fertility news

Infertility affects more than 7.3 million Americans or 1 in 8 couples of childbearing age according to 2002 statistics published by the United States Centers for Disease Control and Prevention. More alarming is a trend that shows infertility is on the rise in the US and in the world. Many people who suspect they may be infertile may delay or never seek treatment for their condition because of financial concerns over the cost of diagnosis, testing and treatment which is often very expensive. For this reason insurance coverage for infertility can be a critical factor in determining who becomes a parent and who does not. It is estimated that about half of people afflicted with infertility do not seek the care they need because they do not have insurance coverage to defray the costs of testing and treatment.

There is a perception among some employers that providing insurance coverage for infertility will significantly increase their medical costs. To explore this perception a survey of 900 employers, conducted by Mercer Health and Benefits, was commissioned by Resolve: The National Infertility Association with support from Organon USA. The results of the survey were surprising and demonstrated that in fact, just the opposite is true. The employers surveyed reported that coverage for infertility diagnosis and treatment had little or no impact on their premium expense and many went on to say that providing coverage has helped them retain and recruit valued employees. Two reasons were given most commonly for offering coverage: 1. to ensure their employees had access to quality, cost-effective care; and 2. to be recognized as a family-friendly employer in an effort to attract and retain valued employees.

Other interesting facts uncovered in the survey include the following:

• Only 20 percent of employers nationwide cover in vitro fertilization (IVF)
• Approximately 37% of said employers cover drug therapy
• About half of these employers cover evaluation by an infertility specialist
• More than two-thirds of employers have been providing infertility coverage at their current level for more than five years
• 65% of the employers cited their primary objective in offering coverage was in response to their employee’s requests for infertility benefits.

The results of this survey are important not just for people trying to have a baby but for the rest of society as well. No insurance coverage can limit the treatment options a person can afford to try and lead them to make choices that may not be healthy because they are worried about the cost For example, a couple with only enough money for one try at in vitro fertilization may put four or five embryos back into the uterus even though their physician thinks one or two is safer. They make this choice to increase their chance of pregnancy knowing they also increase their chance of conceiving more than one baby. The goal of successful infertility treatment is one healthy baby. Conceiving twins, triplets or even more can result from putting too many embryos back into the uterus. When a woman is pregnant with more than one baby it increases the risk of complications for the mother and her babies. Preterm birth, or delivering too early, is one of the most common risks of multiple birth and this affects everyone. The extra care these premature babies need costs society at least $26 billion a year, according to a 2006 report from the Institute of Medicine of the National Academies.

Two out of three employers who did not offer coverage for infertility treatment said they assumed it would increase their cost. This assumption was incorrect based on the results of the Resolve study. As for the cost to society, the 2006 report from the Institute of Medicine of the National Academies showed that insurance coverage is a more cost-effective way to encourage safe medical choices and improve patient care. In conclusion, based on the results of the Resolve study, providing insurance coverage for infertility treatment has many benefits. It enhances patient care and is more cost-effective for patients and society as a whole. These are benefits that far outweigh the risk of increased medical costs.

What can you do if the cost of infertility treatment is a problem? Infertility financing programs are available that offer a range of services as well as programs such as Design RX® for patients with no insurance coverage or paying cash. If you’re not sure what your insurance covers talk to your employer or Human Resources representative. Here are some questions to ask:

• Are infertility treatments covered on the current health plan?
• Is there another plan that has infertility coverage? If so, what is the cost difference? Is it possible to change plans? If so, when?
• Are there restrictions to this plan's infertility benefits?
• Is there a waiting period to start treatment for pre-existing infertility conditions? If so, how long is it?

Be sure to verify the answers you get from either your employer or another benefits representative. If you’d like to give your employer a copy of the survey results the link is provided below.

For more information on the following topics visit these websites:
Design RX®: http://www.designrx.net/

Financing programs: http://www.resolve.org/site/PageServer?pagename=lrn_mta_finprog

Mercer Health and Benefits Survey:
http://www.resolve.org/site/PageServer?pagename=fmed_mcpr2006720

References:

1. Resolve: National survey finds employers covering infertility treatment experience no significant increase in cost. Available at: http://www.resolve.org/site/PageServer?pagename=fmed_mcpr2006720
   
2. Institute of Medicine of the National Academies. Preterm Births: Causes, Consequence, Prevention. Available at:
   http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=1162
   
3. Collura B. Infertility financing programs. Available at:
   http://www.resolve.org/site/PageServer?pagename=lrn_mta_finprog