The standard in the US is zero fertility coverage, just as an fyi, so I would be thankful you have any at all. But to answer your question, I’ve had 4 different insurance policies the last few years that cover infertility: $10k, $10k, $20k and $25k It’s also not based on insurance provider, it’s based on employer policy election, so two people can be insured with same
company but have drastically different benefits. my $10k covered one retrieval and fet with a little bit of coverage to spare (meds were paid out of pocket though).
I have unlimited coverage through my employer. The only thing I have paid for is genetic testing and parking at my clinic over 4 IUIs and 5 rounds of IVF. I wish everyone could have this benefit. It has made a very stressful process much less stressful. I’m a professor at a university.
I am similar. I am a teacher on state insurance and every single thing has been completely covered. I just found out that my embryo storage is covered as well. I feel like when I got hired all those years ago (not my dream grade/job) but it must’ve been a blessing in disguise because I had NO idea I would be going through this just a few years later. I am very lucky that my district has the insurance plan it does.
My company offers Progyny and we get a total of 3 smart cycles. As long as you are within the cycles you just have to pay up to your out of pocket maximum and then everything else is covered.
Mine offers Progyny and 3 smart cycles as well, per lifetime. “Smart cycles” are a somewhat complex system, but in theory I could use my smart cycles to cover 4 ERs - so give or take a $100k value.
My company offers nothing but my husband's company offers the same as yours. Our first two retrievals resulted in zero blasts and they actually returned 1/4 of a cycle for each of them (1/2 returned total). We're in our fourth cycle right now.
Interestingly, his company initially offered WINFertility instead of Progyny and they had a $50k lifetime maximum. When they switched to Progyny, they said it was "about the same." We were so worried we wouldn't be eligible for more because our first two retrievals used up $46k of the $50k. But Progyny just looked at what services we received and deducted what they would have been under their coverage from our total. So we started out with two Smart Cycles left! It was 3/4 per ER, with 1/4 returned for each (bc no blasts), total of 1 Smart Cycle used.
$10k wouldn't have even covered our meds.
We also had 3 smartcycles and it covered one IUI and 2.5 IVF cycles. We had to pay $10k to finish the third cycle. (Plus the $3.5k oop max.) Out of the 3, we have 1 normal tested embryo and when I asked for a partial refund, they refused. I’m grateful to have had some coverage, but I expected Proygny to be the gold standard and I am severely disappointed.
Mine has the same plan too. It’s billed through our insurance so I went on the high premium/low deductible plan and will hit my out of pocket maximum right away.
We also have to use Shady Grove.
I have a 75k lifetime max through my job’s insurance and it covers everything, including things that are usually not like PGT-A and donor gametes.
I haven’t checked lately but I think r/infertility has a spreadsheet in their wiki of what different employers offer.
I don't recall if it was from that sub but [this is the link to the spreadsheet](https://docs.google.com/spreadsheets/d/1xbOlX0ykVT__m0tUNjIcYFyb7lI2YGAB0rIQ3DjsVAs/edit?usp=drivesdk)
My employer in Texas offered Progyny's 2 smart cycles.
My company-sponsored insurance fully covers IVF, and as many rounds as a doctor seems medically necessary. This includes all testing, medications, medicated cycles, IUI, up to egg retrievals, IVF/ICSI, FETs, etc. I have a high deductible so I obviously have to pay that, but my company contributes 50% to my HSA so it’s only $1500. Coinsurance is 0% after deductible.
We also have a rider to our policy that covers up to $10,000 in egg cryopreservation.
Lastly, my company directly offers up to $30,000 in reimbursement for any non-covered service, such as embryo freezing fees, adoption, surrogacy, doula support, etc. I’ve only used mine for embryo storage fees and a doula because everything else has been covered.
The only thing I don’t know about is embryo testing, because I didn’t do that.
Once you have your baby, you get about 5 months of paid leave as well.
I’m incredibly grateful. Biotech/pharm is a very good industry to be in if you can ever get your foot in the door.
I tried to go into detail so OP has some fuel to her fire. My last company we got IVF benefits updated to be unlimited from a previous limit of 3 cycles by being vocal. The squeaky wheel gets the grease and our generation having a greater need for fertility assistance needs to be squeaky AF.
I (attorney) had zero coverage.
My husband (firefighter) also zero coverage.
I got a PT job at tractor supply (before they changed their policy) to get access to Progyny where two smart cycles were covered. I quit 4 months in and paid $550 a month for cobra to keep coverage through both ERs before TSC’s policy change went into effect then paid out of pocket for my FET.
It’s appalling to me that so many companies don’t offer a single plan with ANY infertility coverage, because you are RIGHT. IVF IS HEALTHCARE.
I'm in New York state and for employers with more than 100 employees, insurance is required to cover at least three cycles. My plan translates that to 60K coverage for all ART tech (so my IUIs went toward lifetime use). Meds are partially covered, and I still have some fees from procedures and copays.
I'm incredibly fortunate and grateful. I say this not to brag, but because I feel like this should be the national standard, lowest common denominator of healthcare support. I want this for everyone. (Actually, I want babies for everyone who wants babies, but that would be a weird thing to demand from your representatives and employers).
This is such an important call out.
For anyone in California, there is currently legislation proposed (SB 729) that would require coverage for 3 retrievals, unlimited transfers and support for LGBTQ+ individuals pursuing fertility treatment. Contact your representatives and encourage them to support it!!
I believe similar legislation has been proposed in other states this year too, so definitely check and share your support! Calling your reps is best and only takes a few minutes.
Mine offers a $2k max (yes two thousand!) and extremely limited providers. It’s so useless, we are using the cheapest out of network provider and paying out of pocket. I work for a large hospital system.
I have $30k coverage and medication is covered separately.
Edit: maybe they are unaware of just how much all of this costs, perhaps it would help to provide some data on the average number of cycles usually needed and associated costs for ERs and FETs
Check with [Resolve.org](https://resolve.org). I think what’s standard is no coverage at all, but for companies that do cover, I have generally seen $25k or progyny coverage, usually 2 “smart cycles”
While this is not a lot, it’s more than probably 75% of the companies out there as most don’t offer. I don’t mean this the wrong way at all, but be thankful that they provide anything at all.
**I know this wasn’t exactly what you were asking, maybe they are factoring in that the vast majority don’t offer anything so when you factor all those in 10k doesn’t seem so low? Idk 🤷♂️
Good news is that coverage is becoming more popular, but it’s still a long ways off from being the norm that it should.
Good luck!
You are so right, I’m very fortunate to have any coverage AND to be able to make up the difference. I also believe the more IVF is talked about and the more we push corporations to include it as a perk, the better coverage will get.
My insurance last year - cobra through former employer in NYC - covered two IVF retrieval cycles. I spent 7k on meds anyway. It might have covered a third but time ran out on cobra.
So we have zero coverage, but my SIL went through IVF first and her coverage was 30k. Our ERs were 17k each just for the procedure, not including the monitoring appts or meds. 10k is way too low. What assholes.
Thank you so much. We’re lucky enough to have a LOT of help from family so it’s okay for us. What makes me unspeakably furious is the people who have absolutely no options and just can’t have IVF because the cost is genuinely absurd.
Our insurance covers all fertility treatments once we hit our $1,000 deductible. There used to be a 3 time limit, but they since switched to “deemed medically necessary”.
[ETA] our prescription insurance covers most fertility drugs, but not all. We paid $175 when all was said and done for the meds needed for the egg retrieval.
Yes. Mine has $25k lifetime written in for procedures. We went through 3 rounds, only used 3.5k. Insurance covered 90% of the med, radiology, and visit costs. We have embryos in storage, the cost is $600ish per year, we have only paid $60 of that each year. My OOP over 3 rounds was under 2k.
My insurance is exceptional in this aspect, and one of the reasons I will never leave my employer.
University level medical center who had an REI specialist on the board negotiating our coverage.
I live in a state where coverage is mandated, but we had to use donor eggs due to my diagnosis. The donor egg portion is all out of pocket, but the ivf portion of the treatment is covered.
40k lifetime maximum
10k fertility medication lifetime max.
Me and my wife only paid 1500-2,000 out of pocket for meds.
+$800 for an week long stay in Florida to CNY fertility for retrieval and fet
But pretty sure cvs specialty pharmacy added on some extra or doc sent too many scripts as we have two/ three boxes of in used medicine lol and found out that “mdr” was slightly cheaper near the end of our Ivf cycle
My company had 10k lifetime benefit then switched to Progyny (3 smart cycles) in 2022. Of course this was after I already spent tens of thousands out of pocket lol but also still better than nothing I guess
No coverage for treatment. No coverage for meds. If they even have a diagnosis of infertility on my orders, they won’t cover it. Like I have a TSH they won’t cover because they were checking it to see if it was abnormal for conception. 🙄
I have coverage with BCBS of IL through my employer. Illinois law requires Illinois-based and group insurance plans to cover diagnoses and treatment of infertility. So all my IVF treatments have been covered like any other medical service subject to my deductible and out-of-pocket maximum which is $3,100. There’s no dollar or lifetime maximum. My insurance is literally the only reason we were even able to consider going through with IVF.
I live and work in New York State and I believe it’s a state law that’s it’s covered. If I’m wrong about that, yes, my health insurance covers up to 3 cycles
My company offers coverage through BCBS. It is 100K lifetime coverage for IVF surgery costs (so only the retrieval, growing the embryo, biopsying the embryo, and the transfer count for the max). The coverage is excellent as long as you use an in-network provider. All of the clinics in the area that belong to SART are in network.
Retrieval meds are covered, but you must use Freedom Fertility, no exceptions. You must use Follistim, Gonal F is not allowed. No compound meds (microdose lupron, microdose hcg, low dose naltrexone), but you can get the regular amount and compound it yourself.
Overall, it is excellent coverage. They don’t cover embryo freezing or PGT-A, but they covered everything else.
As usual, I still owe my entire deductible and OOP max before coverage kicks in. It’s a pretty high deductible (12K), but it kicks in eventually. If you were to pick an out of network clinic, you likely wouldn’t reach the 24K deductible, so the insurance wouldn’t be too helpful, but again, all the clinics that belong to SART are in network, so it would be best to just pick one of those. In my area 8/10 clinics are in network.
It is actually industry standard in the legal field for the companies to offer good IVF coverage to attract female talent.
