Fertility Treatments & Insurance

Parent Q&A

  • My wife and I are moving to the United States to the SF Bay Area in the next month.

    We are currently doing egg donation overseas and would need to do ultrasounds and blood tests leading up to appointment. Does anyone know where this can be done and approximately how much it would cost?

    We are planning on going with Kaiser for insurance, is there something particular that we need to ask for or make sure to tell them we need on our insurance that would cover future egg donation/IVF treatments? Is there a better option than Kaiser if we would like better coverage on things like this?

    Additionally, what is the approximate cost of the medications required for egg donation/IVF treatments and is there a way to get the medical insurance to help cover the costs?

    Congratulations on your upcoming move to the Bay Area! We have gone through several IVF procedures with Kaiser. Our insurance policy did not cover IVF but it did cover all the other procedures that were part of our overall fertility treatments. We used an egg donor and paid Kaiser $15,000 which covered all the medical costs for both the donor and myself.  Kaiser doesn't provide egg donors; we went to an outside agency and paid them directly for the donation.

    When we tried again later using the frozen embryos that we already had, the cost was only $4500 for my needs. I don't know the specific costs for the medications since we paid a lump sum. I would advise that when you get insurance through Kaiser, that you specifically what the difference in the annual cost is with and without IVF coverage - it could be that you are better off paying out of pocket for the implantation rather than paying super high annual premiums. 

    I can't speak to the insurance portion of your question, except to say that many policies do not cover fertility treatment. My understanding with Kaiser is that if one's policy does not cover fertility treatment, the only benefit is that most of your lab work may be covered, which is minimal in the scheme of fertility treatment costs.

    I would recommend choosing a clinic based on reviews of REs and proximity to work/home. I've had a positive experience of Reproductive Science Center, which is in San Ramon but has several satellite clinics for scans and routine blood work.

    I can't speak to the cost precisely, but the egg retrieval (including meds) is the most expensive part of treatment, so if you already have the eggs you'll be in good shape financially. I think transfers cost approximately $300 per cycle and meds for transfer cost less than $100 per month, but those are both ballpark figures. I paid for a package, so have no idea how much scans cost.

    Good luck!

    We took 13 months to conceive our son so around month 11 I started digging in. I had a really good Kaiser plan at the time and they only covered 6 rounds of IUI and 50% coinsurance on the meds/labs. Your Kaiser plan may be better, but after looking around... I think that was one of the better infertility treatments offered by many insurers (Anthem, Blue Shield, UHC, Cigna, etc) at the time.

Archived Q&A and Reviews


Questions

Employers who offer coverage for IVF?

May 2008

Hi all, my husband and I have been trying to conceive our first for several years now. We've even done a round of IVF. And now we are going to have to do a second one, but nether of us has coverage for it and raided our retirements to pay for the last cycle. Since I'm not really in love with my job I'm tossing around the idea of getting a new job at a place that has coverage for IVF, even if it is part time. Does anyone know of a resource to find out what employers offer coverage for IVF? Or does anyone work for a company that offers coverage? Thanks! Not Fertile Myrtle


There are two sources that I know of...

1. http://www.ivfconnections.net - go to All Boards (I think you'll have to become a member but it's free and the best resource out there about IVF). Then select the board called Financing IVF. I saw one woman posted a list Nov 07 of companies that have at least some coverage.

2. http://www.inciid.org/article.php?c...rance101+243 - this is another list with more detailed info on the coverage. Good luck! anon


Kaiser Permanente employees who opt for the mid or high level plan get supplemental coverage which covers IVF. And I heard that their Fremont fertility is one of the top 5 in the country for IVF success (or fertility success - not sure which). Considered IVF


Check out Conceive Magazine. I perused it while at the doctor's office and they had an article about the best companies to work for based on adoption and fertility coverage. anon


Dropped by Insurance bc/of Fertility Treatment?

