It’s a sign of the times when the worst problem facing any patient may not be the state of their own health, but the state of their health insurance. This is no less true of infertility coverage than for any other form of insurance. Infertility insurance is vital if you face the prospect of a long journey to conceive using expensive therapies.

In the US many patients have access to basic forms of infertility insurance coverage as part of their employer’s health package. Unfortunately, however, many others who assume they have coverage are sadly mistaken. The issue is complicated by the numerous ways insurance companies attempt to define medical conditions in order, as it would appear to many, to evade financial responsibility.

The fundamental problem centers around insurance companies being heavily profit driven; making the least amount of profit when they have to pay out the most benefits. As a result insurance companies can be expected, where possible, to protect profits by finding ways of restricting the claims of policy owners, or preventing individuals from purchasing policies that are likely to prove expensive for the insurance company in the long run.

New laws will help protect a number of insurance holders – evasions based on claims that infertility was caused by a pre-existing condition may fail under the most recent health care legislation. However, legal arguments based upon the assumption that the ability to conceive is an unnecessary function in a healthy human are more likely to remain a strong legal loophole for insurance companies trying to avoid providing strong proactive infertility insurance coverage.

The core of the debate involves the central definition of health. The ability to survive in good health without having children appears to be a reasonable assumption for many, and by that argument the inability to have children is a great misfortune for some but not actually a matter of health per se. Legislatively speaking, a patient’s battle to obtain infertility treatments is seen as being little different from a fight to receive cosmetic surgery through insurance – a luxury health service rather than an essential one. By this argument infertility insurance is considered to be a luxury insurance only.

The simplest way to ensure that you have sufficient coverage is to specifically purchase an auxiliary policy covering fertility. As with any specialized policy, however, the premiums for such coverage can be relatively expensive. New legal considerations will reduce the problems of pre-existing conditions, making it easier for couples to obtain infertility insurance coverage, but the costs will nevertheless remain high. The advantage, however, remains very real, especially if you already have known risk factors for infertility.

The cost of one round of IVF (in vitro fertilization) is roughly $7,000 (USD). Several cycles are typically needed to come close to assuring conception in those conditions where IVF is appropriate. Additional therapies are generally needed, and certain conditions will require even more expensive therapies. Simple math will make it clear that an insurance policy, even an expensive one, will save substantial money over extended rounds of fertility treatments without insurance.

To find an appropriate infertility insurance policy it is advisable to explore several routes. If you have employer-provided insurance firstly investigate what would be involved in ensuring your policy covers infertility, or what would be involved in extending the policy. If you need to obtain separate fertility coverage, check through your work provider first. It would also be a good idea to confer with insurance agents, and to inquire with your doctor and your support group.

Dr Jan Reid PhD is a former medical researcher, who has personally dealt with the pain of fertility issues, and is passionate about helping others start their own family. To learn more about infertility insurance as well as further information on infertility symptoms, causes and treatments, visit her infertility information website here.