Covered fertility treatments depend on the insurance plan and provider. Make sure that you check the policies to know the extent of the coverage of the plan you have. Some fertility treatments that are covered by the insurance are IUI (intrauterine insemination), IVF (in vitro fertilization), ZIFT, and GIFT. Sometimes they also include diagnostic tests, procedures and surgery. Certain medications like injections, sperm donation and egg donation procedures are not covered.
There are different types of fertility insurance that couples or an individual can choose from.
- Standard Health Insurance – in exchange for a monthly premium, the insurance provider will be paying for certain fertility treatments up to a maximum dollar amount.
- Refund Programs – these are offered by some insurance providers and infertility clinics. When you sign up for one of these programs, you would have to pay for the fertility treatments. If the treatments are not successful, you will be refunded between 70 to 100 percent of the money you have paid.
- Financing – there are programs which allow you to take out a loan to pay for the infertility treatment you will be undergoing. Many programs do not require you to repay the loan in full unless in event of pregnancy.
When talking about fertility insurance, there are also age qualifications. Insurers or insurance providers have certain requirements that applicants should be qualified before obtaining infertility insurance. Some of the requirements would be that couples are both under 40, facing infertility for a certain period of time (between one and five years) and policy holders for at least 12 months.
If you have been denied of coverage, you may still appeal to your insurance company on the grounds that the fertility coverage is a legitimate and necessary medical procedure. Always get legal advice and the support of your doctor when you want the appeal to be successful.
But even after the appeal and the insurance company will still not cover it, infertility treatments, like most medical procedure are tax-deductible. This may include the actual procedures as well as general physician’s visits, drug costs, and many more procedures.