Brenda Messick, Business Manager
Georgia Reproductive Specialists
Atlanta, Ga.
It's no secret that infertility
treatment is often expensive and, as coverage is
not mandated in every state, insurance coverage is not
always available. However, finding out that you have
limited or no insurance coverage does not have to mean
the end of your journey to parenthood. As a patient,
it is important to find a practice where you feel comfortable
and also one that you believe has your best interest
at heart. A quality IVF center will do everything possible
to assure that the cost of treatment does not become
a major factor in the decision to forego treatment.
There are a number of ways to make treatment more affordable
- it's important to do your research before selecting
an IVF center so you can find out which centers provide
the best options for you!
Many centers offer a refund program,
often under the name Shared Risk or Family Building,
which allows patients to pay an up front, flat fee for
a set number of IVF cycles in a certain time period.
If the patient does not conceive after completing all
of the cycles, they are given a refund minus, in most
cases, a minimal enrollment fee. Third parties such
as IntegraMed and ARC administer these programs for
many centers, while others are run directly by the center.
The details of each program are different; for example,
some may count frozen embryo transfers as a separate
cycle while others may count all fresh and frozen embryo
transfers from one retrieval as a single cycle. It is
important to understand all the details of the program
before committing to it because, as the name implies,
there is a "risk" involved. Couples who become
pregnant during the first cycle will pay more by participating
in these programs than they would with traditional fee-for-service;
however, couples who achieve pregnancy in future cycles
will save money.
There
are many advantages to this type of program. The most
obvious advantage is the promise of a refund if there
is not a successful pregnancy by the completion of all
cycles. Another advantage is the effect that participation
in the program can have on a patient's anxiety level.
We have had many patients tell us that they were not
so nervous and anxious during treatment because they
knew that all of their hopes for a family were not riding
on just one cycle…if things didn't go well they
got more chances and, ultimately, money back with which
they could continue treatment or pursue other family
building options such as adoption.
Following
is an example of the parameters of a Shared Risk program
to give you a better idea of the way these programs
work:
The IVF Shared Risk Program is offered to women age
37 or younger who have normal ovarian reserve, no evidence
of uterine abnormalities and have had no more than two
prior IVF cycles. The one-time fee for Shared Risk is
$20,000, covering the cost of up to three IVF treatment
cycles in two years. One cycle is defined as the transfers
of all fresh and frozen embryos from a single retrieval.
If all three attempts fail, the couple will receive
a refund minus the non refundable enrollment fee, which
ranges from $2500 to $6500 depending on the age of the
female and number of prior IVF cycles.
As mentioned, each center offers a variation of the
program so it is important to do research and find out
which one best fits your needs.
A common complaint is that the
cost of infertility treatment is not only high, but
also often hard to predict. Prepaid treatment plans
were developed to allow patients to know, in advance,
exactly how much their treatment will cost. As with
the refund plan, each center that offers a prepaid treatment
plan has different requirements. For instance, in some
centers all couples participating in the prepay plan
pay the same flat amount regardless of their treatment
plan and are then reimbursed at the end of the cycle
for any unused money. In other centers, there is a different
fee structure for each possible treatment plan so each
patient's prepaid amount is customized. The advantage
to this plan is that there are no surprises - all money
is paid up front rather than an ongoing fee-for-service
arrangement.
There are many options available for patients
interested in securing a loan to cover the cost of infertility
treatment. Several local banks have loans available
for couples going through treatment. There are also
loan services available directly through some clinics
and also through third parties including the Family
Fee Plan by CapitalOne and Fertility Treatment Financing
by HealthReady. These programs offer low fixed rates
and low monthly payments for patients who are ready
to commit to treatment but do not have the funds readily
available.
Do
Your Research! - For many patients, every dime and nickel
counts when it comes to paying for fertility treatment.
It is important to make sure everything is being done
to make sure you receive the best care possible, but
also at the lowest cost. If you've called your insurance
company and been told that you do not have any benefits,
it is wise to give your provider the insurance information
anyway. Many centers have specialists on staff who work
to verify insurance benefits and oftentimes can find
coverage for diagnosis or medications when the patient
thought there was nothing available.
Another
way to reduce the overall cost of treatment is to do
price comparisons before purchasing your medications.
In addition to the local pharmacies that supply infertility
medications, there are also a number of mail-order pharmacies
that can provide your medications in one to two days.
A few phone calls and online searches to compare prices
could end up saving you a significant amount of money!
Freedom Drug and Portland Pharmacy are a few of the
mail-order pharmacies that specialize in fertility medications.
It
is important to gather all relevant medical records
before your first appointment with a fertility specialist.
In order to give you the most effective treatment possible,
your physician needs to have your complete medical history
and access to past test results, physician notes and
treatment plans. In many cases, the physician is able
to get significant information from your records and
can then bypass certain costly diagnostic tests and
procedures.
Infertility
treatment often causes a great amount stress and anxiety
for a couple. By doing research and reviewing all financial
options, it is possible to eliminate the financial stress
early on. Talk to the financial coordinator at the center
where you are undergoing treatment and find out exactly
what your options are and then do some investigating
on your own. Don't be afraid to ask questions during
any part of your treatment, whether it is during a meeting
with the financial counselor or an appointment with
the physician, and don't ever lose sight of your ultimate
goal…a baby!
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