Benefit Resource will be closed Monday, January 16 in observance of Martin Luther King Jr. Day.

BLOG

How can we make IVF and insulin more affordable?

Exploring why insurance doesn't cover IVF

Anyone who has encountered IVF treatments or insulin payments is familiar with the overwhelming costs associated with each.

In some instances, insurance may be available to ease the sky high payments. But in other cases, insurance is not available or is simply not enough.

This article will explore why insurance doesn’t cover IVF and ways that IVF and insulin can be made more affordable.

IVF and insurance

In the late 1970s, the first child from IVF was born. At the time, her birth was considered an experimental procedure. This early label of “experimental” put red tape around IVF treatments, making them unpalatable to insurance companies that traditionally do not cover drugs, procedures or tests that have not been determined to provide a measurable benefit to the patient.

However, since that time, more than 8 million births have occurred through IVF. But the initial label has continued to stick to IVF, making insurance companies wary to provide coverage.

It is worth noting that insurance is available to cover the expenses related to initial testing to determine if there is an actual cause for infertility.

Why insurance for IVF needs to change

Going back to insurance not covering IVF, this stance has often lead insurance companies to pay for more IVF pregnancies, due to a combination of factors.

First, given the cost of treatment (with sources citing figures between $10,000 and 20,000 per procedure), prospective parents can only afford one procedure. As such, they are more likely to implant multiple embryos. This increases the potential for multiple children to be born, resulting in a higher risk pregnancy.

The practice is so common that today, nearly 40 percent of IVF children were born from multiple embryo implants.

It would behoove insurance companies and families seeking IVF treatments for insurance to cover a portion of the cost. That being said, some companies can and have opted to allow insurance to cover IVF-related costs. However, unless a federal insurance mandate is passed, not all plans are required to offer coverage.

Hope for the future

One of the largest breakthroughs for those seeking IVF treatment was the announcement of infertility as a disease. More than 12 percent of married women are affected. With infertility regarded as a disease, there is a much higher likelihood it will be recognized as less risky and safer to treat.

Rising above the cost of insulin

Diabetes is another disease that is extremely expensive. While insurance is available to cover insulin, between high deductibles and the high cost of insulin, many are still left with bills that are difficult to pay.

According to WebMD, diabetes costs the country $170B annually. Insurance coverage has been mandated in 46 states to cover diabetes medicine, supplies, and equipment. But, not all devices and supplies are covered. Patients may sometimes still have to fight for insurance companies to cover certain elements of their diabetes treatment.

Making IVF and insulin more affordable

Both IVF and insulin treatments are considered eligible expenses under pre-tax benefit accounts. Through an account like a Flexible Spending Account or Health Savings Account (or Health Reimbursement Account, depending on the employer), the exorbitant expense of IVF and insulin are made somewhat more manageable.

Depending on the type of account a person has, hundreds or even several thousands of dollars could be put toward paying for IVF and diabetes care. For diabetes, this can include the cost of blood-sugar test kits and test strips, glucose-monitoring equipment, and insulin.

Learn more about paying for IVF with a pre-tax account here and search for diabetes-related care items here.

While the future of how insurance companies will handle IVF and diabetes is unclear, we can hope that they will regard each of these diseases in a light that makes them worth covering.


For more guidance on simplifying the complexity of benefits for maximum savings and peace of mind, subscribe to the Benefit Resource Blog today.


Sources: