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Dollars & Sense of Infertility Treatment

How to Pay for Medical Care When You're Trying to Conceive

By Michele St. Martin

Virginia does not require insurance companies to cover infertility treatment, and the Pages have not been able to afford treatment for infertility. They had to pay out-of-pocket surgery expenses. "Our RE (Reproductive Endocrinologist) worded it as 'oviduct repair' and our insurance reimbursed us for 50 percent,"says Lori Page. 

Part of the diagnosis is "severe male factor," but they are unable to find out the cause or whether it can be treated, because they can't afford to pay for the testing and doctors' visits. The Pages had to take out a loan to pay for tubal surgery. They are hoping to be able to secure credit to cover treatment from their RE. Without that credit, they will be unable to pursue infertility treatment.

Why don't insurance policies cover infertility treatment? According to Deborah Wachenheim, government affairs director for RESOLVE, the national infertility advocacy and education organization, the major opponent of legislation mandating that health insurance include coverage for infertility is the insurance industry. The Catholic Church and some employers' groups also oppose legislation that requires that infertility treatment be included in insurance policies.

"Insurance companies and the employers' groups that oppose this coverage use figures that claim it's very expensive to provide this coverage," says Wachenheim, who cites two well-regarded studies that show that it is, in fact, very inexpensive for an insurance provider to add infertility coverage to a health plan; one study says that it would cost just a few dollars a year per insured person, and another says that it would cost about $20.00 a year per insured person. Wachenheim adds that insurance companies feel that any mandate for coverage is a "slippery slope" that leads to other mandated coverage. She also points out that the companies provide industry studies that contradict the studies by RESOLVE, regarding the cost of covering infertility diagnosis and treatment.

Want to see more?

• Later in Life: Pregnancy at 35 and Older
• Preconception Visits: Working With Your Doctor
• Money, Marriage and Medicine: Some Things to Think About
• Talk about it!

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