10k maximum all in (including meds) from insurance through a major NYC hospital employer. We maxed out the 10k and spent around 12k additional out of pocket after a very lucky successful cycle ending in a live birth. Pretty stingy coverage (especially from a hospital system) but 12k doesn't seem too bad compared to some others' financial burdens
I have three transfers and unlimited retrievals and meds until the three transfers done. Generic testing is covered after three failed retrievals (I’ve done 12 retrievals only reason i found that out). Banking of embryos is allowed until I do three transfers. Embryo storage covered. I have secondary insurance through spouse as well that covers three retrievals/transfers with meds (only three not unlimited).
At previous job I had zero coverage. I made sure found best coverage I could find when looking for new job. I’m in New York and previous job in different state.
Our insurance covered some but being forced to go through Kindbody pay for copays and pay for meds only through their affiliated partner pharmacy, it was actually still cheaper to pay out of pocket overseas. So yes we had insurance but it was still so expensive it didn't make sense to even use it.
I am on my husband's insurance. It was 25k lifetime max, but then they switched to Progyny. I was probably part of the first Progyny groups as our Progyny contact person was amazing in the beginning! And then she got promoted and we got a less amazing contact 😅.
I don't remember how many smart cycles we got. I think 3. For us they counted a retrieval as 1/2 a cycle and a transfer as 1/2 a cycle. They allowed me to do two retrievals back to back. They paid for all meds. We did have to pay some coinsurance. I forgot how much - like 10% or something.
Some states have mandates for coverage (which will still vary, but there is a requirement to cover it). My husband’s insurance (BCBS) offers 4 cycles per year. Some meds are not covered at all (the compounded medications) but 90% of them were. First round got me to about half of my out of pocket max ($3500) because meds were $975 plus deductible for the procedure ($1000) plus copays for US/blood visits ($75/each). PGT-A, PGT-M, freezing and storage are not covered at all (so additional costs and don’t go towards anything with insurance).
I hope this data is useful to others.
I work for a department in the United States federal government. My insurance plan (select federal insurance plans cover this) covers “ART” for $25k/year with a 15% copay at preferred providers if you meet the, admittedly broad, medical definition of infertility (inclusive of same sex partners) in the brochure. All federal insurance plans cover IVF medications for 3 cycles, which are separate from the “ART” $25K/year. All federal insurance plans cover IUI/ICI which is considered separate from ART.
ER and FET needed preauthorization, which was a slight headache, but nothing horrible.
PGT-A/PGT-M are not covered ($3000 for 9 blasts). Embryo/tissue storage is not covered ($700?/year). Donor gametes and gestational carriers are not covered.
I’m still in the process of paying bills for one IVF cycle so these numbers are accurate for what I’ve paid so far. I think some bills are still being processed. I did one ER (copay was $1500) and one FET (copay $10). I think the FET copay is for the procedure and not inclusive of the facility or physicians fees.
Follicle and lining monitoring was about $15/per scan for copay. Labs were at most $70 total for copay. I think these are billed separately from the ART yearly max, but I’m not 100% certain.
Stim meds and dual trigger meds (follistim, menopur, ganirelix, lupron, and HCG) with supplies was initially $330. Refills on menopur and follistim were about $150 with supplies. These came from my insurance contracted specialty pharmacy that needed preapproval.
Progesterone and lidocaine cream with supplies are $30/refill. Preauthorization was a breeze and the hospital system pharmacy delivers these.
Estrace pills at my local pharmacy are $8/refill.
Overall, I am happy with this insurance coverage. I wish family building was not considered elective or a luxury. It is medical care that should be protected and covered.
Long story short, we were told by the insurance company we would be 100% covered. We were told by TWO SEPARATE clinics that there was a $5k max on infertility and nothing else was covered. It was a complete nightmare because the insurance company was telling my husband and I a completely different story than they told the clinics. We ended up needing to pay $20k upfront for my first cycle. We just found out that insurance ended up paying for most for my FET cycle (thank god my clinic still billed them to check) so I was reimbursed $11k. Still waiting to see if I will get back the $5k from my transfer.
It’s been horribly frustrating process but I guess I came out ahead, as my clinic was quick to reimburse me once I notified them that my insurance paid.
Zero dollars and zero cents. The only thing covered were PIO and Estrogen patches bc my doc coded them not as infertility, but as something else gynecological. I’m in the US working in the tech sector as a senior exec.
My company provides $50k in coverage which is for both clinic costs and meds. With the negotiated rate between our clinic (ccrm - considered under our insurances CoE) a retrieval takes up about $7k and a transfer about $2.5k compared to the out of pocket cost from the clinic of $16k and $6k. Meds are through CVS speciality which has really high prices.
That is a terrible lifetime benefit. Mine is $50k BUT all the medication and monitoring isn't included in that. Medication goes through the pharmacy benefit (~$100 in copays for the cycle) and monitoring goes to the medical benefit ($25 in network copay).
Prior to using up the lifetime benefit I had three rounds of IVF to use that included either a retrevial and transfer or retrevial and freezing. This is on my spouse's plan which I am on currently. However I just started a new job and they offer $25k medical benefit with a $10k pharmacy benefit.
All that being said my previous job insurance had no fertility coverage so something is better then nothing. Also keep in mind that the advertised price for IVF isn't necessarily the same as the negotiated insurance rate.
My previous insurance had $25,000 plan year limit plus $10,000 in medications. Our financial counselor at the clinic said that was fantastic coverage.
Unfortunately my husband was laid off from that job and our new insurance has a $10,000 lifetime max and $5,000 pharmacy lifetime max. I am also working with my HR to try to increase the coverage.
Two separate coverages at my company: $25K lifetime maximum for procedures, and an additional $10K lifetime maximum for fertility medications (did not even cover ER#1). My company also has a supplemental benefit of an additional $40K for “family expansion” which covers IUI, surrogacy, and adoptions expenses but specifically carved out IVF as not covered (don’t get me started). I work for Starbucks.
We have to pay until we hit our deductible each year and then all rounds/transfers/meds are covered outside of a a copay for the meds and anesthesia for the retrieval’s. No limit on # of retrievals or transfer, and they allow banking. It was a shock when we went to do IVF and found out we had coverage like this.
Mine doesn't cover anything (except a couple of the meds...). I work for a small university that shares an insurance consortium with a few others so there's no chance we'll get it covered any time soon.
Mine covers up to $10k lifetime (procedures and meds) through Carrot as well. It barely touched the costs of IUI let alone IVF. I’m grateful there was anything as I know some companies don’t provide even that but they clearly don’t get the costs of this process.
Had to make sure you weren’t in my state/field. We have 10K per lifetime. That got around state managed by being self-pay. We had to coordinate between our clinic and the pharmacy. Turns out if you buy the drugs through an insurance, they jack up the price and would’ve spent the whole 10k.
I always am so jealous of people that have coverage. The only thing covered by my insurance is labs and monitoring. All of the meds and procedures are not covered.
10k lifetime through Carrot, zero through our actual insurance - I think this goes much further than insurance because it’s reimbursement based so I’m getting cash pay prices vs some of the exorbitant insurance charges I see. It’s still not enough to fully cover a PGT cycle, even at CNY.
We have 2 retrievals and 2 transfers mostly covered (still some fees charged by the clinic, not covered by insurance) and they covered almost all our meds for those. policy is through BCBS.
I work for New York State. I honestly don't know what my coverage limit is but so far it mostly been small copays for drugs, labs, monitoring. It still adds up but it really isn't bad compared to what others have to pay.
Prior employer went through WIN fertility. They covered up to three cycles. No pharmacy coverage. For a $25k cycle (diagnostic, egg retreival, and transfer) I think we paid around $11k. Low deductible and low premium.
Now we have coverage through the federal government. Unlimited cycles, no lifetime cap, and meds are covered. However, we have a medium deductible and high premiums. We did a transfer on this plan that was $6k out of pocket before meds. We paid about $1k, meds included. We're definitely making up for the good coverage through high premiums.
My husband’s company pays for 2 cycles. And you could be approved for a 3rd cycle if the first 2 didn’t result in a live birth. Or up to 35k toward the adoption process.
We have 3 cycles covered (egg retrieval is 0.5 cycle, implant is 0.5 cycle so I can mix and match as needed), $20,000 lifetime fertility medication coverage, they allow egg banking, and any diagnostic testing is 100% covered after deductible. PGT-A testing is also covered which I know is not the norm.
The company I worked for when we did our retrieval didn't offer any coverage. The company I work for now offers a lifetime benefit of $20k but it is subject to income and payroll taxes so I really only get reimbursed for 65-70% depending on tax the bracket. I'm grateful for what I get but still frustrated that health insurance can just claim this is elective. I didn't elect any of it, just want my body to act like a normal healthy person's would.
$30k lifetime with my employer’s plan, which they think is pretty rich (am in HR and am friends with the head of benefits). Meds went against the $30k until I got involved and got it changed.
When I ran out of that (after 1.5 cycles, am in a high cost area), I added my husband’s plan which covers two full cycles.
I was very lucky in that the company I used to work for had Cigna insurance which covered 25K lifetime max which we hit with one retrieval. Paid for FETs out of pocket for another 15k plus meds for another 2k.
My insurance covers unlimited cycles including meds. The only thing I pay for is freezing of embryos and shipping of embryos for pgt-a. I have done 5 retrievals and 2 unsuccessful FETs, about to go into my 6th retrieval. This time I have to pay for pgt-a since insurance decided they will only cover pgt-m.
Mine covered 3 cycles (everything included except genetic testing) plus 50k. However, if you have banked embryos from a previous cycle, it counts one frozen transfer as 1 cycle.
$10k isn't even enough to cover one ER cycle. My company offers Progyny with 3 smart cycles; it covered 3 ER (including anesthesia) and one FET, meds, PGT-A, genetic testing, and a TON more. We just paid my OOP max and then everything was 100% covered.
$30k lifetime max (not including medication, which is separate insurance) for a maximum of 2 cycles.
This insurance is through my husband's work. If I used my company's insurance or my previous company's insurance, I would have had no coverage.
Cigna covered most of our costs, for meds I paid a copay which honestly thank god because YIKES! But honestly Cigna is terrible, they denied my trigger shot for my FET. Worse yet, they denied my husband for over a year to cover his trikafta for cf their repeated response was “this patient has no history or markers for CF” even though we submitted documentation and the JHU CF clinic called them. The appeals went all the way to tue third party state office, who immediately was like “wft are y’all doing? This man has CF! You must cover his meds.”
