Financing infertility treatment is an expanding business. There are shared risk and financial aide programs at infertility clinics, individuals are crowd-sourcing their medical bills, medical finance groups are making IVF specific loans, and a new internet company  claims they can advocate for discounts at clinics for you – although it is not clear what that means. For better and for worse, for profit or not, Assisted Reproductive Technologies (ART) are expensive and many are looking to play the financial game.

Considering this variety of financial options available, infertility treatment can feel like a gamble. In her recent NYTimes Blog, Amy Klein asks one of the big questions about the IVF gamble, “How much would we be willing to spend?”  For many experiencing infertility and seeking treatment, finances are yet another area where a delicate balance must be struck.  Either extreme – nothing or anything – is not usually the answer but is possibly an extreme exit strategy.  One IVF averages $12,400. Based on the statistics, what if it take 3? What if a donor is needed which adds another $20,000 for each attempt? What if your cash savings is only$10,000?  In other words on top of the ups and downs of the infertility roller coaster, you can add figuring out how much financial risk can be tolerated.

That risk and its emotional toll were major reasons why Hasidah was founded.

Assuming the costs involved for the treatment are legitimate and the statistics reliable, the question of how much we are willing to pay is a difficult one. Beyond the individual decision, there are also larger contextual questions. How can the Jewish community ignore the low birthrate? At a time when the length of young adulthood is expanding and affiliation is contracting, can we risk not addressing those who want to build the Jewish community through children? If we can ease the pain of people experiencing infertility, is this a good use of our resources?

Anybody choosing to start a family is taking a risk. Parenthood is a gamble. But ignoring infertility is too high of risk to take for the Jewish community. It is not only alienating those currently in need, it is severing hope for future generations. We can assume some of the risk by providing financial and emotional support to those who are committed to building Jewish families. Financial assistance for ART could lead to successful outcomes for having children. It could also support better emotional health and financial security for those families. That is not a gamble. That is a good investment.

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Like other types of insurance coverage, many people are unaware if they have insurance  for infertility treatment until they find themselves in need of using it. Some may have coverage but are unaware of the limitations or restrictions. The reality is that insurance coverage varies greatly depending on the state, the medical situation, the treatment, and the individual. And the exceptions can make holes big enough to drive trucks through.

According to American Society for Reproductive Medicine, there are 15 states that have some form of insurance coverage requirements for treatment. Most of them cover treatments (Arkansas, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, and West Virginia) while others “offer coverage” (Texas and California).  The coverage mandate in some states includes in vitro fertilization (IVF), in other states it excludes IVF, and in others it includes only IVF. Moreover being in a state with a mandate that includes IVF (or anything else) does not mean that your employer will provide coverage. Many employers are exempt from the law for a variety of reasons.

In addition to exemptions that can entirely eliminate any infertility coverage, insurance may not cover certain treatments or fertility drugs in all cases. The coverage may have specific medical requirements, limitations on methods, age requirements, caps on number of cycles or lifetime spending limits.

IVF procedures are usually performed after prepayment which means a large out-of-pocket expense since the average cost is $12,400.  In a state without a mandate or if the employer doesn’t provide the coverage for whatever reason, that is a potentially roadblocking cash payment standing in the way of a possible solution to infertility. Someone with insurance coverage of 50% for infertility treatment still has to pay $6,200 cash or equivalent for treatment. That is not small change.

Insurance coverage can be helpful and some coverage is better than no coverage. However there are many exclusions, exceptions, hurdles and holes which often make it less effective. The result is that for many people experiencing infertility, insurance is no solution to the expense of infertility.

[For the chart of insurance coverage by state, see American Society for Reproductive Medicine Insurance: http://www.asrm.org/detail.aspx?id=2850]

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The costs of Assisted Reproductive Technologies (ART) like in vitro fertilization (IVF) can be a serious roadblock for many who might benefit from their use. Helping defray those costs is our goal. Below are a couple recent articles in the news about the costs of IVF:

http://www.healthline.com/health-news/women-the-high-cost-of-in-vitro-fertilization-101613

http://www.resolve.org/family-building-options/insurance_coverage/the-costs-of-infertility-treatment.html

 

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