Making Fertility Treatments Affordable

Making Fertility Treatments Affordable

Life is not fair. I don't know how many times in the course of a week that I have to say that. It's the only simple explanation I have as to why some folks must endure rigorous testing, invasive procedures, drugs and, sometimes, pure utter emotional hell in their efforts to conceive a child, while others can practically just look at each other and - Poof! - another little bundle of joy is on the way.

Once you admit that fact and get past the initial shock of facing a fertility challenge, it's not long before you run head on into another hurdle that makes "fixing" the problem even harder - cost. It's unfair enough that many of us have to struggle to get pregnant. But the struggle is doubled by the fact that in most places, insurance still does not cover even some of the most basic fertility tests and procedures. For others, even insurance itself isn't affordable. So what do you do?

Over my years of fighting my way along the long road of fertility testing and treatment, I've learned a number of lessons about minimizing cost that may help you, whether you're just starting out or you're already involved in treatment. Hopefully these tips will help you save not only money, but potential heartache as well.

GET TO THE RIGHT DOCTOR - right away!

I've said it before and I'll say it again - if you have been trying for over a year to get pregnant (6 months if you're over 30) don't waste time with your Ob/Gyn!! I don't care if you like that doctor so much that you want him/her to be your child's godfather/mother - that still doesn't make him/her qualified to do the right tests and help you make the right decisions. Please - get to someone whose business it is to GET women pregnant, not see them once they're already in that condition! The best doctor to see is a Reproductive Endocrinologist (RE). But, at the very least, go to a board-certified Ob/Gyn who ONLY sees patients who are TRYING to get pregnant. A qualified doctor may cost more per visit, but spending the money to get the right care will cost you less (cash, time and emotional distress) in the long run.

There are a number of ways to find a good doctor. First, check out to see what REs or Ob/Gyns practice in your area. Second, ask around to everyone you know that may have had problems getting pregnant. Ask people on bulletin boards, chats or mailing lists online of you don't personally know anyone who has been through this. Remember - you're not necessarily looking for reports of instant "success" at getting pregnant under a doctor's care. You're looking for those who have been quickly diagnosed and who have been helped to make educated choices about their treatments by their doctor.

I realize that some women need referrals to see specialists as a result of the lovely HMO system, but I've told many of women before - that's an easy one to get around. If your primary doctor doesn't want to refer you, switch primary doctors. Switch to someone who will give you a referral. It may sound like a desperate measure, but the old saying is true - desperate times call for desperate measures.

INSURANCE - that ugly nine letter word

My husband and I are fortunate enough to have health insurance, and I am thankful for that. Until we faced infertility, I just assumed our health insurance policy paid for just about everything health-related. But then I "heard through the grapevine" that it was rare for any policy to cover infertility, and I assumed ours was no different. I did read the policy a bit and there it was in black and white - no infertility treatment was covered. So we waited - put it off. We hoped that "time" would bring a prayed-for miracle. It didn't. And 3 ½ years later we were still in the same situation - we weren't pregnant and hadn't even seen one doctor.

It wasn't until we finally decided to throw caution to the wind and go to a Reproductive Endocrinologist that I found out that the cost of my initial office visit, all of my initial blood work, hysterosalpingogram, ultrasounds and even a laparascopy were primarily absorbed by my insurance. I didn't want to say anything in fear that it was a mistake and would be caught. I read through my insurance policy once again with a fine-tooth comb and realized that DIAGNOSIS was covered - only TREATMENT wasn't. I was thrilled with what cost I was lucky to avoid.

That lesson should point out that there may be a lot in the fine print that could benefit you. The bottom line here is that you must get intimate with your policy. I realize that reading your health insurance policy is not going to be on your top 10 best reads list this year, but it needs to be a top priority if you want to save money.

One gem I recently heard about was a woman whose policy said it covered "all recombinant gene technology drugs." Did you realize that the newer injectables such as Gonal FÒ and FollistimÒ are recombinant gene technology drugs? This gal used that argument to get her insurance plan to pay for her injectables! They didn't have a rebuttal.

That leads me to my last point with regards to insurance plans - never say never! As much as the fertile world assumes that fertility problems are "all in our heads" the fact of the matter remains - infertility by and large is a medical condition. If you and your doctor can find a cause of the infertility, then you have a strong argument for treatment of that medical condition. If your infertility is being caused by endometriosis, polycystic ovarian syndrome, thyroid problems, bacterial infections, or any one of the other numerous possible causes - use that condition as the reason for treatment. Many of these causes can lead to other more serious health conditions and you need to use this argument to show why your insurance should "pick up the tab."

