How will you afford fertility treatment?

Paying-for-Infertility-Treatment

After making the big decision to try for a baby, not being able to conceive can be a very emotional experience. Finding out that you need fertility treatment may amplify these feelings, with the stress of how you’ll pay for treatment adding even more pressure.

The cost of fertility services can vary widely, depending on your clinic and the medications used in your treatment cycle. On average, one cycle can cost:

Paying for Fertility Treatment

Although these numbers can be daunting, there’s good news: There are many ways to help make treatment more financially accessible, including insurance coverage, savings programs, and financing options.

Insurance coverage

You may have heard that insurance doesn’t usually cover infertility treatments, but that’s beginning to change. Many companies are recognizing the importance of fertility assistance and choosing plans that include treatment benefits. Where you live can also impact coverage—16 US states currently have insurance requirements in place for infertility treatment:

  • Arkansas
  • California
  • Connecticut
  • Delaware
  • Hawaii
  • Illinois
  • Louisiana
  • Maryland
  • Massachusetts
  • Montana
  • New Jersey
  • New York
  • Ohio
  • Rhode Island
  • Texas
  • West Virginia

If your employer’s health plan doesn’t cover fertility treatments, you can talk to them about making a change. Read more about the Coverage at Work Initiative at resolve.org.

Know your plan 

If you live in a state with infertility coverage laws, it’s still important to verify the type of plan your employer has. In some cases, your plan may not provide coverage. Check on whether:

  • The policy was written and/or resides in your state
    Out-of-state plans may not provide infertility treatment benefits
  • You have a fully insured or self-insured plan
    Self-insured plans are exempt from state laws
  • Your company has enough employees to be required to provide coverage
    Some states allow exemptions for smaller companies   
      

More information on fertility treatment coverage by state can be found at resolve.org. 

Contact your provider

Once you’ve verified that coverage exists, your insurance provider can help you understand your plan’s benefits and limitations, referral requirements, and whether preauthorization is necessary. It’s also important to confirm drug coverage for infertility medications.

Submitting a predetermination of benefit letter to your insurance company before treatment can give you a better idea of the costs you’ll be responsible for.

If you have questions about insurance coverage for fertility treatment, assistance is available. Call 1-866-LETS-TRY for support.

Medication savings programs

Some fertility drug manufacturers offer savings programs to help make treatment more affordable. Many people can benefit, including:

  • Military personnel and their spouses
  • Patients with no insurance coverage

Your fertility clinic can answer questions about the types of drugs they’ll prescribe for treatment. Program information can usually be found on the drug manufacturer’s website.

If you’re eligible for medication savings, you may only be able to have prescriptions filled at certain pharmacies. Because the same medication can vary in price dramatically, it’s important to verify participating pharmacies before having medication filled.

Learn about programs that can help make several common fertility drugs more affordable at FertilitySavings.com.

Clinic payment plans

Treatment clinics understand the financial hardships you are facing. Many offer affordable payment plans, have relationships with financing companies, and offer medication discounts.

Some clinics offer package pricing. These allow you to pay a discounted price upfront for a certain number of treatment cycles. You usually won’t receive money back if you’re successful on your first try, but some programs will offer a refund if you reach the end of your package without success.

Infertility loan programs

RESOLVE: The National Infertility Association has compiled a comprehensive list of infertility financing programs. Some are now offering shared risk refunds and bundling options at reduced costs.

View RESOLVE’s list of infertility financing programs.

Grants and scholarships

For people who need help paying for infertility treatment, grants and scholarships are available from nonprofit organizations. Eligibility requirements and application deadlines must be met.

View a comprehensive list of grants and scholarships on resolve.org. 

FSA, HSA, and HRA accounts

Your employer may offer special accounts to help you save on medical costs. These include:

  • Flexible spending account (FSA)
    FSAs can be used for certain out-of-pocket healthcare costs, including copays, deductibles, and some medications. Your employer may contribute, but is not required to. You may only defer $2,650 to your account each year.

     
  • Health savings account (HSA)
    These cover qualifying medical expenses, but can only be used with a high deductible health plan. Account contributions are capped at $3,450 for an individual, and $6,900 for a family. Funds in these accounts roll over each year.

     
  • Health reimbursement account (HRA)
    HRAs are funded by your employer. Qualifying medical expenses and reimbursement limits are also employer determined. Money in these accounts may be rolled over each year. 


The money you defer to these accounts isn’t taxable, making them great cost-saving tools for treatment expenses. 

Home equity loans

If there’s a good amount of equity in your home, using a home equity loan or a home equity line of credit may offer a way to fund treatment. Talk to a professional and shop around for the best rates.

Tax deductions

Starting in 2019, you can deduct unreimbursed allowable medical care expenses for the year only if that amount exceeds 10% of your adjusted gross income. Ask your tax professional for details and keep accurate records of your paid expenses throughout the year.

Save on medication

You may qualify for medication savings if you’re using certain fertility drugs.