Covering infertility


Right now, the Institute of Medicine panel is weighing in on whether infertility treatments are an essential medical benefit to manage a medical disorder or a non essential benefit, Michelle Andrews writes in a Kaiser Health News column. This is part of the process to determine what will be covered in health plans offered through state-based insurance exchanges by 2014. The IOM panel will deliver its recommendations on essential health benefits to Health and Human Services.

Andrews reveals that 15 states currently require that insurance plans cover infertility treatments. Many employers however have found ways to get around providing the coverage. Only about 20% of employers’ health plans cover ART, according to a 2006 survey of 931 employers. A majority of the companies that do not offer it cite cost as the reason why, but 91% of companies that do offer it say it increased their costs very little according to Resolve: The National Infertility Association.

Many health plans pick and choose coverage. Some cover fertility drugs to stimulate ovulation or intrauterine insemination, some cover a single cycle of IVF, some cover no part at all.

“It’s too soon to know how the coverage issue will be resolved in the health insurance exchanges,” Andrews writes. Apparently, the primary reason most employers provide ART coverage is because their employees ask for it. Be sure to let your employer and your state representatives know how you feel on this important issue.

Source: National Partnership for Women and Families, MedicalNewsToday


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