Is IVF Covered by Health Insurance?
Many people dream of having a child, but not everyone achieves that dream as easily as they would hope. In vitro fertilization, or IVF, is a highly successful fertility treatment for individuals experiencing a wide range of fertility complications, including those that are unexplained.
IVF is a multi-faceted treatment that oversees all areas of conception to increase the likelihood of a successful pregnancy. Unfortunately, IVF is quite costly, which leaves many wondering, “is IVF covered by insurance?” The team at the Center for Fertility and Gynecology discusses IVF insurance coverage with their Los Angeles, Tarzana, and Bakersfield, CA, patients, and helps them in planning for IVF costs.
Fertility Treatment and Insurance Requirements in California
Insurance mandates are controlled at the state level, which means that insurance coverage requirements vary depending on where you live. The state of California requires insurers and health service plans to offer some degree of coverage for infertility treatment, but it falls short of specifying that IVF treatment must be covered. As a result, it is the insurer’s (or an employer’s) choice as to whether or not IVF costs are covered.
In most cases, individual health plan coverage does not include benefits for IVF treatment, though they may cover the costs of some of the initial fertility services leading up to IVF, such as fertility testing and fertility medication.
It is somewhat more common for employer sponsored insurance plans to offer coverage for IVF treatment. IVF benefits are determined by an employer’s negotiations and agreements with their insurance company. Kaiser Permanente is one of the most widely offered employer sponsored insurance plans in California, and many Kaiser members who are part of an employer health plan enjoy IVF benefits.
Understanding Your Coverage
Whether or not a person has coverage for IVF treatment is solely dependent on their health insurance plan. Understanding insurance benefits can be complex, but our financing team works closely with insurance providers to obtain all possible coverage for fertility services. This means that, even if IVF is not specifically covered, we will utilize coverage for other related costs, so that we minimize out-of-pocket expenses for our patients.
Patients should also understand that they may still incur out-of-pocket expenses if they have coverage for IVF treatment. It is not unusual for an insurance plan to provide only partial coverage for IVF treatment, or to only pay for one IVF cycle, even if multiple cycles are needed.
Furthermore, some insurance providers have prerequisites before IVF coverage kicks in. For instance, they may require that patients undergo several cycles of IUI treatment before covering the cost of IVF treatment. We look into all insurance coverage requirements to give our patients a thorough understanding of what IVF treatment may cost.
Financing Out-of-pocket IVF Expenses
IVF treatment is costly, but our financial team works within our patients’ budget to allow them access to fertility assistance. When insurance coverage is not available, or is not sufficient to cover all IVF costs, patients may explore financing options such as payment plans, and personal or medical loans or credit cards.
Get in Touch
If you have experienced fertility problems and would like to learn more about IVF and the cost of treatment, the fertility specialists at the Center for Fertility and Gynecology would be happy to answer any questions you may have. To get in touch, contact us online, or call (818) 881-9800 at your earliest convenience.
