Financing fertility treatment can be a significant challenge for many prospective parents. Since most health insurance coverage is provided through an employer, the first step to financing treatment often begins at work.
While fertility coverage specifically is not mandated in Tennessee, some employers may choose to include fertility treatment coverage in their health insurance benefits package. According to Mercer’s 2021 National Survey of Employer-Sponsored Health Plans, 32% of small employers (i.e., those with 50-499 employees) and 61% of large employers (i.e., those with 500 or more employees) offer some type of fertility insurance coverage. Employers in the technology, consulting/accounting, and banking/finance industries are the most likely to offer fertility treatment coverage, as are large retailers like Target, Starbucks, and Walmart.
Talking to Your Employer About Fertility Care Coverage
To find out if your employer-provided health plan covers fertility treatment, speak with the benefits contact within your human resources department. You could also call the customer service number on the back of your insurance card and ask about coverage.
You’ll want to ask more than whether or not coverage is offered on your plan. If your employer offers the option of several plans, be sure to ask about the following:
• Which plans, if any, offer coverage? This is especially important during open enrollment so you can consider switching.
• You’ll also want to know details of the plan, such as whether or not there is a waiting period before you can access the benefits,
which specific procedures are covered, and any age limits on coverage.
Just because a plan offers coverage, doesn’t mean your insurance company will pay for everything related to your treatment. If your plan does cover fertility treatment, do the following:
• Ask for a copy of the plan in writing so that you can review it carefully.
• Confirm that you understand your deductible, what is applied towards the deductible, your co-pay, and your networks.
• Confirm whether pre-authorizations for treatments are required, and if so, how that process works.
• Review your plan periodically throughout your treatment and make sure you understand how everything is covered and what you’ll be responsible for paying.
Our financial counselor can guide you through your insurance plan and help you understand what’s offered. Be sure to tap into this valuable resource – you’re not alone in trying to understand your options!
What if Your Employer Doesn’t Offer Fertility Insurance Coverage?
Consider asking them to add fertility coverage to one or more of the health plans offered! The argument for offering fertility coverage is quite strong – infertility is a common issue that affects about 17.5% of the global population – roughly one in six adults worldwide. Given the prevalence of infertility, it makes sense that employers would consider offering support for workers facing it.
Offering coverage for fertility treatment, including IVF, hasn’t been found to increase insurance premiums in the vast majority of cases for group plans. In fact, including fertility treatment in plans may actually lower costs overall as it allows patients to shape their treatment based on medical needs rather than on what they can pay for. If a plan allows for several IVF cycles, for instance, a patient may not feel pressured to use as many embryos in a single cycle, which lowers the risk of more complicated and potentially costly higher-order births.
RESOLVE has a number of resources that will help guide your conversations with your employer seeking coverage for fertility treatment. Resources include a section for employers and a section for employees which includes a sample letter.
As with everything on your journey toward parenthood, being an informed, empowered advocate is key. Need guidance? We are here to help.
Fertility Insurance Coverage FAQ
How do I know if I have fertility treatment coverage?
To know if you have fertility treatment coverage, review your health insurance policy or contact your insurance provider. Look for specific language regarding fertility treatments and coverage details.
Can I pay for fertility treatment out of pocket?
Fertility treatments can also be paid for out of pocket. Costs can vary depending on the treatment type and other factors.
Are there alternatives for financing fertility treatment in Tennessee?
At Tennessee Fertility Institute, we offer several financing options to help you navigate the path to parenthood while lessening the financial burden. Through our partnership with Bundl Fertility™, we offer aspiring parents the option of combining multiple fertility treatment cycles into one package for a reduced up-front cost. If your treatments aren’t successful, you may be eligible to recoup some or all of your investment. We also offer additional financing solutions through Future Family, Lending Club, and CapexMD.
Learn More About Fertility Insurance Coverage in Tennessee
If you’re considering undergoing fertility care for your family-building journey and want to know more about your insurance options, we encourage you to connect with Tennessee Fertility Institute. In addition to exceptional fertility care, our team will also help you navigate your coverage and make the most out of your benefits whenever possible. To learn more about fertility care and insurance coverage, contact Tennessee Fertility Institute today.