If you’re contemplating infertility treatment, there are a few pieces of information to research out. Infertility treatment can be quite costly, even if you have some form of health insurance coverage. After having gone through several IUI cycles, these were the issues and concerns I had to personally ask myself and deal with when it came to financial aspects of infertility treatment.
For those with health insurance
Does my health insurance plan cover infertility treatment? If so, does it cover only certain procedures, only ovulation induction or more advanced procedures such as IVF? This is very important to find out. I have known some friends whose health insurance plan only covers ovulation induction procedures, whereas another friend’s insurance plan covered ovulation induction as well as one IVF treatment cycle per lifetime. You should also find out whether the insurance covers any laboratory work being performed. One thing I found out in the beginning was that a certain procedure had to be performed at the hospital was not going to be covered because the hospital didn’t accept my insurance even though my doctor accepted my insurance (this didn’t even make sense to me!). For this test, I had to pay out of pocket. Some infertility centers are located within a hospital medical center and certain procedures may have to be performed at the hospital. Take it from me, ask about everything being covered! Don’t leave out one thing! For us, our plan also had out of network benefits so we could see a provider who was not in network. Not all providers take insurance. Were you aware of that??? Check to see ALL of your plan benefits. If you are able to, sometimes having the freedom of going out of network if a nice option if you needed to. Again, check and double check everything or you might find yourself with a heftier bill.
Does my provider participate with my insurance? Do I have an in-network deductible to pay before any coverage begins? For me personally, I chose a physician who was in-network for me but had to meet my in-network deductible prior to any coverage beginning. Check your deductibles to meet. Check co-pays if any.
Another piece of advice a good friend mentioned to me is checking the start and end dates of your health insurance plan year. For example, our health insurance plan year started in September 2011 and will end in August 2012. You want to be aware of this when planning treatment or doctor visits. If your year ends in July and you decide to start treatment in July, whatever amount you spend towards your deductible will be lost as August will start a new insurance calendar year. Those with Flexible spending accounts, be sure to spend the amount you already allotted so you do not lose any money.
When undergoing infertility treatment, medication (meds) is involved. Whether oral or injected, meds cost money. I can’t speak for oral meds but injectable medications can cost $300+ for a syringe. And if you need a few syringes per cycle, this can add up. Keep in mind, everyone has different requirements for the amount of hormone they will need so only your Reproductive Endocrinologist can determine this for you. You cannot determine this on your own. Check your health insurance plan to see if infertility medications are covered. If you have difficulty paying for your medications, inquire at your infertility center if they have special programs for financial difficulty. Another option is your fertility pharmacy. Many women order their infertility drugs from a specialty pharmacy that specializes in infertility drugs. Check with your specialty pharmacy to see if they have discount programs for infertility medications. A word about purchasing infertility drugs off the internet. Keep in mind some infertility drugs need special handling and refrigeration. If you buy these meds from someone other than a pharmacy, you don’t know how the medication has been handled and whether it has been stored properly. Another word on meds is if you are prescribed a brand name medication which is usually more expensive than say a generic, inquire whether the doctor approves of a generic medication which should be less cost wise.
Before hubby and I started a IUI treatment cycle, I asked the doctor’s secretary to give me all the costs possible in the cycle from the blood draws, ultrasounds, office visits, tests at the hospital (as opposed to the doctor’s office), names of meds to be used during cycle, how many syringes if she knew, sperm wash to insemination. At my center, I also had to pay a monitoring fee. Your center or physician’s office may have different tests and protocols so it’s always good to double check all costs, as best as possible.
With that said, I was always learning as I was forwarding myself along each cycle and yes, sometimes here and there came an unexpected test. But after 2 cycles, I did feel as I was getting the hang of it. Certainly be flexible to the unexpected but if you can learn as much as possible of what’s involved, you will find yourself less stressed. At least if you know a cycle can cost you at least $2000, you can budget that into your spending. I am conservative so I always give myself say an extra $800-$1000 in case of unexpected items. Tests are expensive!
BTW, my center didn’t allow a payment plan but check with your center on their payment policies.
In the beginning, doing all this research and information finding seems daunting but the more you know, the better off you will be! (I have always felt that way about life!) And remember to write everything down, and ask for individuals’ names to jot down as well. You never know when you may have to reference them.