Does Insurance Cover Freezing Eggs?
Not many insurance companies cover in vitro fertilization (IVF) and even fewer cover the freezing of eggs for more general purposes. Before purchasing a health insurance policy, make sure your insurer covers the procedure you want. Also, be sure to understand the out-of-pocket costs associated with long-term egg freezing and storage.
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Health insurance companies cover a number of conditions, procedures, and other expenses and put these treatments within reach of those who otherwise would not be able to afford them. While certain services are always covered under general health insurance policies — such as childbirth, pediatric care, or many preventative services — many other medical procedures or visits are not. Those that are deemed cosmetic, unnecessary, or unorthodox are often not covered.
The practice of oocyte cryopreservation, or freezing eggs for later, is usually considered an unorthodox procedure that is not medically necessary outside of fertility contexts. However, it’s becoming a more popular procedure, with some major corporations — like Apple and Google — offering to cover the costs.
One fertility benefits company estimated that 76,000 women might opt for egg freezing in 2018, according to The Washington Post. However, the success rate could be a 50 to 60 percent chance of a live birth for women who froze their eggs in their early 30s or earlier, but data shows the success rate may drop for women who freeze eggs later.
While a few insurers will cover fertility treatments, including the diagnostic and blood tests done before egg retrieval and storage, not all of them do. While in high demand, in vitro fertilization, including egg freezing in long-term storage, is often denied by insurance except in specific cases. If you want to have your eggs frozen for a purpose other than IVF, you may need to work out a payment plan with the facility to cover those costs out of pocket.
Does Insurance Cover In Vitro Fertilization?
Currently, only 15 states have mandated coverage for infertility. Couples or women in those states can usually get some kind of coverage for the egg freezing process for IVF purposes. Within those states, couples or women may find that their IVF — including fertility medication, egg retrieval, egg freezing, and embryo freezing — is either covered in full or in part. This can be incredibly helpful since IVF is quite a bit more expensive than other types of fertility treatments.
Outside of those states, however, most insurance plans do not pay for any IVF, even if they cover other fertility treatment options. Even if you find an insurer that will cover the cost of freezing of eggs for IVF, chances are that they will not cover long-term storage fees of frozen eggs for more general goals, such as for fertility preservation — so that you can put off becoming pregnant until a later time.
Choosing the Right Insurance Provider for You
The best practice when choosing an insurance provider is to compare benefits and costs. If you think that you may want to freeze your eggs, compare that benefit among insurers.
You’ll also want to find out if you’re in a state with mandated IVF coverage. Most East Coast states such as Rhode Island, Connecticut, and New York have a state mandate to cover IVF in the individual and small group insurance markets. Most non-coastal states do not cover IVF at all. Texas, Montana, and Arkansas are the exceptions, with each of those states either covering IVF or offering coverage within the small group insurance market.
If an insurance company does not fully cover the practice of long-term egg storage or doesn’t cover it at all, then you’ll want to look at the potential out-of-pocket costs to you before choosing that company. You can do this by researching various clinics and egg storage facilities to see what their self-pay cost is. In most cases, you can get a discount if you self-pay. Many facilities also offer payment plans or other options if you’re paying for it on your own.
Most fertility and egg storage clinics are often considered “out-of-network” for many insurance plans. But if you live in a state that mandates some form of infertility coverage for IVF you might be able to find a facility that is considered “in-network,” which will cut your out-of-pocket costs. Even so, it’s important to understand what you’ll be expected to pay for — and how those costs will fit into your budget.
Some states are now forcing health insurance companies to cover the preservation of eggs and embryos for patients who have illnesses or ongoing treatment that may threaten their fertility. For example, as of August 2018, Illinois patients in certain situations (including undergoing cancer treatment) can get insurance coverage for their cryogenic storage needs by law.
If you research, comparison shop, and learn about out-of-pocket costs, you can avoid both unnecessary cost and inconvenience in changing health insurance companies later to suit your needs.
Whether or not your insurance company will cover your choice to freeze your eggs long-term for a non-IVF purpose depends on both the company and the laws in your state. Find an insurance company that offers coverage for egg storage by comparison shopping.
While many Americans get their health insurance through their employer, there are still ways to save costs. For example, a health savings account, or HSA, can offer a tax-advantaged way for you to save up the funding to pursue egg collection and storage. Some insurance plans offer health savings accounts, others do not. Talk with your insurance representative about what is available with your plan.
Even though covering the cost of freezing your eggs is difficult as many providers do not cover it, it’s not impossible.
Author: Jeff Gitlen