, you can sort through your options to see which funding sources are available for your IVF journey. We recommend following these steps.
Find out where fertility coverage is required
Today, 16 states have laws that require insurers to either fully cover or offer coverage for infertility testing and treatment. The specific state laws on these differ in their scope. If you live in one of these states, though, it's important to look at your coverage.
In 2020, these states include:
- New Jersey
- New York
- Rhode Island
- West Virginia
However, even some of these states have insurance mandate exceptions. For example, employers in Illinois with less than 25 employees do not have to provide coverage.
Talk to your insurer
If you're not in a state with coverage, you do have other options when it comes to covering your IVF cost with insurance. First, take a look at your current health insurance plan. You may be surprised to find out it includes IVF coverage in some form or another.
Call your insurance carrier and ask a few important questions:
- What type of fertility testing is covered?
- Are there any restrictions regarding age or marital status?
- If necessary, what type of fertility treatments are covered?
During your search, you may find that your policy covers every aspect of fertility testing and treatment, including IVF. Other policies will only cover certain elements, like blood or infertility tests. Unfortunately, for others, there are many policies that will not cover any aspect of fertility testing or treatment.
Talk to your employer
Due to the private and stressful nature of infertility, you may be afraid to discuss the issue with your employer. It’s important to remember that a simple conversation could make a difference, not only for you, but for your colleagues.
In these cases, you can also schedule an appointment with your HR representative, rather than your manager. You can talk to them about the possibility of finding health insurance that covers IVF. They may be able to find an IVF rider benefit to add to your current plan or help you replace your current plan with one that provides the option of having IVF coverage in the future.
Look into health insurance that covers IVF
If conversations with your insurance company and employer haven’t been successful, you can also consider a non-group insurance plan. These individual plans can come with a high monthly premium, but even so they may be much more affordable than paying out-of-pocket for an entire cycle of IVF.
It's a much more drastic option, but if you're in the position to do so, you can also consider finding a job with IVF benefits. Companies with headquarters in the previously mentioned states that require IVF coverage may be an option. GlassDoor also lists companies with the best fertility benefits.
Research other fertility savings
If you need to find more ways to save on fertility treatment, start by being open and honest with your doctor. When it is safe to do so, your doctor can prescribe generic or insurance-covered medications to help lower your costs. They may even recommend prescription rebates or saving programs.
Still looking for ways to save? There are also grants and scholarships you may be eligible for. Check out our comprehensive list of programs available to certain individuals.
Finally, talk to your accountant to see if you're eligible for any tax deductions at the end of your journey. While it will depend on many factors, you may have medical write-offs that could help relieve your financial burden.