Assisted reproductive technology and health insurance

There’s really not much question about it: assisted reproductive technology is expensive. Some procedures are cheaper than others, and there are sometimes ways to cut costs, but few people are going to jump into ART without blinking an eye at the price tag. So how does health insurance come into play when considering the cost of ART?

Does my insurance cover ART?

Even if your healthcare provider recommends a certain fertility treatment or form of assisted reproductive technology, there’s no guarantee that insurance will cover it. Insurance plans, even ones from the same insurance provider, vary greatly, and it’s not always clear what you can expect your insurance to cover. Some plans will cover the whole cost of a treatment, and some will cover none. It’s not a slick solution, but the best way to find out if your insurance covers your assisted reproductive technology is to call your insurance provider and ask.

What are the laws?

There are 15 U.S. states with laws requiring insurers to cover or offer coverage for infertility diagnosis and treatment. So if you live in Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, or West Virginia, your insurance plan might cover your assisted reproductive technology treatment.

Because we’re dealing with health insurance, things are bound to get complicated. Some states specifically don’t cover in vitro fertilization, some require that couples have a five-year history of infertility, and some allow exemptions for businesses with fewer than 50 employees.

What should I do next?

With knowledge of your state’s laws about infertility treatments being covered by insurance, consider contacting your insurance provider to see what treatments you can expect them to cover. Of the different procedures you might be pursuing, ICI, IVI, and IUI will likely be the cheapest. If you’re not receiving support from insurance, you might consider looking into one of those forms of insemination along with fertility treatments. It’s still possible to have more expensive treatments like IVF, GIFT, and ZIFT done without insurance, but it will be expensive.

How can I afford ART without insurance?

There are some specific grants available that are dedicated to helping cover the cost of infertility treatments and assisted reproductive technology. Some are only available to U.S. citizens, and others are just for residents of specific states, but they can provide substantial assistance to couples who meet the requirements. Many of these grants offer more than $10,000 toward assisted reproductive therapy, and they’re easily searchable online.

  • “Insurance coverage in your state.” Resolve. Resolve: The National Infertility Association. 2016. Web.
  • “Health insurance 101.” Resolve. Resolve: The National Infertility Association. 2016. Web.
  • “Infertility treatment grants and scholarships. Resolve. Resolve: The National Infertility Association. 2016. Web.
  • “State laws related to insurance coverage for infertility treatment.” NCSL. National Conference of State Legislatures. July 1, 2014. Web.
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