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Should IVF Be Covered by Insurance?

Updated on February 4, 2009

There’s a lot of debate about whether or not In Vitro Fertilization (IVF) procedures should or should not be covered by insurance. I present a few of the arguments here. Be sure and make your opinion known on the poll to the right!

Should IVF be covered by standard health insurance

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IVF’s Current Insurance Status

Unless your health insurance policy specifically provides for infertility treatments, IVF is probably not going to be covered. Even if your insurance covers some infertility treatments, they can still exclude IVF. However, if the IVF treatment is done in conjunction with surgical procedures that are necessary for diagnosis of your infertility problem, insurance may pay for a portion or all of the procedure. It all depends on your policy. But in general, most insurance policies don’t cover infertility.

You can get a separate policy that specifically covers infertility treatments, including IVF.

The Case for Coverage

The battle for infertility (including IVF) coverage by insurance companies is currently being fought in the court system. Proponents cite the following reasons why medical insurance should cover infertility treatment:

  • Infertility is a treatable medical condition. These may be structural problems, disease, or hormonal imbalance. Such problems are medically treatable with non-experimental, minimally invasive procedures such as IVF and artificial insemination.
  • Infertility is a serious, life-limiting medical problem. The sadness and stress associated with not being able to have children can dramatically affect the quality of life for those affected.
  • Providing coverage for infertility is cost effective. The pressure to have successful IVF (as well as a desire to ultimately have more than one child) results in self-paid IVF treatments transferring multiple embryos, and multiple births are more expensive.
  • It’s okay for fertile health plan members to subsidize infertility treatment because the infertile members subsidize the child birth and pregnancy costs of the others.

Fighting For IVF Coverage

Laws regarding insurance coverage are different depending on which state you’re in. The American Society of Reproductive Medicine has created a website that details the infertility coverage mandated by law in each state.

Laws are changing daily and the fact is that you need to be very careful if you expect insurance to cover your IVF treatments. It is advisable to consult with a lawyer familiar with IVF insurance work if you have any questions about the insurance company’s responsibility to pay for a particular infertility treatment.

I suspect the comments on this one to be lively! Let’s hear what you have to say!

Image Credit: cesarastudilo, Flickr

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