Oct 2007

I am going to see a reproductive specialist in a week and a half. A friend of mine who has been through IVF told me that when her husband got a sperm analysis he was dropped by his insurance carrier. She has since been deemed uninsurable after taking Clomid. The reason she said was because insurance companies realize that with fertility treatments the chances of multiple births and early delivery rise. They were both using individual plans.

I am starting to freak out because my husband and I have an individual plan, and because of our careers will probably never be on a group plan where this sort of thing doesn't happen.

Has anyone had experience going through fertility treatments while enrolled in an individual health plan?

I should also mention that I am paying out of pocket for my treatments because I know that my plan does not cover fertility treatment.

Any advice that anyone has on this subject (soon) would be greatly appreciated! Freaking Out


I am no expert on insurance companies and really, really feel for you. As someone who paid for private insurance through a long fertility process, I want to let you know that my insurance SAID that they did not cover ANY fertility treatments. But, in actual fact, they covered most of the blood work and of course all of the hospital; birth, amniotic testing,..... thousands of dollars.

I had to pay my endicrinologist and the pharmacy myself, but a whole lot more than I expected was covered.

Of course they jacked up the rates as I went along! Started pregnancy at $300 a month by the end, they had me at $750! After the medical OK, I switched policies and started second pregnancy at $200something and ended it at $830ish..... of course I had to drop it and now my children have coverage but I don't. (What? Am I going to charge it? When could I pay it back? Never so, and it's been several years now....a check up is under $100, so, no accidents!)

In the final accounting, it was a lot less $ to have insurance than pay as you go. Plus, if there were medical problems..... Been through the mill, but have healthy kids!


you can be dropped from an individual policy for fertility or anything else ranging from breast implants to cataract surgery. you cannot be dropped from a group policy for the same things. best advice is to get group insurance through work. if that isn't possible, you can occasionally get a rider w/ your policy. good luck! self-employed MD


Insurance companies cannot drop you once you have a policy in place unless you have lied or omitted information about health issues, including past or ongoing fertility treatments. If they could drop you for having fertility treatments, they could drop you for any catastrophic issue, like organ transplants or cancer. Because they can't drop you, they make you go through a rigorous underwriting process, and they can pull your medical records. Carriers can also decline to offer you coverage. For instance, they will not offer you coverage if you are pregnant, or if you are a man who is expecting a baby with anyone, even if the partner and baby are not coming onto the plan with you. The insurance companies can raise your rates based on claims history. The rates can be anywhere from 25 to 100% higher than standard if your health history or claims history with them warrants it. Most individual insurance plans do not cover fertility treatments. I would recommend consulting an independent broker who specializes in individual and family plans to help you. Anon


Should we switch insurance to pay for fertility treatments?

Dec 2006

Hi and thanks for any information that you can offer us, we had have not the best experience with Kaiser at Oakland, Our insurance doesn't cover infertility I can not even pay for this separately, Kaiser business policy or wherever. My wife Oby there, make us think that there is not hope, when there is not a test yet confirming anything wrong. I'm dessapointed, frustrated, and getting old. I saw the advices about fertility centers but I'm not sure to what health insurance we should switch, anyway, if somebody can recommend us also fertility doctors would be great, we decided to start all over. Thanks, best for you all Jeff


Hi There! My husband and I have 7 month-old twins and went to a wonderful fertility center called RSC out in San Ramon (there is also one in Orinda). We worked with Dr. Galen who is the head guy there and a real expert who's been in the field since the begining. We live in Kensington, but strange enough the only woman I've met so far with twins near my age-- she's also in the neighborhood-- also went to the same center and doctor! She had a very good experience there as well. She used to attend a twins group out in Walnut Creek and most of the women in the group were also Dr. Galen's patients. We had Kaiser, but they discontinued fertility coverage just a few months after we began the whole process. We ended up paying for IVF out of pocket. The cost is around 12,000 depending on the amount of drugs you'll need. But, hey, most people spend twice that on a car . . . You can go to RSCbayarea.com Good luck!!