The very last point I'd like to make in this section is that you should become familiar with your state or country's insurance laws or pending regulation. Although most states here in the US do not mandate infertility insurance coverage, there are at least a dozen states that do have some sort of rules promoting coverage. However, even these states vary in degrees of coverage - from mandating full coverage (including IVF treatment) to only mandating that employers must offer coverage. Many other states also have various degrees of pending legislation in the works.

I work in this field for a living and can hardly keep up with all that's going on with legislation. This alone is one of the strongest reasons to become involved in your country's national infertility support organization. By becoming a member of your country's national support organization, you will be kept abreast of what's legislation is going on.

COMPARISON SHOPPING - now at a fertility clinic near you?

Unfortunately, my best friend Debbie had to learn this lesson the hard way. I have found that most doctors hate having their practice referred to as a business, but let's face it - that's what it is. And sooner or later, like every other business, it will get competition. Believe it or not, this IS happening here already in some areas of our country. (I just returned from Los Angeles a while back and visited no less than 2 dozen different clinics in a 120 mile radius!) And you, inevitably, will benefit from this! Take for instance, the story of my friend who switched doctors:

Debbie went to a noted Reproductive Endocrinologist (RE) for over 2 ½ years and although he did aid in bringing my beautiful godchild into this world, it came at a very high price. It wasn't until Debbie went back to the doctor in hopes of a second child and experienced some problems with his office that she decided to transfer to another RE and found out how outrageously expensive her former RE had been. Just to note, here are some comparisons. Her former RE's charges were: initial office visit - $200, ultrasound - $465, IUI - $450. Her new RE charged her for: initial office visit - $115, ultrasound - $95, IUI - $200. Both doctors had the same credentials and both were in the same geographical area - go figure!

The lesson here should be to make sure that you get their costs up front. You don't want to sacrifice quality for cost, but you should make it weigh into your decision on who you see and just how you're going to go about treatment.

Lastly, let's not forget about the multitude of fertility drugs that accompany treatment. If you aren't one of the fortunate ones to get your drugs picked up by insurance, there are some legal ways of still cutting costs if you need to purchase your medication. (I say legal way here, because I realize many women now trade/swap medication through the Internet - a practice I can understand, but will never condone because of the risk. Please realize that it's not only risky to you legally, but medically and financially as well!)

Nevertheless, once again - shop around. You may like that neighborhood pharmacy down the block that fills your standard prescriptions. But on the average, because they are full service, neighborhood pharmacies usually charge anywhere from $5-10/amp of medication more than some other specialty pharmacies. If you need medication, shop the Internet! There are literally dozens of pharmacies now specializing in lower cost medicine on the Net. And many of them offer not only free shipping, but superior service and next day delivery.

NO COVERAGE/NO INSURANCE - where else to turn?

If you are in this situation, you'll want to make sure that you not only comparison shop, but that you also investigate other avenues of financing your diagnosis and treatment.

Only five years ago there wasn't a single place to turn to. Nowadays, there is hope. One of those avenues now happens to be The Fertility Foundation, a non-profit organization dedicated to helping others financially with fertility treatment.
Many other non-profit larger foundations also offer health-related grants that few folks know about. Get on the Web! Search the plethora of foundations that exist out there. It may be like looking for a needle in a haystack, but you never know what you may turn up!

I have also heard in recent years many stories of women "financing" their treatments through credit cards, secondary mortgages and the like. Although these may be a creative way of "coming up with the cash," be aware that that little bundle of joy isn't going to be cheap once, and if, the treatments work. So try to keep these things perspective. Once again, if you choose to use these methods to finance treatment, shop around. I have even heard of some banks that make low rate adoption and treatment loans available to qualifying individuals, believe it or not.

Last of all, don't forget friends and family. Remember those folks? You know, the ones who keep asking when you're going to have a family and giving unwanted advice? Sometimes it's actually worth the effort to show them on paper what costs you're looking at in given cycle. Who knows? You may be surprised to find how anxious those in-laws actually are to be grandparents!

No matter what your situation, I still believe the old adage is true - where there is a will, there is a way.

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