Most insurance coverage provides no fertility benefits. I’d like to see this change.
by John Storment, M.D.
“Let them eat cake” is the traditional translation of the French phrase “Qu’ils mangent de la brioche”, supposedly spoken in the 17th century by “a great princess” upon learning that the peasants had no bread. It reminds me of the narrow view our government and third party payors take toward treatment of infertility and fertility benefits.
Health insurance guarantees that an individual will not have to bear the entire burden of his/her health care expenses. But in the case of infertility, the majority of patients bear the responsibility of covering the costs of treatment. Depending on the cause of the fertility problem and the therapy used to treat the problem, that cost can be considerable.
By some estimates, as much as 50% of those who need advanced infertility care never receive it. The reasons most often cited are lack of affordability in the absence of insurance coverage for IVF and other advanced treatments. The number of patients who seek fertility treatment continues to rise. Though many attribute this increase to women becoming mothers at more advanced ages, the fastest growing segment are women under the age of 25.
Infertility is not a rare disorder – it affects 1 in 8 couples attempting pregnancy. That’s way more common that most medical illnesses and yet the treatment of infertility is still not routinely a covered benefit. Despite the fact that the American Society for Reproductive Medicine (ASRM) has formally defined infertility as a “disease,” most managed-care insurance plans still do not cover fertility treatments, such as intrauterine insemination (IUI) or in vitro fertilization (IVF).
Can you imagine the public outrage if we learned that prostate cancer affects 1 in 8 men every year, but it is not a covered illness?
There are currently 19 states that have some mandate for coverage for infertility, and 13 of these include an IVF mandate. There are also increased numbers of businesses who include the treatment of infertility as well as expenses associated with adoption as part of their benefits package. For twenty years, Fertility Answers has provided our employees with infertility coverage – many of which are still employed with us today. Woman’s Hospital in Baton Rouge, Lafayette General Hospital and St. Tammany Hospital all provide infertility coverage for their employees. (See our list of Louisiana companies that provide fertility benefits.) Despite many pleas from Louisiana citizens to the state legislature to provide a mandate that provides at least partial coverage, no progress has been made. Interestingly, our Arkansas neighbors to the north provide every citizen with one covered IVF cycle!
My intent on this blog is to encourage all who are impacted by infertility to get involved now. I strongly recommend you to contact your employers and state representatives. I can provide oodles of data that prove providing fertility benefits can save money in the long run. But until they hear your personal stories and journeys, they will not seek change. Until they hear from those most affected, they will turn a deaf ear and simply reply, “let them eat cake”. Find your district state legislators and email them with your story.
No one expects to receive the diagnosis of infertility. Yet more than 7 million Americans are subject to that diagnosis. No one expects that their insurance company will deny them coverage for this medical condition. But most do. Let’s use our voices to change this.