Infertility, IVF and Insurance

Only 16 states have laws concerning insurance coverage for infertility treatments and five states have fertility preservation laws, which require insurance companies to help women undergoing chemotherapy freeze their eggs before starting cancer treatment. In states lacking these laws, many insurance companies refuse to cover treatments that can help families conceive. The Centers for Disease Control and Prevention estimates that about 12 percent of women of childbearing age deal with infertility.

Good reasons that infertility should be covered are that the World Health Organization and the American Medical Association both consider infertility a disease and the Supreme Court has ruled that reproduction is a vital life function. Yet few women have insurance coverage for infertility. We know how women who suffer from infertility feel about the lack of insurance, but how do doctors feel about it?

A survey of members of the Society for Reproductive Technology shows that a large majority (>95%) favored insurance for fertility preservation for cancer patients and for avoidance of genetic disorders; 62.3% were supportive of infertility insurance coverage for transgender patients; 78% supported expanding insurance for the broadest segment of the general uninsured population; 76.7% supported expanding insurance contingent on elective single embryo transfer (eSET); and 51.3% would consider expanding insurance contingent on lowering charge per cycle in general, but only 23% responded as to what lower charge would be acceptable.

Three of four factors were shown to be predictive of attitudes willing to expand insurance: practice setting (academic > hybrid > private), practicing in a mandated state, and higher annual volume of cases (>500 cycles); these had significant increased adjusted odds ratios ranging from 1.7 to 2.9. A fourth factor, the professional role one had in the practice, was not found to be of significant predictive value.

They concluded that great majority of respondents were supportive of expanding insurance for specific segments of vulnerable populations with special needs and for the population who are presently uninsured. Furthermore, the majority of respondents would consider expanding insurance coverage contingent on age-appropriate eSET but have concerns about reduced reimbursement. Those most likely to be willing to expand insurance are those who practice in an academic setting or a mandated state and/or have a high annual volume of cases.

Unfortunately in the current political climate the chance of expanding insurance coverage for infertility or IVF is probably zero.

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