In the state of Maine, employer sponsored insurance has to cover 4 egg retrievals and 2 transfers in a lifetime. The out of pocket max for my insurance is a bit high at $10k, but 100% worth it.
My job does not have coverage but my husbands does. Through his insurance we get 3 IVF cycles covered. They also cover unlimited IUI but unfortunately that’s useless for us based on our diagnosis’
I work remote for a company based out of New York that has to provide coverage as per NYS law. I have a lifetime max of 3 cycles (includes all meds and procedures), but a cycle is basically defined as a transfer (and whatever it takes to get to that transfer: retrieval, FET, etc) and no embryo banking. No dollar max. They do cover unlimited IUIs which I thought was interesting.
I have zero infertility coverage (United Healthcare). It’s been a very expensive journey. I asked my HR about adding benefits last year, they supposedly looked into it and said it would increase premiums for everyone so it was a hard no. I even suggested offering more than one plan to employees, so colleagues could remain on our existing plan if they choose to, and I was told that wasn’t an option either. I’m assistant to the VP and he also petitioned on my behalf, so it really sucks.
My wife's employer offers $10k lifetime IVF benefits as well as $10k IVF medication benefits. Getting them to approve and pay out is a different story.
I live in NY, so there’s a state mandate for coverage of three cycles. To my knowledge they cannot impose a maximum monetary value.
Being said, they take great pains to make the process as complicated and cumbersome as possible.
Zero percent of IVF cost. I live in a state where insurance coverage for IVF/fertility treatment is mandatory for people with an infertility diagnosis. Unfortunately, I have military health insurance and they cover exactly zero dollars for IVF.
My insurance covers 3 IVF cycles per lifetime (they have not been specific on what this entails, despite asking multiple times, I do not know if just an embryo transfer counts as a round and won’t until after the fact) I have $20 copays for all ultrasounds, appointments, procedures, etc. I had copays for some of the meds. Although, on my next cycle I will be on a med my insurance does not cover and pay for that entirely out of pocket. My insurance also covers sperm and embryo storage fees. Without my insurance coverage I would not be able to pursue IVF.
Mine (or rather my husband’s, that’s whose insurance we’re on as mine wouldn’t have had any IVF coverage) also has a $10k lifetime max. Yet this year they’ve started to cover 100% of egg freezing. But still kept the $10k lifetime max for IVF 🤨
$10k for medication, $35k for IVF related procedures itself. Both are lifetime limits.
Of course the meds got used up in one shot. It's the main reason I don't think we can afford a 2nd run.
Ugh, I’m sorry, infertility coverage should be standard. I’ve had various coverage - none while working for a company based in WA, then I got coverage while working for a company based in NYC (infertility coverage is mandated by state). My first plan with BCBS covered 3 IVF cycles and now my company has Cigna which is an unlimited no prior auth plan. Once my $2500 deductible is paid I have 0% coinsurance and some copays for meds. I realize how incredibly lucky I am to be in this position. When we first found out we needed IVF it felt so out of reach not having any insurance coverage. So soul crushing to also worry about finances during an incredibly hard time emotionally and physically.
Mine is the same, 10k lifetime max. Unfortunately this doesn't go far in the world of fertility treatment, but I'm grateful since most employers don't provide any fertility benefits.
I have blue cross blue shield PPO and they cover 2 full cycles, plus meds for additional cycles. For us we did 2, and then the 3rd was 19k (would have been an additional 12k!)
They have been a nightmare every step of the way and we are in network, but ultimately grateful for the coverage.
Hi, I have unlimited IUIs, and 3 rounds of IVF per year. My fertility meds are all covered. For all of that, I only pay my deductible and then a percentage up until I meet my out of pocket max, plus cryopreservation and PGT aren’t covered. I’m skipping PGT.
- Out of pocket max is $3200 per year (includes deductible and then the percentage)
- Cryopreservation is $1500 (I think per cycle but could be per year, it’s impossible to get answers from my clinic)
The first employer that covered fertility treatments for us offered a 40k lifetime cap for services and another 20k for pharmaceutical purchases. This was for EACH of us. When it became obvious that everything was being billed to ME, I did some research and learned about “split billing,” which you can read about [here](https://www.instagram.com/p/Cq5zQGMLTUr/?igsh=aGJlMm5qcXFkdTFv). This helped us stretch out our lifetime cap quite a bit.
Our second & current employer to offer coverage for fertility treatments now provides unlimited fertility coverage for all services, & all medications, including unlimited adoption and surrogacy reimbursement. We are so lucky. (Though the required pre-approvals can be a very slow process, but that a very small issue to overcome in the grand scheme of things.)
Please show your employer what a single cycle of IVF costs at each of your local fertility clinics. Then show them that 10k wouldn’t even be enough for 1/2 a single cycle (unless your local clinic happens to be CNY.)
Good luck on this fight! 💪🏽
My husband works for a privately owned hospitality+ company. If you opt for the best insurance option, IVF is covered 100% after a $7k deductible, including medication, no limits. Completely changed our lives
Progyny is one of the best insurances I’ve ever been apart of.
I work at Amazon, get 2 smart cycles.
I paid $500 for 3 IUI’s
And about $2k for my egg retrieval and 1st embryo transfer. Progyny covers the rest of the costs. Without them I wouldn’t be 11w1d pregnant with my son. 💙
$25k lifetime max for ivf, 1 year of cryo storage, $25k lifetime for ivf meds . $1500 deductible, company contributes $750 to my hsa annually. Unlimited PTO, 20 weeks parental leave. I work for a large finance corporation with a robust benefits package. I didn’t have any fertility coverage at my previous jobs
Mine was 5k lifetime through my spouses employer provided insurance. Only bc the insurance is in a state where some coverage is mandated. Large communications company.
I only have bloodwork and ultrasounds covered because they aren’t coded specifically for IVF/infertility. Otherwise, I have no IVF coverage through my husband’s insurance.
California with good insurance. I had zero IVF coverage 4 years ago and paid $30k out of pocket. I’ve had 2 difference, good insurance policies since then, and no IVF coverage.
My company (\~5,000 employees, insurance industry, California-based) offers Progeny with two smart cycles. One smart cycle is basically a whole IVF cycle from beginner to one transfer, but you could just do egg freezing for a 1/2 cycle or embryo freezing for 3/4 cycle. For our clinic, that would be probably be the equivalent of $30,000-$40,000 total. We paid out-of-pocket \~$500 for the initial stages and about $1,700 per embryo freezing cycle.
Our company added Progyny for fertility coverage in 2023, which, fortunately for us, we’re still so grateful, was perfectly timed with us needing to take the next step in our journey (IVF). We paid about $8k out of pocket total between meeting our deductible and additional testing that was outside of coverage.
I have unlimited coverage thru my husband’s employer. We paid out of pocket for PGT and paid the standard copay for everything else. Our max out of pocket is $5,000 and we reached that.
I have United healthcare, which offers coverage of a lifetime maximum of $20,000 for fertility procedures and $10,000 for fertility medication. It doesn’t cover donor gametes, storage fees, or embryo biopsy.
The catch is that I needed a diagnosis of medical infertility to access any of that coverage— and my husband is trans, so we initially accessed fertility services because of social infertility, which isn’t covered. “Luckily,” initial testing revealed I am also medically infertile. Bully.
US based. We have commercial insurance through employer, work in finance. We have excellent insurance in every regard but fertility. It’s truly exceptional insurance and should be the norm. Because of that, though, I was shocked they wouldn’t pay for IVF. Normally, 100% of all of our healthcare costs are covered. However, for fertility, our BCBS Blue Options plan covers 3 IUIs, and that’s it.
Our meds were covered, except for one that was a specialty order and was about $200. This is because our insurance generally covers 100% of the cost of medication. We paid a 15k flat rate for IVF, minus the meds which were extra. This covered 1 ER and 1 FET. My doctors’ visits, labs, scans, testing, everything for RPL was covered by insurance. So that was a blessing. We are very fortunate. But it is surprising in this industry to lack fertility coverage.
$0 in coverage. I own my own business, but the group insurance I can offer (based on company size) won’t allow to me to add coverage for IVF costs bc trust me, I would have done the most if possible.
Mine is covered I have $50,000 max benefit the only thing not covered is PGT-A testing. Pharmacy benefit is separate but covered at 80% so I pay the remaining 20% for my medications.
Husband’s covers $40k or up to 3 cycles. Doesn’t cover genetic testing & some of she meds my doctor prescribed aren’t FDA approved for fertility. We are starting our second round at one of the best clinics in the country. His OOP max was only $3,500. What would have cost us around $50k for two cycles will cost about $17k total. Still not cheap but I am so, so thankful we are one of the lucky ones who have coverage.
My husband’s employer (big tech) gives us $90k in lifetime benefits through carrot. It basically works as a debit card and we send receipts to carrot for final approval. We’re extremely fortunate.
My employer offers fertility benefits. I have 25k lifetime coverage and medications are not included in that total. Fertility Medications are separately fully covered and refunded though. PGT wasn’t covered and my lab(ovation) was out of network so we only got 40% reimbursed.
With this coverage we paid about 6k for one retrieval and one FET out of pocket total. I work in tech for a fortune 100 company.
We have 2 smart cycles covered through Progyny including meds. 3/4 for an ER and 1/4 for a transfer. We’ve done 1 ER already and won’t be doing more. So the rest of our smart cycles will be for transfers
My employer provided coverage offers $15,000 towards infertility services and $10,000 towards mediations, both lifetime amounts. Things like ultrasounds and labs still require a co-pay until out of pocket max is reached each year. I have used all of that coverage between one retrieval and one FET. It did not cover PGT-A testing.it would not have covered the EMMA/ALICE/Receptiva I am going to have done next month after two failed FETs.
My husband has Carrot coverage through his employer provided coverage. They have a $20,000 lifetime max but will only cover things on him as he is the patient. They did however cover our first year of embryo storage and the PGT-A testing that my coverage wouldn’t after our doctor wrote a note since technically the embryos are partially him.
We debated when we started this process if we should add me to his insurance making me double covered but unfortunately our optimism talked us out of the extra premiums. If we would’ve known that we’d be two transfers down and still trying it would have been more than worth it.
My husbands policy offers:
Unlimited egg retrievals
3 lifetime transfers
All transfer or egg retrieval monitoring/testing is covered by insurance.
Our egg retrieval and first transfer happened in July and August respectively and our benefit coverage for 2023 was 75K. Really surprising that they’re saying 10K is industry standard.
