Financials and Infertility
Welcome to the world of financials and infertility. Working through the financials that accompany fertility treatment is one of the most daunting and frustrating things for our infertility patients. Little is harder for us at FIRM than seeing a couple miss out on their dream of having a family because of monetary constraints. As a result, we do everything we can to lower the barrier for our patients. Here are a few best practices that we’ve learned over decades of being in the field of infertility.
Know Your Insurance — The Devil Is In The Details.
Unlike some of the northeastern states, Texas does not have a legal mandate that requires insurances to cover infertility. This means that insurance plans are all over the place. If you have insurance, your insurance is going to fall into one of three categories: it will have no infertility benefits (somewhat common), it will have partial infertility benefits (most common), or it will have complete infertility coverage (least common). The best way to find out what box your insurance falls into is to go the old-fashioned route, and spend 40 minutes on the phone with them to figure it out.
When you are on the phone with your insurance provider, you need to be sure to ask the right questions. Per insurance companies, an infertility treatment cycle is broken into four phases: diagnostic testing, medications, monitoring, and treatment. Each phase of the treatment has a cost associated with it, and the more boxes your plan checks off, the less you will have to pay out-of-pocket. In the best-case scenario, all those boxes will be checked. In the most likely scenario, you will probably have testing and/or monitoring coverage. In the worst-case scenario, none of the boxes will be checked. One of the most important things is even in the worst-case scenario, don’t give up hope. There are still a myriad of options available to you.
Plan B, C, and Quite A Few More.
So you’ve gotten off the phone with your insurance company, and you come to the realization that you will still face some significant out-of-pocket expenses. Your goal should be to see what you can do to whittle down that out-of-pocket figure to a point where infertility treatment is a feasible option for you. Here are three ways to go about doing that.
- Financing - There are a number of companies that provide financing specifically for couples seeking infertility treatment. Generally, the interest rates are based on your credit score. If your score is good, this can be a great option. Do a simple Google search; you’ll find a plethora of vendors.
- Discounts - Discounts are a big deal in the world of infertility. Infertility is one of the few remaining medical fields that have not been largely consolidated by regional and/or national healthcare organizations. This means that most clinics are still run as boutique operations, which consequently means that they have a lot of discretion in how they handle individual cases. Most clinics have discounts for cash-pay patients. If you are a teacher, police officer, or a member of the armed forces (active or retired), there is a good chance that the clinic has specific discounts earmarked for people just like you. Don’t be afraid to ask the clinic in question…chances are they have discounts but do not advertise them widely.
- Save - This is tried-and-true advice. Just because you can’t afford treatment in 2017, don’t give up hope. A bit of dedicated saving can make it a very real possibility in 2018. My advice to you would be to do an initial consult, get a realistic idea of what it will cost to run a successful treatment cycle, and then save to meet that goal.
We also have an in-house muticycle discount plan option for cash pay patients. We typically can offer up to a 25% discount on your 2nd cycle and up to a 50% discount on your third cycle. No other clinic gives this kind of discount to all cash pay patients, regardless of their prognosis. We here at Frisco Institute for Reproductive Medicine do this to help encourage you to continue treatment and not give up due to financial constraints. We have seen that many patients can and will get pregnant if they stick with it. Cumulative pregnancy and live birth rates can increase with the number of treatment cycles in the appropriate candidates.
Here at FIRM, we take a very hands-on and holistic approach to working with our patients throughout their infertility journey—and that includes the financial component. When you come in for a new patient consult, you’ll sit down with one of our financial counselors who has already done the research leg-work for you. The goal is to give you the most accurate information so that you are empowered to make the best decision for you and your family. We would love to work with you and help you build your family.