Infertility & Insurance, or Lack Thereof

Disclaimer.. this very well may turn into a rant….

Like most things in life, if you don’t have genuine experiences with something, you’re probably not going to know a whole lot about it. Same went for me about Infertility before I was diagnosed. I had heard of it, and I knew what it was, but I didn’t know any of the details. As it turns out, one of those very important details is that Infertility treatment is HELLA expensive. Oh, and it’s also not covered under nearly all insurances. Yes, you read that correctly. Insurance does NOT cover Infertility treatment.

The very second that Infertility was entered into my chart my insurance company stopped paying for any and all treatments. I’m not going to name drop the company for the pure fact that it doesn’t matter, because NO insurance companies (that I am aware of) in the state of Maine cover it. Because they don’t have to. I had a tiny piece of hope left in me that when I married Mike and went on his insurance, we would be Okay. He did, after all, have 28 insurance plans to choose from. I was wrong. Not ONE of them offers coverage for fertility treatment. As if going through this battle isn’t enough, we also have to pay for everything out of pocket. I’m going to give you a rough breakdown of what we could expect to spend for our miracle baby.

• Consultation with Reproductive Endocrinologist (usually between 30-60 minutes) – $200-500.
• Pelvic Ultrasound to evaluate pelvis and uterus (these are done at the beginning of your journey and regularly throughout to monitor the goods) – $150-500.
• Blood work – $100-400 per test.
• Semen Analysis – $50-300.
• HSG (see previous post Hysterosalpingogram..Whaaa?) – $800-3,000
• Clomid medication – $10-100 each round.
• Monitored Clomid round (blood work, medication, ultrasounds, sperm processing, insemination) – $800-4,000.
• Intrauterine Insemination (IUI, artificial insemination) – $300-1,000 each round.
• Injectable Fertility Drugs – $1,500.
• Monitored round with injectable fertility drugs – $2,000-3,000.
• In Vitro Fertilization (IVF) – $11,500 and up.

I could continue, but I think you get the gist of it. Someone who does only one round of everything above, and get’s their baby from the first IVF attempt will still spend upwards of $25,000. The IVF success rate for a woman my age is 43%, so there is a chance I would need to do a second round. Basically, it is unobtainable for a couple to have a child if they need Infertility treatment. Unless I sold my kidney on the black market, that is.

My question is how can an insurance company tell me what is or isn’t medically necessary? Being infertile can cause depression, feelings of no self-worth. It breaks up otherwise happy marriages. It takes the main thing that women were put here to do, procreate, away. It is listed as a “disease” in every insurance pamphlet I looked through, yet they refuse to help cover it. Can you think of any other “diseases” that aren’t covered, and it is just considered acceptable? Should we stop treating cancer, Cystic Fibrosis, MS? When an ex-alcoholic has cirrhosis of the liver, and they get added to the transplant list and cured using state funds, am I not supposed to be bitter? I have an organ in my body that doesn’t work correctly, and I did nothing to cause it. How can they decide this is just not worth fixing?

As I guessed, this turned into a rant. Knowing what I am up against after my break from trying to conceive is stressful and scary. I’ve already paid thousands towards this baby I may never have, and it’s just the tip of the iceberg. There are 15 states so far that have insurance mandates requiring employers to offer coverage, and I’m confident the numbers will rise. I’m going to stay persistent with educating those who may not know, and fighting our rights to be parents.

Cyster Love,

Heather

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