Adapted from the original post by Mirza
The road to parenthood is exciting, but can also be a complex one, especially if you run into roadblocks on the fertility journey. The complexity applies to the financial side of the journey, too, given the high cost of fertility care, medications and everything else you may need in order to have a baby. While many of us won’t be able to pay for everything out of pocket in cash, there are a few financial options to help you reach your family-building goals – let’s walk through these options with Mirza – a company that is redefining how employees provide for their families through employer benefits, with a zero-interest “care now, pay later” benefit, unlocking affordable childcare.
There is no “one-size-fits-all” in reproductive health. What you need and what that costs will vary – sometimes wildly. What you can expect to pay and what the best way to make that happen will depend on your situation. To estimate what you may need, you can try Mirza’s financial planning tool that lets you calculate the exact costs specific to your family-building needs.
Using health insurance for fertility coverage
When it’s available to you as an option, health insurance is a no-brainer as a way to finance fertility treatments, tests, medications or supplements. However, not all insurance plans include fertility coverage. Look into your plan to see if it includes fertility treatment and if so, what exactly you can get covered.
If you have access to an FSA or HSA, see if you can tap into those, too, as they let you pay for some of the fertility-related products and services, using your pre-tax dollars. Medications, supplements and tests are often eligible.
State mandates and eligibility for fertility coverage
Nineteen states have insurance laws around fertility coverage; ten states mandate that employers provide coverage for IVF cycles. Other states require some aspects of fertility care, like a doctor visit or diagnostic testing. Even in states that don’t require fertility coverage, some companies do provide insurance with access to fertility care, especially if you work for larger companies that prioritize healthcare access as a recruitment and retention tool. So, don’t just assume that you don’t have coverage – always check your plan.
Beyond where you live, eligibility and coverage will depend on several factors, including how many employees the company has or how the insurance is funded. State laws vary, so it’s best to clarify with your employer and insurance provider on what you can expect to have covered. If you don’t have coverage through your primary insurance, taking out an additional insurance plan or finding an alternative provider may be an option.
While health insurance can help cover some of the expenses, there may be restrictions on what treatments can be covered, or how you can access certain treatments. For example, you may be required to undergo a set number of IUI cycles before you can have an IVF cycle covered. Plans typically have a $25,000 lifetime maximum, which only covers one or two IVF cycles, leaving many to pay out of pocket for additional cycles when the covered cycles don’t lead to a pregnancy or additional rounds are needed to expand the family.
What if your employer doesn’t offer fertility coverage?
If your employer’s insurance policy does not offer fertility benefits, it may be worth asking for further support. Like the saying goes, you miss 100% of the shots you don’t take. Get the conversation going in your workplace and talk to HR or your manager about offering an insurance option that includes fertility care. Make your case, use statistics as leverage and shoot your shot! Bonus point if you can enlist colleagues to join you – having access to fertility coverage will help many.
If it also makes sense career-wise, you or your partner may also want to explore a new job with fertility coverage – and even a better parental leave policy. Some companies contract with a fertility-specific insurance provider like Progyny to offer premium coverage; others offer plans through traditional, comprehensive insurance companies and include fertility care.
Taking out a fertility loan
Loans to finance fertility care are another commonly used option. Fertility loans can come from a fertility financing company or be a traditional personal loan. They are normally a lump sum loan, and can be used for a single IUI or IVF cycle. Shop around for the best interest rate and a payment plan that best suits your situation. Some clinics have relationships with loan providers who may offer you a preferential rate. (But not always – definitely do your homework.)
Downsides of fertility loans
Loans do have some disadvantages to keep in mind. When you need more rounds or more complex treatments, additional loans may be required, saddling you with multiple loans. Taking out a loan in general can lower your credit score in the short term. If not repaid on the agreed-upon payment schedule, it can hurt your credit score in the long term, too.
Applying for fertility grants
Grants for fertility treatments is another option to finance family building. The sources vary ,but the most common are fertility clinics, nonprofit organizations and state/local governments. Grants can be applied to a specific treatment or clinic in the form of a free or discounted treatment. They can cover a significant portion of your treatment costs, if not the entirety.
Drawbacks of fertility grants
The biggest downside to fertility grants is the very limited availability and uncertainty. You’ll have to make sure you meet each grant’s specific criteria, then apply for one (or more). The restrictions can be around age, marital status, residence, or diagnosis. Not everyone who applies will get the grant, so you may have to apply for a few to receive one grant.
The process can involve a lot of paperwork and some require an application fee. Some grants require you to be public about your struggles – for example, sharing your story in a video posted on Instagram may be a requirement. In those cases, take into account your own comfort level, as well as consider how your partner and your future child may feel about openness in this area.
Accessing fertility clinics’ payment options
Many fertility clinics offer payment plans and discounts to make treatments more accessible. Given the high cost of fertility care, clinics are used to helping patients with payment options, so don’t hesitate to inquire what options might be available to you. Treatment prices range widely from clinic to clinic. You may be tempted to select the clinic with the lowest quote, but it’s wise to check the success rates of each clinic, as well as make sure you are a good fit for the clinic before pulling the trigger.
Some clinics offer refund programs. In these programs, you pay a higher-than-usual fee, usually between $20,000 and $30,000, but sometimes higher. If you do not get pregnant after a set number of IVF cycles, the clinic will refund a part or a whole of what you paid for. In a way, the financial risk is shared between the clinic and you, so the downside is that your cost ends up higher if you do get pregnant in your first cycle than you otherwise would. Terms vary depending on the clinic, and many have eligibility criteria.
Final words
As with any other financial decisions, it’s best to take your time and do your research before deciding how to pay for your fertility journey. If starting a family is still a few years down the road for you, great. Make a plan now on how you'll save for the journey. If you don’t end up needing it, you can always use the fund for something else. If you are already in the midst of it all, ask questions, find out what financial options you have access to, and be realistic about what you can afford. And don't forget - you have several ways to save on Ovaterra supplements.
Don’t forget to deduct fertility expenses from your taxes
If you itemize your tax deductions, remember that many of the expenses related to medical care, including those for fertility care, are tax-deductible. Keep the receipts of your fertility expenses and include them in your deductions. More on deducting fertility expenses from your taxes here.
Try Mirza’s financial planning tool
To help you figure out your family building expenses, Mirza has built a financial planning tool. Mirza’s tool considers fertility and childcare costs, accounts for parental leave from work and provides a comprehensive report you can use to plan your next steps. Sign up and try the beta version for free here.
Ovaterra provides reproductive health resources for general, educational purposes only. This content is not intended to replace medical advice from a qualified healthcare professional. Similarly, when making your financial decisions, please consult qualified financial professionals who can make individual recommendations.
