In addition to raising enough funds for your journey, there are many ways to make the IVF portion more affordable, making your funds go even further.
Understand Your Health Insurance Coverage
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As of 2017, there is no U.S. federal mandate for health insurance companies to provide infertility coverage. There are 15 U.S. states that have infertility insurance coverage mandates requiring that employers provide some form of coverage. Although there are many exceptions, this is the best place to start to see if you have health insurance coverage for IVF and/or surrogacy.
You could call or write your insurance company yourself and see if they will give you a clear answer, or you could have the professionals do it for you at no cost to you. EMD Serono, Inc., a division of the leading fertility pharmaceutical company, Merck KGaA, has a program called "Fertility Lifelines" which you can call at 1-866-538-7879. They will contact your insurance company on your behalf and find out exactly what it would cover. If you find you don’t have IVF or surrogacy coverage and you have insurance through your employer, you could ask your employer to add fertility treatments to current or future plans. Resolve has fantastic templates and tools to help with this.
Sometimes it makes sense to purchase a private insurance plan that does have fertility/IVF treatment coverage instead of going through your employer. Here are some things to consider when looking at insurance plans to purchase. You could consider changing employers for better health insurance coverage, though understandably, this isn't always possible. Many companies do offer excellent infertility coverage. Here is a list of the best companies for infertility coverage in 2016.
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How we did it: We live in Maryland, which is one of the few states with an insurance coverage mandate. Unfortunately, my employer and my husband's employers were exempt from this mandate due to being self-insured. I utilized Fertility Lifelines and learned our insurance would cover intrauterine insemination (IUI) but not IVF. Since I was born without a uterus and hoped to do gestational surrogacy, this coverage level was disappointing for us. I did write to my company’s corporate Human Resources Department asking for my employer to add more infertility coverage, but they were unable to do so at the time. |
Run Expenses Through Your Insurance First
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Even if your insurance states that they do not cover IVF or fertility treatments, it may be beneficial to have your RE bill through your insurance just to be sure. Often, insurance companies cover tests, procedures, or medications that are not only used for IVF or that could also be considered diagnostic. For example, blood work and ultrasounds may be considered diagnostic and therefore covered. Some medications have other uses (such as certain antibiotics) and may also be covered. Ask your clinic/doctor to run everything through insurance first; you might be surprised by how much is covered. The same goes for your surrogate, ask her to run items such as medication, bloodwork, or a psychologist through her insurance and you may pay lowered agreed upon rates or the copays if they are approved. |
How we did it: My RE was with a teaching hospital and it is my opinion that being within a hospital practice, more items were covered by my insurance then they would have been with a standalone IVF clinic. Also, since my insurance covered IUI, some tests and procedures that would have been used for IUI or surgery, such as monitoring ultrasounds, bloodwork, and anesthesia for the retrieval, were all covered by my insurance. Some of the medication costs were also covered by my insurance. The embryologist and transfer fees were not covered. |
Use Your FSA or HSA on Medical/IVF and Medication Expenses
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Some employers offer a “Flexible Spending Account” (FSA). HealthCare.gov explains that a Flexible Spending Account (also known as a flexible spending arrangement) “is a special account you put money into that you use to pay for certain out-of-pocket health care costs. You don't pay taxes on this money. This means you'll save an amount equal to the taxes you would have paid on the money you set aside.”
This would be most helpful for the IVF portion of your journey. The (2017) maximum was $2,500, which both you and your spouse could deposit, so up to $5,000 tax-free towards IVF or medical expenses. The risk is that your FSA funds expire 12/31 of the same year, so this is most helpful when you can plan ahead and complete your IVF during the same year. |
How we did it: We contributed to an HSA for several years before beginning our journey, and utilized the money to help pay for services whenever possible. We knew we needed to save up money for surrogacy, and this was a great tax-free way to do so. |
There is another type of medical savings account called a “Health Savings Account” (HSA),
which HealthCare.gov explains as “A type of savings account that allows you to set aside money on a pre-tax basis to pay for qualified medical expenses. A HSA can be used only if you have a High-Deductible Health Plan (HDHP).
High-deductible plans usually have lower monthly premiums than plans with lower deductibles. By using the untaxed funds in an HSA to pay for expenses before you reach your deductible and other out-of-pocket costs like copayments, you reduce your overall health care costs. HSA funds roll over year to year if you don't spend them. An HSA may earn interest.”
For an added benefit, pay for your medical expenses with a rewards-earning credit card, and then reimburse yourself from your FSA/HSA for the tax-savings.
Maximize Your Medical Expense Tax Deductions
Note: Always consult a tax professional before claiming surrogacy specific deductions.
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Some financial advisors may argue that your surrogate’s medical expenses are eligible, others will not. This is a professional judgement call, and may result in you being audited or denied expenses you previously claimed.
The IRS website has a publication that defines what is considered a medical expense, and which expenses you can deduct. I suggest reading the entire document yourself and consulting with a professional. Below is a sample worksheet to track your medical expenses. Remember to track everything medical, not just IVF/surrogacy related expenses, including dentists appointments, Primary Care doctors, and prescriptions.
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How we did it: We tracked anything and everything, but in the end were not able to benefit from the deductions, since our expenses ending up being so minimal, and spread out over two years. | ||
Take Care When Choosing Your IVF Clinic
Prices can vary dramatically between IVF clinics, even those just a few miles apart. In some cases it might be worth a few hours drive to save a few thousand in treatment costs (be sure to factor in the stress this may cause you and wear and tear on your vehicle, since you go to appointments almost daily towards the end!). Do your research on success rates, and read about patient experiences on specific clinics and doctors.
If your clinic is far from your surrogate, you could consider shipping your embryos or driving them yourself to a clinic closer to her for an easier transfer. Weigh the cost of her travel expenses, costs of the new clinic and shipping charges. Do your research!
If your clinic is far from your surrogate, you could consider shipping your embryos or driving them yourself to a clinic closer to her for an easier transfer. Weigh the cost of her travel expenses, costs of the new clinic and shipping charges. Do your research!
Ask For Self-pay Discounts
Many clinics/pharmacies offer discounts for customers that do not have insurance coverage and are paying out-of-pocket. Often, they charge lower rates for self-pay customers. You won’t know unless you ask!
For an added benefit, pay for expenses with a rewards-earning credit card.
For an added benefit, pay for expenses with a rewards-earning credit card.
Apply for Discounted (or Free) IVF Medication Programs
There are several discounted medication programs through leading pharmaceutical companies.
Ferring Pharmaceuticals Inc. has the Heart Beat Program to help minimize costs for individuals undergoing cancer treatments and working to preserve their fertility. Call 888-347-6415 for more information.
Perhaps the most popular discount medication program is the Compassionate Care Program, run by EMD Serono, Inc., which provides income-based savings on medications purchased directly from their company. Visit EMD Serono’s website or call 1-866-LETS-TRY to learn more.
Perhaps the most popular discount medication program is the Compassionate Care Program, run by EMD Serono, Inc., which provides income-based savings on medications purchased directly from their company. Visit EMD Serono’s website or call 1-866-LETS-TRY to learn more.
Research Pricing on IVF Medications and Pharmacies
Look For Active Duty Military or Veteran Discounts
Do Your Research Before Using an International IVF Clinic or Surrogacy Agency
Consider a Natural Cycle (Frozen) Embryo Transfer
Research Shared-Risk Programs
IVF Clinical Trials Are an Option
Consider Genetic Testing of Your Embryos
Consider Embryo Adoption
Delay for Frozen Embryo Transfer