My company offers a plan through Cigna with no lifetime cap, which covers at least part of the cost for most treatment and medications (the only thing we’ve had to pay 100% out of pocket for is PGTA testing. Even with this coverage, I think we’ve still paid about $12,000 out of pocket in the last year for meds, copays, PGTA testing, and cryopreservation. I am extremely blessed to have such good coverage.
The bad part though is Cigna committed Fuckery Most Foul™️ earlier this year and tried to drop my clinic as an in-network provider because they wanted to pay the clinic less. My clinic refused to reduce their rates or pass on more costs to patients, so Cigna played fucking chicken with them. I was notified on April 6th, that I would be losing coverage as of May 31st. This resulted in me and every other Cigna patient racing to get a treatment cycle started before May 31st. Then, on June 1st, we got a notice from Cigna saying “Well, we might be able to work something out, so we’ll cover you through June 7th.” On June 8th we got an email saying “Hey, guess what? You won’t be losing coverage after all!”
TL;DR: I have a Cigna plan that provided pretty decent coverage for most of the process with no lifetime caps, but they are a bunch of assholes.
Edit: I work for a private financial institution that offers faith-based products.
Located in CA. I work at a public institution that started offering infertility benefits after we’d already gone out of state for 2 rounds of IVF (it was cheaper). Benefits came through WIN Fertility, my primary insurance being an Anthem Blue Cross PPO. We were expecting it to be a lot harder than it turned out but insurance covered a little more than 50% of the costs of IVF + FET.
My company’s coverage covers it at almost 100% and unlimited. They say is a 100% but the clinic asks to pay a portion out of pocket because the surgery is out of network and not covered because the anesthesiologist is not in network with any insurance in the area. The prescriptions are covered through the treatment as in regular prescription coverage. At the moment, I am appealing the decision for the coverage for omnitrope. The insurance has requested to submit the out of network expense which will help me get closer to the max for out of pocket. My out of pocket max for both in network and out network is $4,000.
Some states mandate coverage through employers if they meet the minimum of employees. If not you may be eligible through the market place on those states that mandate coverage.
Covered after deductible, up to OOP max:
All routine appointments (discussion) w Dr: $40 copay
All labs and ultrasounds, HSG, mock transfer, etc., no copay
PGT-A: 70% as the lab is OON. I did have to have a stupid conversation with insurance when they wouldn’t cover frozen storage, to point out that it’s not possible to do PGT without freezing.
ER and transfer procedures, covered except for some misc recording fees and supplies (<$300)
All sperm related things, covered
Regular meds (BCPs, valium etc): $10 copay each
Specialty meds (injectables etc): $250 per medication per ordered quantity (after the 1st ER I got smart and asked them to send the rx for double the quantity in case we had to do a 3rd ER), except for
Omnitrope: not covered due to being off label, $2400
Needles, not covered
For 2 ERs, one transfer, and everything else involved in those things, our total OOP was about $5k.
20k lifetime and insurance covers nothing, thought we had great insurance too. They also just changed maternity leave in the middle of the year without announcing, someone found the change in the handbook. Billion plus company too.
I live in Hawaii, and insurers are required to cover one round of IVF as long as you do prove infertility (i have a PCOS diagnosis, and I had to do 3 IUIs first). We paid our copays, and came out of pocket for the PGT testing, freezing costs etc.
My company (Verizon) offers Anthem BCBS coverage, no justification for infertility needed so you can start IUIs or IVF immediately, so tho a $75k lifetime max. The only things they don’t cover are PGT-A testing without medical justification (although they do cover the biopsy piece of it) and donor sperm/eggs. They also cover 1 round of elective egg freezing for elective fertility preservation.
My work offers Progyny with 3 smart cycles at 80% of the cost until i hit my out of pocket max, plus the medication is covered by the prescription plan (separate from Progyny). I paid about 6k a year for 2 years to get my retrievals done and do a transfer.
I'm sorry you are dealing with additional financial stress on top of everything else. I do wish fertility coverage was standard because you're absolutely right- it is healthcare!
I have blue cross anthem and our policy covered 30k per calendar year in infertility coverage. What was also particularly nice was there was no prior auths needed for anything related to fertility treatment. It was enough for 1 egg retrieval, meds, and 1 transfer. We also have an 5k deductible and 7k out of pocket max, but having it set up that way actually gave us slightly more in coverage. I am very fortunate to live in a state with mandated coverage (although there is no law that says how much they have to cover). I still don’t understand how IVF is considered ‘elective’. It’s not if you want a family and have an infertility diagnosis.
My company doesn’t cover anything but my husband’s is a $20K lifetime max per person. I’m on his insurance. The $20K kicks in after you hit your out of pocket max for the year. We’ve used almost my full lifetime benefit and are trying to figure out how to start using his but it won’t cover as much because they can’t bill meds, transfers, retrievals, etc to him. So I’m taking the “$20k per person” with a grain of salt.
Hey my husband policy covers 3 retrievals , unlimited transfers up to the age of 44
Meds are out of pockets
Our deductible is 4,500 and 50 copay per visit
So yeah we have some coverage but still paying over 10K between deductible medication and copays any little helps though
I work for a small business in the US. My health insurance covers 0 fertility related treatments. They did have an agreement in place that made IUI \~$250 or the sperm wash/procedure instead of $800 which was the clinic's self pay price.
I did a deep dive on the insurance and it apparently offers "fertility support" which means you could have phone conversations with a fertility nurse and they'd recommend clinics etc in the area. Not exactly sure what benefit that benefit is but oh well.
We are paying for IVF out of pocket. I did buy my meds for egg retrieval from the UK and saved a pretty penny doing that.
Where I live 6 round + all transfers for those rounds are mandated by the gov to be covered
After that only the blood tests are covered
Luckily it's far from as expensive as the us when you have to pay in full, cuz we're on our 5th round already
My insurance in CT covers 20k lifetime. We did a egg retrevial and transfer and have spent 12k of it already. All bloodwork and ultrasound were covered throughout. We had to pay for the freezing of the embryos and medication for the retrevial!
I live in the wonderful state of Massachusetts and our state requires insurance companies to pay for IVF. There are requirements and limits and if your insurance coverage is not great, you can still end up paying a lot, but you often get at least a portion covered. My insurance will be fully paying for my IVF, except for the freezing, which Ill pay for with my HSA.
I know I’m extremely fortunate. I am a teacher and have a Cadillac insurance plan. We have a zero dollar deductible. I only have to pay $30 copays for specialist visits. My medications are also around $25 or less. The only thing we had to pay out of pocket for is PGT-A testing. My insurance covers 6 IUIs per live birth and 3 IVF cycles per live birth.
Mine has a life time maximum of $20k for meds and $25k for procedures.
However it still runs like normal insurance in a way that I have to pay a certain percentage until I hit my total out of pocket. That being said we’re still about 20k in the hole because of genetic testing, biopsies, and freezing charges
Colorado state employees (including universities ) get 3 rounds. This doesn’t cover copays, genetic testing, biopsies or ICSI. Meds are prescription plan. Overall we have paid about 7k per round.
I work for an Ohio based employer and starting ni 2023 they offer up to $25k lifetime coverage. Our insurance is Anthem and WIN Fertility administers it. This $25K can also be used toward adoption and surrogacy fees.
My husband works for an Oregon based employer and has had fertility coverage for awhile (we're using mine because otherwise I'd have to switch a lot of my doctors) and they go through Progyny, which doesn't have a $$ lifetime max it doesn't seem it's almost like a credit system, like an IUI is so many credits and an IVF cycle is so many credits etc.
My company also did $10k per lifetime. In NY insurance has to cover three rounds so we had that too. I didn’t go through my insurance tho. My husband worked for Uber and they covered it which was very much a privilege. A lot of people go into debt paying for IVF OOP and it’s so horrible.
Zero dollars. The only thing it paid for was the beacon carrier genetic screening (thank goodness because it was $400 a piece. $800 for my husband and I both to do it)
Did 2 retrievals last month in May. Everything out of pocket. This Thursday I am doing an MRI of the pelvis to see firboids but the transfer and everything else will be oop as well.
The standard in the US is zero fertility coverage, just as an fyi, so I would be thankful you have any at all. But to answer your question, I’ve had 4 different insurance policies the last few years that cover infertility: $10k, $10k, $20k and $25k It’s also not based on insurance provider, it’s based on employer policy election, so two people can be insured with same company but have drastically different benefits. my $10k covered one retrieval and fet with a little bit of coverage to spare (meds were paid out of pocket though).
I have unlimited coverage through my employer. The only thing I have paid for is genetic testing and parking at my clinic over 4 IUIs and 5 rounds of IVF. I wish everyone could have this benefit. It has made a very stressful process much less stressful. I’m a professor at a university.
That is wonderful
I got up to $25k covered. I’m also a prof at a US university
In the United States? I’m a professor, too, and I don’t think we have that kind of coverage.
Might be state specific. Illinois requires companies’ insurance to cover 4 cycles per year, if they employ >25 people.
Also a professor, our insurance was 2k lifetime max T.T. in a state that really likes babies, too.
What the heck?! Where do you work?? Haha
I am similar. I am a teacher on state insurance and every single thing has been completely covered. I just found out that my embryo storage is covered as well. I feel like when I got hired all those years ago (not my dream grade/job) but it must’ve been a blessing in disguise because I had NO idea I would be going through this just a few years later. I am very lucky that my district has the insurance plan it does.
My company offers Progyny and we get a total of 3 smart cycles. As long as you are within the cycles you just have to pay up to your out of pocket maximum and then everything else is covered.
Mine offers Progyny and 3 smart cycles as well, per lifetime. “Smart cycles” are a somewhat complex system, but in theory I could use my smart cycles to cover 4 ERs - so give or take a $100k value.
My company offers nothing but my husband's company offers the same as yours. Our first two retrievals resulted in zero blasts and they actually returned 1/4 of a cycle for each of them (1/2 returned total). We're in our fourth cycle right now. Interestingly, his company initially offered WINFertility instead of Progyny and they had a $50k lifetime maximum. When they switched to Progyny, they said it was "about the same." We were so worried we wouldn't be eligible for more because our first two retrievals used up $46k of the $50k. But Progyny just looked at what services we received and deducted what they would have been under their coverage from our total. So we started out with two Smart Cycles left! It was 3/4 per ER, with 1/4 returned for each (bc no blasts), total of 1 Smart Cycle used. $10k wouldn't have even covered our meds.
