Infertility, Insurance, and Insanity- Part One

Once and a great while there is an upside to our failure to conceive. For instance, we learned Friday that we saved over $11,000 on our 2013 taxes due to our outrageous out-of-pocket medical expenses. Of course we would rather have a baby and the money even if it means we had to pay more in taxes, but you have to celebrate the small wins in life.

Our tax benefit was so great because we pay 100% out of pocket for our procedures. Our medical insurance does not include fertility treatments and we live in a state that does not mandate coverage. We racked up a ridiculously high deduction because we completed two fresh cycles and one frozen cycle last year over the course of multiple extended out-of-state trips. Our deduction that was ironically greater than the deduction for an additional dependent would have been.

Yay us.

Just think, if the government required fertility treatments to be covered by insurance they would have $11,000 more dollars to spend.  In addition, more people would have babies which would also increase the tax base. More money would be spent on treatments, competition would increase, costs would come down, and insurance premiums would barely budge due to the relatively small number of claims compared to more common treatments like Type 2 diabetes or smoking induced illnesses.

Image: Andrew Magill via Flickr

Image: Andrew Magill via Flickr

So why not cover fertility treatments?

According to some, there are a number of reasons why infertility should not be covered. Over the course of a few posts I plan to tackle them all.

Insurance Coverage Fallacy Number 1- Infertility Treatment is Elective and Should Not Be Covered

I mention diabetes and smoking induced illnesses because one common argument against covering fertility treatments is that most of the 90% of people who have never faced infertility view treatment to have your own genetic child as “elective.”

For most people, the powerful desire to conceive, carry, and give birth to a child is no more elective than eating too much junk or smoking is to those addicted to bad food or cigarettes. Before you get all worked up, yes,  I know there are type two diabetics who eat healthy, make good choices, and exercise only to still be plagued with the illness thanks to bad genes. I will likely be one of them someday given my family history coupled with the fact that I developed gestational diabetes when pregnant with Spork.

I also know there are many people who never  smoked a day in their life who battle serious respiratory illnesses. My father passed away at 41 from throat and lung cancer and never touched a cancer stick.

So I think I am pretty safe drawing these correlations.

Now that I have addressed the exceptions, let’s honestly talk about everyone else.  Smokers choose to inhale toxins proven to cause serious health issues, yet treatment for emphysema and lung cancers are covered by insurance. Many diabetics choose to eat crap despite knowing the potential costs and risks. These choices and treating the outcomes are expensive but are fully covered by insurance.

Yet infertility is not covered by most company plans and only 15 states mandate some sort of coverage.

Unlike diabetes or smoking related illnesses, infertility is not typically caused by choices couples make in life. Most commonly, infertility is caused by circumstances outside of the couple’s control. Dealing with this hardship causes enormous emotional pain, not to mention a massive financial burden that puts a significant strain on a couple. Modern companies who care about the well-being of employees choose to offer insurance coverage in order to provide for a productive and focused workforce. Unfortunately that situation is all too rare.

The fact that fertility treatments are not covered is a sad situation which is at least in part due to how quiet sufferers are about treatments, its causes, and its many emotional, financial and physical burdens. If infertility affected more people and we were more open about it, it would be impossible for a politician or employer to fail to support coverage and remain in business.  Alas it affects only about 8% of us, and of that number there are many who do not want to pursue aggressive options like IVF.

Which leads me to the next common argument against covering fertility treatments which I will attack in Part 2.

Insurance Coverage Fallacy Number 2- If Fertility Treatments Were Covered People Wouldn’t Adopt


9 thoughts on “Infertility, Insurance, and Insanity- Part One

  1. I wouldn’t hesitate to throw in there that i infertility is generally thought of as a woman’s problem, and women’s health issues are always a battle.

  2. Great post. Congrats on your refund. I spent somewhere between $8000-$9000 for the twins, some of which was covered (thank goodness) I think treatments should be covered because studies show that you are less likely to get multiple births with IVF than IUI but IUI is much cheaper so people go for that option. Same think with IVF, if people weren’t so worried about only having one shot they would be more willing to only implant one embryo instead of three (although as I mentioned in the first point, Drs. have really limited the number of embies they will transfer).

    • Great points Shannon. I’ll work on including them in future posts.

      Oh how I wish the $11k was a refund. Bill is self employed so assuming he has a decent year we always cut a check on 4/15. Sigh.

      But at least this year’s check is minimal thanks to our misadventures in baby making.

      • Sorry, I didn’t mean to say it was a refund rather than a claim, I am just so exhausted right now!

  3. You are spot on. My husband is a urologist, and through his work I’ve learned that penis pumps, for ED, are covered by almost all insurance companies. Apparently the right to have sex is more of a priority than the right to carry a child.

  4. Congrats on your windfall (sorry you “earned” it)! Fabulous idea for posts (insurance coverage for fertility treatments) – I absolutely love it!

    • Thank you. For future posts I want to make better fact based arguments and maybe in the end boil it down into a simple one pager people can give congressmen and employers.

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