Top Questions About Affording Infertility Treatment Answered by a Financial Counselor
How can I afford infertility treatment: A question that nearly every patient asks themselves, and many find challenging to answer. It is one of the biggest barriers associated with beginning the journey to overcoming infertility, and typically the last thing a patient or couple trying to conceive, wants to think about. The Shady Grove Fertility Financial Counselors, or, our affording infertility treatment specialist superstars, are at your service to explain the cost of treatment and the extent of your infertility insurance benefit prior to initiating therapy. Their expertise allows them to help maximize the insurance benefits that may be available to you through your insurance plan.
We asked one of our fabulous Financial Counselors from the Rockville, MD office, Caitlin Sanchez, some of the questions that she receives from patients on a daily basis. We also asked for some advice and tips that would help patients prepare themselves for the financial portion of their fertility journey. Here is what Caitlin had to say:
Common Questions – Affording Infertility Treatment
I’m getting new insurance, what do I do?
Because insurance is employer driven, patients are advised to call their employer or HR Department for details, or contact their insurance provider directly. Coverage may vary based on the location of your employer. For example, if a patient lives in Virginia, but the employer is located in Maryland, their insurance may be subject to the Maryland Mandate, which provides benefits for infertility treatment. Furthermore, if a patient’s insurance is through a Maryland employer, we recommend that the patient becomes familiar with the Maryland Mandate.
What can a new patient expect for the financial consultation portion during their first visit?
At Shady Grove Fertility, the financial team verifies their benefits prior to coming in for their first visit. Even if the patient’s insurance policy says treatment isn’t covered, we will verify with the insurance company, just to make sure. The patient’s financial counselor will provide an estimate of how much coverage their insurance will provide for treatment. However, it is important to note that our estimate isn’t guaranteed until submitted it to the patient’s insurance; there is a chance that the patient will either have more/less coverage than we anticipated. Approximately 90% of patients have coverage for their initial consultation and about 70% of patients have some coverage for infertility treatment.
What do you advise new patients to do before they come in? How can they feel more prepared?
It is helpful for the patient to understand a little about their insurance prior to meeting with their financial counselor. Insurance can be overwhelming, so having a little bit of understanding of their insurance coverage may help them gain some control over their fertility journey.
We advise new patients to call their employer and speak with their insurance company. Also, insurance companies use specific “fertility lingo.” When speaking with an insurance company, a patient will often ask about coverage for fertility treatment and although they are correct, insurance companies might not recognize what they are asking. Try asking about: “In Vitro Fertilization” and “Artificial Insemination.”
More information on understanding your benefits
We are both getting tested for infertility, whose insurance can we use?
Whether you and your partner have a joint plan or separate benefits, insurance coverage for fertility treatment is determined by the patient receiving treatment. For example, in the case of male factor infertility, we would still have to use the female’s insurance because she is still the patient being treated with either IUI or IVF.
If there is no female partner, please contact your insurance company for details.
What should a patient expect if they don’t have insurance coverage? What are their options?
The hardest part about affording infertility treatment without insurance coverage is that a patient must pay in full prior to treatment. The good news is Shady Grove Fertility has an extensive list of unique financial options for patients who do not have insurance coverage. These include:
- Shared Help Fertility Treatment Discount Program
- Multi-Cycle Discount Program for IVF
- Shared Risk or 100% Refund Guaranteed for IVF and Donor Egg
- Shared Donor Egg
- Financing through Fertility Finance
- Global Fees
- Discounted Medication Programs
- Cade Foundation: Grants for Fertility Treatment and Domestic Adoption
- Pay It Forward Fertility Foundation – Grants for Fertility Treatment
- Medicard Patient Financing (for Canadian Patients)
If you would like to learn more about affording infertility treatment or are ready to schedule an appointment at Shady Grove Fertility, call one of our New Patient Liaisons at 877-971-7755.