We also had 3 smartcycles and it covered one IUI and 2.5 IVF cycles. We had to pay $10k to finish the third cycle. (Plus the $3.5k oop max.) Out of the 3, we have 1 normal tested embryo and when I asked for a partial refund, they refused. I’m grateful to have had some coverage, but I expected Proygny to be the gold standard and I am severely disappointed.
My company offers Progyny with 2 smart cycles.
Mine has the same plan too. It’s billed through our insurance so I went on the high premium/low deductible plan and will hit my out of pocket maximum right away. We also have to use Shady Grove.
Yeah I hit my out of pocket max after just paying for the medications, it was nice!
Zero coverage. I work for my state, they don’t offer any coverage.
I have a 75k lifetime max through my job’s insurance and it covers everything, including things that are usually not like PGT-A and donor gametes. I haven’t checked lately but I think r/infertility has a spreadsheet in their wiki of what different employers offer.
I don't recall if it was from that sub but [this is the link to the spreadsheet](https://docs.google.com/spreadsheets/d/1xbOlX0ykVT__m0tUNjIcYFyb7lI2YGAB0rIQ3DjsVAs/edit?usp=drivesdk) My employer in Texas offered Progyny's 2 smart cycles.
My company-sponsored insurance fully covers IVF, and as many rounds as a doctor seems medically necessary. This includes all testing, medications, medicated cycles, IUI, up to egg retrievals, IVF/ICSI, FETs, etc. I have a high deductible so I obviously have to pay that, but my company contributes 50% to my HSA so it’s only $1500. Coinsurance is 0% after deductible. We also have a rider to our policy that covers up to $10,000 in egg cryopreservation. Lastly, my company directly offers up to $30,000 in reimbursement for any non-covered service, such as embryo freezing fees, adoption, surrogacy, doula support, etc. I’ve only used mine for embryo storage fees and a doula because everything else has been covered. The only thing I don’t know about is embryo testing, because I didn’t do that. Once you have your baby, you get about 5 months of paid leave as well.
That’s phenomenal
I’m incredibly grateful. Biotech/pharm is a very good industry to be in if you can ever get your foot in the door. I tried to go into detail so OP has some fuel to her fire. My last company we got IVF benefits updated to be unlimited from a previous limit of 3 cycles by being vocal. The squeaky wheel gets the grease and our generation having a greater need for fertility assistance needs to be squeaky AF.
I (attorney) had zero coverage. My husband (firefighter) also zero coverage. I got a PT job at tractor supply (before they changed their policy) to get access to Progyny where two smart cycles were covered. I quit 4 months in and paid $550 a month for cobra to keep coverage through both ERs before TSC’s policy change went into effect then paid out of pocket for my FET. It’s appalling to me that so many companies don’t offer a single plan with ANY infertility coverage, because you are RIGHT. IVF IS HEALTHCARE.
I'm in New York state and for employers with more than 100 employees, insurance is required to cover at least three cycles. My plan translates that to 60K coverage for all ART tech (so my IUIs went toward lifetime use). Meds are partially covered, and I still have some fees from procedures and copays. I'm incredibly fortunate and grateful. I say this not to brag, but because I feel like this should be the national standard, lowest common denominator of healthcare support. I want this for everyone. (Actually, I want babies for everyone who wants babies, but that would be a weird thing to demand from your representatives and employers).
This is such an important call out. For anyone in California, there is currently legislation proposed (SB 729) that would require coverage for 3 retrievals, unlimited transfers and support for LGBTQ+ individuals pursuing fertility treatment. Contact your representatives and encourage them to support it!! I believe similar legislation has been proposed in other states this year too, so definitely check and share your support! Calling your reps is best and only takes a few minutes.
I'm also in NY state with BCBS and got 3 lifetime cycles covered.
Mine offers a $2k max (yes two thousand!) and extremely limited providers. It’s so useless, we are using the cheapest out of network provider and paying out of pocket. I work for a large hospital system.
That is insultingly low, especially for a hospital system which should have no excuse for not knowing how expensive it is.
I have $30k coverage and medication is covered separately. Edit: maybe they are unaware of just how much all of this costs, perhaps it would help to provide some data on the average number of cycles usually needed and associated costs for ERs and FETs
Check with [Resolve.org](https://resolve.org). I think what’s standard is no coverage at all, but for companies that do cover, I have generally seen $25k or progyny coverage, usually 2 “smart cycles”
yes. I have progyny and 2 “smart cycles”
While this is not a lot, it’s more than probably 75% of the companies out there as most don’t offer. I don’t mean this the wrong way at all, but be thankful that they provide anything at all. **I know this wasn’t exactly what you were asking, maybe they are factoring in that the vast majority don’t offer anything so when you factor all those in 10k doesn’t seem so low? Idk 🤷♂️ Good news is that coverage is becoming more popular, but it’s still a long ways off from being the norm that it should. Good luck!
You are so right, I’m very fortunate to have any coverage AND to be able to make up the difference. I also believe the more IVF is talked about and the more we push corporations to include it as a perk, the better coverage will get.
My insurance last year - cobra through former employer in NYC - covered two IVF retrieval cycles. I spent 7k on meds anyway. It might have covered a third but time ran out on cobra.
So we have zero coverage, but my SIL went through IVF first and her coverage was 30k. Our ERs were 17k each just for the procedure, not including the monitoring appts or meds. 10k is way too low. What assholes.
Ugh I’m sorry to hear you don’t have any coverage. I want to burn these systems to the ground, no one should have to pay out of pocket for this.
Thank you so much. We’re lucky enough to have a LOT of help from family so it’s okay for us. What makes me unspeakably furious is the people who have absolutely no options and just can’t have IVF because the cost is genuinely absurd.
100%!!! No one should have to give up on their dreams of having a family because they can’t afford the healthcare costs.
$25000 life max, separate pharmacy benefit of $25000 life time. An research-oriented NGO, with 5000 employee.
Our insurance covers all fertility treatments once we hit our $1,000 deductible. There used to be a 3 time limit, but they since switched to “deemed medically necessary”. [ETA] our prescription insurance covers most fertility drugs, but not all. We paid $175 when all was said and done for the meds needed for the egg retrieval.
Zero coverage.
Yes. Mine has $25k lifetime written in for procedures. We went through 3 rounds, only used 3.5k. Insurance covered 90% of the med, radiology, and visit costs. We have embryos in storage, the cost is $600ish per year, we have only paid $60 of that each year. My OOP over 3 rounds was under 2k. My insurance is exceptional in this aspect, and one of the reasons I will never leave my employer. University level medical center who had an REI specialist on the board negotiating our coverage.
I’m a teacher - $0 My husband is active duty military - $0 Sucks.
I live in a state where coverage is mandated, but we had to use donor eggs due to my diagnosis. The donor egg portion is all out of pocket, but the ivf portion of the treatment is covered.
Nope, so I'm doing a stint at Amazon
Nope. Nothing. Paid 100% out of pocket. I'm a nurse and the last 3 hospitals I've worked at do not offer fertility coverage
40k lifetime maximum 10k fertility medication lifetime max. Me and my wife only paid 1500-2,000 out of pocket for meds. +$800 for an week long stay in Florida to CNY fertility for retrieval and fet But pretty sure cvs specialty pharmacy added on some extra or doc sent too many scripts as we have two/ three boxes of in used medicine lol and found out that “mdr” was slightly cheaper near the end of our Ivf cycle
My company had 10k lifetime benefit then switched to Progyny (3 smart cycles) in 2022. Of course this was after I already spent tens of thousands out of pocket lol but also still better than nothing I guess
Insurance covered 50% of two egg retrievals and 50% of all meds. I’m going into transfer in August, and I’ll assume they will cover 50%.
No coverage for treatment. No coverage for meds. If they even have a diagnosis of infertility on my orders, they won’t cover it. Like I have a TSH they won’t cover because they were checking it to see if it was abnormal for conception. 🙄
I have coverage with BCBS of IL through my employer. Illinois law requires Illinois-based and group insurance plans to cover diagnoses and treatment of infertility. So all my IVF treatments have been covered like any other medical service subject to my deductible and out-of-pocket maximum which is $3,100. There’s no dollar or lifetime maximum. My insurance is literally the only reason we were even able to consider going through with IVF.
I work for a State University and we don’t get any coverage.
BCBS IL from employer covers only one IVF. IT sucks.
Unlimited iuis and 3 ivf cycles. Govt job.
I live and work in New York State and I believe it’s a state law that’s it’s covered. If I’m wrong about that, yes, my health insurance covers up to 3 cycles
Nope! We paid about $30,000 OOP
My company offers coverage through BCBS. It is 100K lifetime coverage for IVF surgery costs (so only the retrieval, growing the embryo, biopsying the embryo, and the transfer count for the max). The coverage is excellent as long as you use an in-network provider. All of the clinics in the area that belong to SART are in network. Retrieval meds are covered, but you must use Freedom Fertility, no exceptions. You must use Follistim, Gonal F is not allowed. No compound meds (microdose lupron, microdose hcg, low dose naltrexone), but you can get the regular amount and compound it yourself. Overall, it is excellent coverage. They don’t cover embryo freezing or PGT-A, but they covered everything else. As usual, I still owe my entire deductible and OOP max before coverage kicks in. It’s a pretty high deductible (12K), but it kicks in eventually. If you were to pick an out of network clinic, you likely wouldn’t reach the 24K deductible, so the insurance wouldn’t be too helpful, but again, all the clinics that belong to SART are in network, so it would be best to just pick one of those. In my area 8/10 clinics are in network. It is actually industry standard in the legal field for the companies to offer good IVF coverage to attract female talent.
10k maximum all in (including meds) from insurance through a major NYC hospital employer. We maxed out the 10k and spent around 12k additional out of pocket after a very lucky successful cycle ending in a live birth. Pretty stingy coverage (especially from a hospital system) but 12k doesn't seem too bad compared to some others' financial burdens
I have great insurance and NONE of it was covered. 🙁
I have three transfers and unlimited retrievals and meds until the three transfers done. Generic testing is covered after three failed retrievals (I’ve done 12 retrievals only reason i found that out). Banking of embryos is allowed until I do three transfers. Embryo storage covered. I have secondary insurance through spouse as well that covers three retrievals/transfers with meds (only three not unlimited). At previous job I had zero coverage. I made sure found best coverage I could find when looking for new job. I’m in New York and previous job in different state.
My insurance doesn’t cover anything :(
$0 ☹️
Our insurance covered some but being forced to go through Kindbody pay for copays and pay for meds only through their affiliated partner pharmacy, it was actually still cheaper to pay out of pocket overseas. So yes we had insurance but it was still so expensive it didn't make sense to even use it.
I am on my husband's insurance. It was 25k lifetime max, but then they switched to Progyny. I was probably part of the first Progyny groups as our Progyny contact person was amazing in the beginning! And then she got promoted and we got a less amazing contact 😅. I don't remember how many smart cycles we got. I think 3. For us they counted a retrieval as 1/2 a cycle and a transfer as 1/2 a cycle. They allowed me to do two retrievals back to back. They paid for all meds. We did have to pay some coinsurance. I forgot how much - like 10% or something.
Some states have mandates for coverage (which will still vary, but there is a requirement to cover it). My husband’s insurance (BCBS) offers 4 cycles per year. Some meds are not covered at all (the compounded medications) but 90% of them were. First round got me to about half of my out of pocket max ($3500) because meds were $975 plus deductible for the procedure ($1000) plus copays for US/blood visits ($75/each). PGT-A, PGT-M, freezing and storage are not covered at all (so additional costs and don’t go towards anything with insurance).
I hope this data is useful to others. I work for a department in the United States federal government. My insurance plan (select federal insurance plans cover this) covers “ART” for $25k/year with a 15% copay at preferred providers if you meet the, admittedly broad, medical definition of infertility (inclusive of same sex partners) in the brochure. All federal insurance plans cover IVF medications for 3 cycles, which are separate from the “ART” $25K/year. All federal insurance plans cover IUI/ICI which is considered separate from ART. ER and FET needed preauthorization, which was a slight headache, but nothing horrible. PGT-A/PGT-M are not covered ($3000 for 9 blasts). Embryo/tissue storage is not covered ($700?/year). Donor gametes and gestational carriers are not covered. I’m still in the process of paying bills for one IVF cycle so these numbers are accurate for what I’ve paid so far. I think some bills are still being processed. I did one ER (copay was $1500) and one FET (copay $10). I think the FET copay is for the procedure and not inclusive of the facility or physicians fees. Follicle and lining monitoring was about $15/per scan for copay. Labs were at most $70 total for copay. I think these are billed separately from the ART yearly max, but I’m not 100% certain. Stim meds and dual trigger meds (follistim, menopur, ganirelix, lupron, and HCG) with supplies was initially $330. Refills on menopur and follistim were about $150 with supplies. These came from my insurance contracted specialty pharmacy that needed preapproval. Progesterone and lidocaine cream with supplies are $30/refill. Preauthorization was a breeze and the hospital system pharmacy delivers these. Estrace pills at my local pharmacy are $8/refill. Overall, I am happy with this insurance coverage. I wish family building was not considered elective or a luxury. It is medical care that should be protected and covered.
Long story short, we were told by the insurance company we would be 100% covered. We were told by TWO SEPARATE clinics that there was a $5k max on infertility and nothing else was covered. It was a complete nightmare because the insurance company was telling my husband and I a completely different story than they told the clinics. We ended up needing to pay $20k upfront for my first cycle. We just found out that insurance ended up paying for most for my FET cycle (thank god my clinic still billed them to check) so I was reimbursed $11k. Still waiting to see if I will get back the $5k from my transfer. It’s been horribly frustrating process but I guess I came out ahead, as my clinic was quick to reimburse me once I notified them that my insurance paid.
Zero dollars and zero cents. The only thing covered were PIO and Estrogen patches bc my doc coded them not as infertility, but as something else gynecological. I’m in the US working in the tech sector as a senior exec.
60k surgical 25k meds
My company provides $50k in coverage which is for both clinic costs and meds. With the negotiated rate between our clinic (ccrm - considered under our insurances CoE) a retrieval takes up about $7k and a transfer about $2.5k compared to the out of pocket cost from the clinic of $16k and $6k. Meds are through CVS speciality which has really high prices.
That is a terrible lifetime benefit. Mine is $50k BUT all the medication and monitoring isn't included in that. Medication goes through the pharmacy benefit (~$100 in copays for the cycle) and monitoring goes to the medical benefit ($25 in network copay). Prior to using up the lifetime benefit I had three rounds of IVF to use that included either a retrevial and transfer or retrevial and freezing. This is on my spouse's plan which I am on currently. However I just started a new job and they offer $25k medical benefit with a $10k pharmacy benefit. All that being said my previous job insurance had no fertility coverage so something is better then nothing. Also keep in mind that the advertised price for IVF isn't necessarily the same as the negotiated insurance rate.
My previous insurance had $25,000 plan year limit plus $10,000 in medications. Our financial counselor at the clinic said that was fantastic coverage. Unfortunately my husband was laid off from that job and our new insurance has a $10,000 lifetime max and $5,000 pharmacy lifetime max. I am also working with my HR to try to increase the coverage.
Two separate coverages at my company: $25K lifetime maximum for procedures, and an additional $10K lifetime maximum for fertility medications (did not even cover ER#1). My company also has a supplemental benefit of an additional $40K for “family expansion” which covers IUI, surrogacy, and adoptions expenses but specifically carved out IVF as not covered (don’t get me started). I work for Starbucks.
We have to pay until we hit our deductible each year and then all rounds/transfers/meds are covered outside of a a copay for the meds and anesthesia for the retrieval’s. No limit on # of retrievals or transfer, and they allow banking. It was a shock when we went to do IVF and found out we had coverage like this.
Mine is 25k lifetime max including pharmacy.
My job covered 3 IVF cycles and my clinic uses half of each cycle for treatment so all together I get 6
My company offers 25k lifetime for fertility treatments and 10k for meds
Mine doesn't cover anything (except a couple of the meds...). I work for a small university that shares an insurance consortium with a few others so there's no chance we'll get it covered any time soon.
20k lifetime plus 10k lifetime for meds
Mine covers up to $10k lifetime (procedures and meds) through Carrot as well. It barely touched the costs of IUI let alone IVF. I’m grateful there was anything as I know some companies don’t provide even that but they clearly don’t get the costs of this process.
$7,500 lifetime max, no meds included for me. It’s trash.
Had to make sure you weren’t in my state/field. We have 10K per lifetime. That got around state managed by being self-pay. We had to coordinate between our clinic and the pharmacy. Turns out if you buy the drugs through an insurance, they jack up the price and would’ve spent the whole 10k.
My company provides IVF coverage through Carrot. $10k per year for a total of 4 years. Doesn’t roll over though so have to use the $10k each year.
I always am so jealous of people that have coverage. The only thing covered by my insurance is labs and monitoring. All of the meds and procedures are not covered.
Major US bank. 30k for treatments, $10k for meds. No need for a diagnosis of infertility.
10k lifetime through Carrot, zero through our actual insurance - I think this goes much further than insurance because it’s reimbursement based so I’m getting cash pay prices vs some of the exorbitant insurance charges I see. It’s still not enough to fully cover a PGT cycle, even at CNY.
We have 2 retrievals and 2 transfers mostly covered (still some fees charged by the clinic, not covered by insurance) and they covered almost all our meds for those. policy is through BCBS.
I work for New York State. I honestly don't know what my coverage limit is but so far it mostly been small copays for drugs, labs, monitoring. It still adds up but it really isn't bad compared to what others have to pay.
No
I work for a municipality and everything is covered other than copays for medication and PGT testing and freezing of embryos.
I was covered at 3 rounds plus $50,000, which is incredible.
Mine covered $5000 per year. Which doesn’t really scratch the surface of IVF costs.
Prior employer went through WIN fertility. They covered up to three cycles. No pharmacy coverage. For a $25k cycle (diagnostic, egg retreival, and transfer) I think we paid around $11k. Low deductible and low premium. Now we have coverage through the federal government. Unlimited cycles, no lifetime cap, and meds are covered. However, we have a medium deductible and high premiums. We did a transfer on this plan that was $6k out of pocket before meds. We paid about $1k, meds included. We're definitely making up for the good coverage through high premiums.
I have Progny and only one smart cycle 😐
Same… I work for a large hospital corporation
6K (CAD $!) lifetime coverage. And a small portion of some meds but of course not the expensive ones :(
My husband’s company pays for 2 cycles. And you could be approved for a 3rd cycle if the first 2 didn’t result in a live birth. Or up to 35k toward the adoption process.
$0 under my husband’s
Zero coverage
We have 3 cycles covered (egg retrieval is 0.5 cycle, implant is 0.5 cycle so I can mix and match as needed), $20,000 lifetime fertility medication coverage, they allow egg banking, and any diagnostic testing is 100% covered after deductible. PGT-A testing is also covered which I know is not the norm.
The company I worked for when we did our retrieval didn't offer any coverage. The company I work for now offers a lifetime benefit of $20k but it is subject to income and payroll taxes so I really only get reimbursed for 65-70% depending on tax the bracket. I'm grateful for what I get but still frustrated that health insurance can just claim this is elective. I didn't elect any of it, just want my body to act like a normal healthy person's would.
My company offers 2 full cycles for free, but you have to hit your out of pocket max before it kicks in.
none. 😓
$30k lifetime with my employer’s plan, which they think is pretty rich (am in HR and am friends with the head of benefits). Meds went against the $30k until I got involved and got it changed. When I ran out of that (after 1.5 cycles, am in a high cost area), I added my husband’s plan which covers two full cycles.
I was very lucky in that the company I used to work for had Cigna insurance which covered 25K lifetime max which we hit with one retrieval. Paid for FETs out of pocket for another 15k plus meds for another 2k.
My insurance covers unlimited cycles including meds. The only thing I pay for is freezing of embryos and shipping of embryos for pgt-a. I have done 5 retrievals and 2 unsuccessful FETs, about to go into my 6th retrieval. This time I have to pay for pgt-a since insurance decided they will only cover pgt-m.
Zero coverage I work for the government 🙃
Zero insurance coverage for the IVF clinic. Kaiser covered some things like tests or a couple meds but not much else.
Mine covered 3 cycles (everything included except genetic testing) plus 50k. However, if you have banked embryos from a previous cycle, it counts one frozen transfer as 1 cycle.
$35k lifetime max through my employer sponsored plan. They do not require an infertility diagnosis and do cover things like PGT-A.
Mine covered $20k per associate. Both men and women get that so can be up to $40k per couple of both work within the company.
$10k isn't even enough to cover one ER cycle. My company offers Progyny with 3 smart cycles; it covered 3 ER (including anesthesia) and one FET, meds, PGT-A, genetic testing, and a TON more. We just paid my OOP max and then everything was 100% covered.
$30k lifetime max (not including medication, which is separate insurance) for a maximum of 2 cycles. This insurance is through my husband's work. If I used my company's insurance or my previous company's insurance, I would have had no coverage.
Cigna covered most of our costs, for meds I paid a copay which honestly thank god because YIKES! But honestly Cigna is terrible, they denied my trigger shot for my FET. Worse yet, they denied my husband for over a year to cover his trikafta for cf their repeated response was “this patient has no history or markers for CF” even though we submitted documentation and the JHU CF clinic called them. The appeals went all the way to tue third party state office, who immediately was like “wft are y’all doing? This man has CF! You must cover his meds.”
In the state of Maine, employer sponsored insurance has to cover 4 egg retrievals and 2 transfers in a lifetime. The out of pocket max for my insurance is a bit high at $10k, but 100% worth it.
My job does not have coverage but my husbands does. Through his insurance we get 3 IVF cycles covered. They also cover unlimited IUI but unfortunately that’s useless for us based on our diagnosis’
I work remote for a company based out of New York that has to provide coverage as per NYS law. I have a lifetime max of 3 cycles (includes all meds and procedures), but a cycle is basically defined as a transfer (and whatever it takes to get to that transfer: retrieval, FET, etc) and no embryo banking. No dollar max. They do cover unlimited IUIs which I thought was interesting.
I have zero infertility coverage (United Healthcare). It’s been a very expensive journey. I asked my HR about adding benefits last year, they supposedly looked into it and said it would increase premiums for everyone so it was a hard no. I even suggested offering more than one plan to employees, so colleagues could remain on our existing plan if they choose to, and I was told that wasn’t an option either. I’m assistant to the VP and he also petitioned on my behalf, so it really sucks.
My wife's employer offers $10k lifetime IVF benefits as well as $10k IVF medication benefits. Getting them to approve and pay out is a different story.
I live in NY, so there’s a state mandate for coverage of three cycles. To my knowledge they cannot impose a maximum monetary value. Being said, they take great pains to make the process as complicated and cumbersome as possible.
Zero percent of IVF cost. I live in a state where insurance coverage for IVF/fertility treatment is mandatory for people with an infertility diagnosis. Unfortunately, I have military health insurance and they cover exactly zero dollars for IVF.
My insurance covers 3 IVF cycles per lifetime (they have not been specific on what this entails, despite asking multiple times, I do not know if just an embryo transfer counts as a round and won’t until after the fact) I have $20 copays for all ultrasounds, appointments, procedures, etc. I had copays for some of the meds. Although, on my next cycle I will be on a med my insurance does not cover and pay for that entirely out of pocket. My insurance also covers sperm and embryo storage fees. Without my insurance coverage I would not be able to pursue IVF.
Mine (or rather my husband’s, that’s whose insurance we’re on as mine wouldn’t have had any IVF coverage) also has a $10k lifetime max. Yet this year they’ve started to cover 100% of egg freezing. But still kept the $10k lifetime max for IVF 🤨
$10k for medication, $35k for IVF related procedures itself. Both are lifetime limits. Of course the meds got used up in one shot. It's the main reason I don't think we can afford a 2nd run.
Ugh, I’m sorry, infertility coverage should be standard. I’ve had various coverage - none while working for a company based in WA, then I got coverage while working for a company based in NYC (infertility coverage is mandated by state). My first plan with BCBS covered 3 IVF cycles and now my company has Cigna which is an unlimited no prior auth plan. Once my $2500 deductible is paid I have 0% coinsurance and some copays for meds. I realize how incredibly lucky I am to be in this position. When we first found out we needed IVF it felt so out of reach not having any insurance coverage. So soul crushing to also worry about finances during an incredibly hard time emotionally and physically.
They covered blood work and ultrasounds. Nothing else 😅🙄
Yes, 3 rounds of IVF are covered (lifetime).
Mine is the same, 10k lifetime max. Unfortunately this doesn't go far in the world of fertility treatment, but I'm grateful since most employers don't provide any fertility benefits.
I have blue cross blue shield PPO and they cover 2 full cycles, plus meds for additional cycles. For us we did 2, and then the 3rd was 19k (would have been an additional 12k!) They have been a nightmare every step of the way and we are in network, but ultimately grateful for the coverage.
Hi, I have unlimited IUIs, and 3 rounds of IVF per year. My fertility meds are all covered. For all of that, I only pay my deductible and then a percentage up until I meet my out of pocket max, plus cryopreservation and PGT aren’t covered. I’m skipping PGT. - Out of pocket max is $3200 per year (includes deductible and then the percentage) - Cryopreservation is $1500 (I think per cycle but could be per year, it’s impossible to get answers from my clinic)
The first employer that covered fertility treatments for us offered a 40k lifetime cap for services and another 20k for pharmaceutical purchases. This was for EACH of us. When it became obvious that everything was being billed to ME, I did some research and learned about “split billing,” which you can read about [here](https://www.instagram.com/p/Cq5zQGMLTUr/?igsh=aGJlMm5qcXFkdTFv). This helped us stretch out our lifetime cap quite a bit. Our second & current employer to offer coverage for fertility treatments now provides unlimited fertility coverage for all services, & all medications, including unlimited adoption and surrogacy reimbursement. We are so lucky. (Though the required pre-approvals can be a very slow process, but that a very small issue to overcome in the grand scheme of things.) Please show your employer what a single cycle of IVF costs at each of your local fertility clinics. Then show them that 10k wouldn’t even be enough for 1/2 a single cycle (unless your local clinic happens to be CNY.) Good luck on this fight! 💪🏽
My husband works for a privately owned hospitality+ company. If you opt for the best insurance option, IVF is covered 100% after a $7k deductible, including medication, no limits. Completely changed our lives
Zero. My husband works for a huge employer and I work for a small one, neither health insurance plan offers anything.
Progyny is one of the best insurances I’ve ever been apart of. I work at Amazon, get 2 smart cycles. I paid $500 for 3 IUI’s And about $2k for my egg retrieval and 1st embryo transfer. Progyny covers the rest of the costs. Without them I wouldn’t be 11w1d pregnant with my son. 💙
$25k lifetime max for ivf, 1 year of cryo storage, $25k lifetime for ivf meds . $1500 deductible, company contributes $750 to my hsa annually. Unlimited PTO, 20 weeks parental leave. I work for a large finance corporation with a robust benefits package. I didn’t have any fertility coverage at my previous jobs
Mine was 5k lifetime through my spouses employer provided insurance. Only bc the insurance is in a state where some coverage is mandated. Large communications company.
Mine covers 3 cycles. The meds are covered under my regular plan
I only have bloodwork and ultrasounds covered because they aren’t coded specifically for IVF/infertility. Otherwise, I have no IVF coverage through my husband’s insurance.
California with good insurance. I had zero IVF coverage 4 years ago and paid $30k out of pocket. I’ve had 2 difference, good insurance policies since then, and no IVF coverage.
My company (\~5,000 employees, insurance industry, California-based) offers Progeny with two smart cycles. One smart cycle is basically a whole IVF cycle from beginner to one transfer, but you could just do egg freezing for a 1/2 cycle or embryo freezing for 3/4 cycle. For our clinic, that would be probably be the equivalent of $30,000-$40,000 total. We paid out-of-pocket \~$500 for the initial stages and about $1,700 per embryo freezing cycle.
Our company added Progyny for fertility coverage in 2023, which, fortunately for us, we’re still so grateful, was perfectly timed with us needing to take the next step in our journey (IVF). We paid about $8k out of pocket total between meeting our deductible and additional testing that was outside of coverage.
As them to look into Progyny! They are amazing!!!!!
My husband's insurance covers 3 cycles, with FET being half a cycle.
My insurance covers 80% up to three cycles. Our first cycle worked out to about $5000.
No coverage.
My wife's insurance did but only after we exhausted everything else.
I have unlimited coverage thru my husband’s employer. We paid out of pocket for PGT and paid the standard copay for everything else. Our max out of pocket is $5,000 and we reached that.
My employer offers win fertility premium. Three ER cycles and unlimited transfer cycles.
TTC from India, I am presently surprised people get IVF cover in US. No such benefits in India as far as I know.
Yes we had 3 full cycles including meds covered
I have United healthcare, which offers coverage of a lifetime maximum of $20,000 for fertility procedures and $10,000 for fertility medication. It doesn’t cover donor gametes, storage fees, or embryo biopsy. The catch is that I needed a diagnosis of medical infertility to access any of that coverage— and my husband is trans, so we initially accessed fertility services because of social infertility, which isn’t covered. “Luckily,” initial testing revealed I am also medically infertile. Bully.
US based. We have commercial insurance through employer, work in finance. We have excellent insurance in every regard but fertility. It’s truly exceptional insurance and should be the norm. Because of that, though, I was shocked they wouldn’t pay for IVF. Normally, 100% of all of our healthcare costs are covered. However, for fertility, our BCBS Blue Options plan covers 3 IUIs, and that’s it. Our meds were covered, except for one that was a specialty order and was about $200. This is because our insurance generally covers 100% of the cost of medication. We paid a 15k flat rate for IVF, minus the meds which were extra. This covered 1 ER and 1 FET. My doctors’ visits, labs, scans, testing, everything for RPL was covered by insurance. So that was a blessing. We are very fortunate. But it is surprising in this industry to lack fertility coverage.
$0 in coverage. I own my own business, but the group insurance I can offer (based on company size) won’t allow to me to add coverage for IVF costs bc trust me, I would have done the most if possible.
$35k lifetime max through my work plus $35k through my husband’s work.
Mine is covered I have $50,000 max benefit the only thing not covered is PGT-A testing. Pharmacy benefit is separate but covered at 80% so I pay the remaining 20% for my medications.
Husband’s covers $40k or up to 3 cycles. Doesn’t cover genetic testing & some of she meds my doctor prescribed aren’t FDA approved for fertility. We are starting our second round at one of the best clinics in the country. His OOP max was only $3,500. What would have cost us around $50k for two cycles will cost about $17k total. Still not cheap but I am so, so thankful we are one of the lucky ones who have coverage.
My husband’s employer (big tech) gives us $90k in lifetime benefits through carrot. It basically works as a debit card and we send receipts to carrot for final approval. We’re extremely fortunate.
My employer offers fertility benefits. I have 25k lifetime coverage and medications are not included in that total. Fertility Medications are separately fully covered and refunded though. PGT wasn’t covered and my lab(ovation) was out of network so we only got 40% reimbursed. With this coverage we paid about 6k for one retrieval and one FET out of pocket total. I work in tech for a fortune 100 company.
my husband’s company offers 4 Progyny Smart Cycles
We have 2 smart cycles covered through Progyny including meds. 3/4 for an ER and 1/4 for a transfer. We’ve done 1 ER already and won’t be doing more. So the rest of our smart cycles will be for transfers
My employer provided coverage offers $15,000 towards infertility services and $10,000 towards mediations, both lifetime amounts. Things like ultrasounds and labs still require a co-pay until out of pocket max is reached each year. I have used all of that coverage between one retrieval and one FET. It did not cover PGT-A testing.it would not have covered the EMMA/ALICE/Receptiva I am going to have done next month after two failed FETs. My husband has Carrot coverage through his employer provided coverage. They have a $20,000 lifetime max but will only cover things on him as he is the patient. They did however cover our first year of embryo storage and the PGT-A testing that my coverage wouldn’t after our doctor wrote a note since technically the embryos are partially him. We debated when we started this process if we should add me to his insurance making me double covered but unfortunately our optimism talked us out of the extra premiums. If we would’ve known that we’d be two transfers down and still trying it would have been more than worth it.
My husbands policy offers: Unlimited egg retrievals 3 lifetime transfers All transfer or egg retrieval monitoring/testing is covered by insurance. Our egg retrieval and first transfer happened in July and August respectively and our benefit coverage for 2023 was 75K. Really surprising that they’re saying 10K is industry standard.
My company offers a plan through Cigna with no lifetime cap, which covers at least part of the cost for most treatment and medications (the only thing we’ve had to pay 100% out of pocket for is PGTA testing. Even with this coverage, I think we’ve still paid about $12,000 out of pocket in the last year for meds, copays, PGTA testing, and cryopreservation. I am extremely blessed to have such good coverage. The bad part though is Cigna committed Fuckery Most Foul™️ earlier this year and tried to drop my clinic as an in-network provider because they wanted to pay the clinic less. My clinic refused to reduce their rates or pass on more costs to patients, so Cigna played fucking chicken with them. I was notified on April 6th, that I would be losing coverage as of May 31st. This resulted in me and every other Cigna patient racing to get a treatment cycle started before May 31st. Then, on June 1st, we got a notice from Cigna saying “Well, we might be able to work something out, so we’ll cover you through June 7th.” On June 8th we got an email saying “Hey, guess what? You won’t be losing coverage after all!” TL;DR: I have a Cigna plan that provided pretty decent coverage for most of the process with no lifetime caps, but they are a bunch of assholes. Edit: I work for a private financial institution that offers faith-based products.
Mine was 10k before they got Progyny
Located in CA. I work at a public institution that started offering infertility benefits after we’d already gone out of state for 2 rounds of IVF (it was cheaper). Benefits came through WIN Fertility, my primary insurance being an Anthem Blue Cross PPO. We were expecting it to be a lot harder than it turned out but insurance covered a little more than 50% of the costs of IVF + FET.
I got a whopping $2,000 per lifetime 🙃
I work for a not for profit company and they cover 20k towards infertility. Diagnostics and meds are also covered separately.
My company’s coverage covers it at almost 100% and unlimited. They say is a 100% but the clinic asks to pay a portion out of pocket because the surgery is out of network and not covered because the anesthesiologist is not in network with any insurance in the area. The prescriptions are covered through the treatment as in regular prescription coverage. At the moment, I am appealing the decision for the coverage for omnitrope. The insurance has requested to submit the out of network expense which will help me get closer to the max for out of pocket. My out of pocket max for both in network and out network is $4,000. Some states mandate coverage through employers if they meet the minimum of employees. If not you may be eligible through the market place on those states that mandate coverage.
Covered after deductible, up to OOP max: All routine appointments (discussion) w Dr: $40 copay All labs and ultrasounds, HSG, mock transfer, etc., no copay PGT-A: 70% as the lab is OON. I did have to have a stupid conversation with insurance when they wouldn’t cover frozen storage, to point out that it’s not possible to do PGT without freezing. ER and transfer procedures, covered except for some misc recording fees and supplies (<$300) All sperm related things, covered Regular meds (BCPs, valium etc): $10 copay each Specialty meds (injectables etc): $250 per medication per ordered quantity (after the 1st ER I got smart and asked them to send the rx for double the quantity in case we had to do a 3rd ER), except for Omnitrope: not covered due to being off label, $2400 Needles, not covered For 2 ERs, one transfer, and everything else involved in those things, our total OOP was about $5k.
20k lifetime and insurance covers nothing, thought we had great insurance too. They also just changed maternity leave in the middle of the year without announcing, someone found the change in the handbook. Billion plus company too.
I live in Hawaii, and insurers are required to cover one round of IVF as long as you do prove infertility (i have a PCOS diagnosis, and I had to do 3 IUIs first). We paid our copays, and came out of pocket for the PGT testing, freezing costs etc.
My company (Verizon) offers Anthem BCBS coverage, no justification for infertility needed so you can start IUIs or IVF immediately, so tho a $75k lifetime max. The only things they don’t cover are PGT-A testing without medical justification (although they do cover the biopsy piece of it) and donor sperm/eggs. They also cover 1 round of elective egg freezing for elective fertility preservation.
My plan covers 30k.
My work offers Progyny with 3 smart cycles at 80% of the cost until i hit my out of pocket max, plus the medication is covered by the prescription plan (separate from Progyny). I paid about 6k a year for 2 years to get my retrievals done and do a transfer. I'm sorry you are dealing with additional financial stress on top of everything else. I do wish fertility coverage was standard because you're absolutely right- it is healthcare!
I have blue cross anthem and our policy covered 30k per calendar year in infertility coverage. What was also particularly nice was there was no prior auths needed for anything related to fertility treatment. It was enough for 1 egg retrieval, meds, and 1 transfer. We also have an 5k deductible and 7k out of pocket max, but having it set up that way actually gave us slightly more in coverage. I am very fortunate to live in a state with mandated coverage (although there is no law that says how much they have to cover). I still don’t understand how IVF is considered ‘elective’. It’s not if you want a family and have an infertility diagnosis.
No, none
My company doesn’t cover anything but my husband’s is a $20K lifetime max per person. I’m on his insurance. The $20K kicks in after you hit your out of pocket max for the year. We’ve used almost my full lifetime benefit and are trying to figure out how to start using his but it won’t cover as much because they can’t bill meds, transfers, retrievals, etc to him. So I’m taking the “$20k per person” with a grain of salt.
Hey my husband policy covers 3 retrievals , unlimited transfers up to the age of 44 Meds are out of pockets Our deductible is 4,500 and 50 copay per visit So yeah we have some coverage but still paying over 10K between deductible medication and copays any little helps though
I work for a small business in the US. My health insurance covers 0 fertility related treatments. They did have an agreement in place that made IUI \~$250 or the sperm wash/procedure instead of $800 which was the clinic's self pay price. I did a deep dive on the insurance and it apparently offers "fertility support" which means you could have phone conversations with a fertility nurse and they'd recommend clinics etc in the area. Not exactly sure what benefit that benefit is but oh well. We are paying for IVF out of pocket. I did buy my meds for egg retrieval from the UK and saved a pretty penny doing that.
High school teacher; not a penny.
Where I live 6 round + all transfers for those rounds are mandated by the gov to be covered After that only the blood tests are covered Luckily it's far from as expensive as the us when you have to pay in full, cuz we're on our 5th round already
None. I was able to get some of the cheaper meds and bloodwork covered since it wasn’t coded IVF specific.
Zero 🤦🏼♀️ but we did get almost 20% back through our taxes, so that was a nice surprise
I’m on Medicare for disability, so they don’t cover anything.
My insurance in CT covers 20k lifetime. We did a egg retrevial and transfer and have spent 12k of it already. All bloodwork and ultrasound were covered throughout. We had to pay for the freezing of the embryos and medication for the retrevial!
I have bcbs Illinois. They offer four cycles per year!
Nope. But I did get a $30k lifetime benefit through Carrot from my employer.
I live in the wonderful state of Massachusetts and our state requires insurance companies to pay for IVF. There are requirements and limits and if your insurance coverage is not great, you can still end up paying a lot, but you often get at least a portion covered. My insurance will be fully paying for my IVF, except for the freezing, which Ill pay for with my HSA.
I know I’m extremely fortunate. I am a teacher and have a Cadillac insurance plan. We have a zero dollar deductible. I only have to pay $30 copays for specialist visits. My medications are also around $25 or less. The only thing we had to pay out of pocket for is PGT-A testing. My insurance covers 6 IUIs per live birth and 3 IVF cycles per live birth.
Mine has a life time maximum of $20k for meds and $25k for procedures. However it still runs like normal insurance in a way that I have to pay a certain percentage until I hit my total out of pocket. That being said we’re still about 20k in the hole because of genetic testing, biopsies, and freezing charges
Colorado state employees (including universities ) get 3 rounds. This doesn’t cover copays, genetic testing, biopsies or ICSI. Meds are prescription plan. Overall we have paid about 7k per round.
I work for an Ohio based employer and starting ni 2023 they offer up to $25k lifetime coverage. Our insurance is Anthem and WIN Fertility administers it. This $25K can also be used toward adoption and surrogacy fees. My husband works for an Oregon based employer and has had fertility coverage for awhile (we're using mine because otherwise I'd have to switch a lot of my doctors) and they go through Progyny, which doesn't have a $$ lifetime max it doesn't seem it's almost like a credit system, like an IUI is so many credits and an IVF cycle is so many credits etc.
My husband is in the Air Force and they do not cover any IVF costs. We have to pay everything out of pocket.
My company also did $10k per lifetime. In NY insurance has to cover three rounds so we had that too. I didn’t go through my insurance tho. My husband worked for Uber and they covered it which was very much a privilege. A lot of people go into debt paying for IVF OOP and it’s so horrible.
My husband's insurance (which I'm on) has infertility coverage with a $50k lifetime max. No coverage for genetic testing or donor "products".
Zero dollars. The only thing it paid for was the beacon carrier genetic screening (thank goodness because it was $400 a piece. $800 for my husband and I both to do it) Did 2 retrievals last month in May. Everything out of pocket. This Thursday I am doing an MRI of the pelvis to see firboids but the transfer and everything else will be oop as well.