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Health insurance for infertility treatment can be a complicated – and touchy – subject. It affects a lot of people – approximately 6 million women experience the pain of infertility each year in the United States. The health insurance laws in the state you live in may have a lot do with the extent of your coverage; for example whether your employer is required to provide infertility insurance or not.
One reason that infertility insurance is so expensive and hard to come by is because the procedures are so complicated – an in-vitro fertilization procedure can cost $10,000 or more. Not surprisingly, many insurance companies simply don't provide – or provide very limited – insurance coverage for infertility.
There are some things you can do if you aren't covered for infertility treatment under your health insurance. Firstly, make sure you read and fully understand your insurance policy – some policies exclude actual treatments only, some exclude diagnosis too.
Determine whether you live in a state that has mandatory infertility insurance coverage – New York, for example is one of several such states. Under the mandate, your state must ensure that insurers provide fertility insurance as part of a standard plan, or as an option to purchase for a reasonable price.
If you are shopping around for health insurance, never mention that you are looking specifically for fertility insurance, or that this may later be a concern. As this coverage is so costly, insurance companies have the right by law to turn down your application for insurance – without giving you a reason.
If you are denied coverage, it is also possible to appeal to your insurance company on the grounds that the fertility coverage is a legitimate and necessary medical procedure. To appeal any decision successfully, always obtain legal advice, and you may need the support of your doctor.
And if your insurance company just won't cover it, the good news is that infertility treatment, like most medical procedures are tax-deductible. This includes the actual procedures as well as general physician's visits, drug costs, etc.
•Arkansas
•Hawaii
•Illinois
•Maryland
•Massachusetts
•Montana
•New Jersey
•New York
•Rhode Island
•West Virginia
Others, called “mandated to offer" states, require infertility benefits to be offered for additional purchase.
•California
•Connecticut
•Texas
Seems pretty clear cut, right? Of course! Everything that involves Government and Insurance is uncomplicated!?! To make it even more complicated, large, national corporations oftentimes offer the same benefits company-wide, resulting in exceptions to the State’s directive. Consult your Human Resources office to find out which State’s laws govern your companies policies. For example, you may live in a state that mandates coverage, but work for a company that is not required by the federal government to meet the State’s benefit mandate, find out which State’s mandate they must follow. On the other hand, if you live in a state that does not require fertility coverage; you may still be covered through your employer. Speak with your HR department and find out exactly what rules your company follows.
In addition to these complications, many times your healthcare plan may cover some parts of your treatment even if you work in a state that does not mandate coverage. It is extremely important, therefore, that you contact your company’s Human Resources department and your healthcare plan provider to discuss in detail your benefits. Don’t delay speaking with your HR Dept. start getting educated about your options today.