The Price of Infertility & Insurance Coverage

For all the years I spent taking my time getting a procedure done here and there to find out why I was not getting pregnant, money was never an issue. We never needed a significant amount for any specific procedure. Luckily, our insurance paid 50% for most procedures related to finding causes for infertility so my medical co-pays were more than manageable.

When you finally decide that you want to pursue having children, you realize it’s going to cost you. When you want something that badly, what doesn’t? Our insurance did not cover anything to do with IUI or In Vitro so we were on our own to pay for it. Thank God we owned a house with equity or my husband would have been working a lot of overtime just to pay for our medications. To be honest, we never really worried about the money we would need to pay for IUI or In Vitro. I think we just figured it would all work out and we were optimistic that the money would come from somewhere.

My mother-in-law knew the owners of a pharmacy through her work as a nurse. We were told that we could receive a significant discount on medications in comparison to other pharmacies if we paid cash and ordered everything at once from this particular couple. We asked our friends who had done In-Vitro how much we should expect to pay for medications and they said in the ball park of $5,000. We needed to budget this. We ordered the medications we needed from the pharmacy and almost $6,000 later, we realized we could have gone to our local pharmacy and saved money even without medical coverage. We felt taken advantage of and quite angry- after everything we had been through, you would think these pharmacy owners who were "friends" of my MIL would have shown us some empathy and stuck to their word. Right around this time, I won a financial settlement that helped pay for all the meds we needed. This was, however, yet another obstacle we didn't need to deal with.

After choosing our Doctor, we found we also needed money to complete the In Vitro process through the ART (Assistive Reproductive Therapy) Center in Beverly Hills. The name of that city alone scared the heck out of me. All I saw were dollar signs! We assumed the fees would be unmanageable. However, we were treated with such dignity and respect that we knew it was worth the money spent. We were given a price list early on and were able to budget appropriately. All fees were paid in advance so there were never uncomfortable conversations about finances in the office because everything was handled by mail. We were treated like royalty and never ran into another couple in that office even if they were 10 feet away from us. The discretion and professionalism of this facility was second to none.

Since we had a price list, we were able to choose which procedures we wanted done throughout the course of our treatment with the ART Center. We appreciated this part of the process since it made decision making easier. We took out a second mortgage on our house to pay for everything. The house was new when we bought it and we opted for In Vitro payments instead of a backyard! I am sure our neighbors were wondering what was going on. Everyone else had completed their landscaping and here my husband and I had all this stuff but no lawn. At least the front yard was completed by the builders before we moved in so we weren’t a complete eye sore. We had visions of a nice yard with a swing set anyway so we knew we would make it up to the neighbors down the road.

Still, I have some issues with the insurance company. In my case, I had been labeled with “unexplained infertility” yet I became pregnant with my first In Vitro so I felt the insurance company should have continued to pay for my procedures. In Vitro was the next course of treatment for me in my quest to figure out my infertility so it should have been considered a treatment in my eyes. Come to think of it, my IUI’s should have been covered as well. And why do they only pay 50% to find answers to infertility? If I could not get pregnant, then I would have to have something medically wrong with me needing medical attention. That prompted me to need a specialist because I did not receive the answers I needed through my regular OBGYN. I know this is a medical and ethical point of contention but when will insurance companies get with the times? This isn’t the 1800’s where when you couldn’t get pregnant you either ignored it or were killed for it. Women today are starting family’s later in life and given all of the things we are surrounded by daily that can cause possible infertility, this should be addressed or recognized at the very least by some sort of major institution.

I know this quest can cost a lot of money and I know not everyone can make ends meet. I have friends that have sold homes and moved into apartments to pay for their infertility treatments. We do what we have to. Insurance companies won't pay for these procedures because women are waiting until they are older (in a lot of cases) to have children making complications more feasible. It means insurance companies would have to pay more towards treatment....and don't we give them so much darned money every month to pay for this anyway? I don't get the justification to NOT pay for treatment, and then if an insurance company does, why only at 50%? Yet an insurance company will pay for substance abuse treatment when someone chooses, on purpose, to harm their bodies. Or they pay for Chiropractic or mental health treatments- but not infertility. Will we ever see a change in this ruling and get some justification?

Gina