Infertility affects 15% of reproductive-aged couples worldwide.
According to the World Health Organization, 48 million couples and 186 million individuals deal with this medical condition. As a disease, just like any other, treatment should be part of health plans and easily accessible for anyone. Yet, many employers still fail to provide health insurance that covers infertility treatments. Additionally, less than half of all U.S. states have some form of fertility insurance coverage laws.
Right now, the cost of infertility treatment is extremely high.
Thus, covering it without health insurance can cause financial hardship for those struggling to conceive or carry a pregnancy to term. It also makes finding an effective treatment much more difficult.
Ultimately, many will not be able to afford it.
With health insurance that covers this medical condition, employers can make the family planning process more accessible and stress-free. In addition to providing financial aid, companies that offer infertility coverage as a benefit can also increase awareness about this disease and reduce the ongoing stigma.
There are many reasons employers should consider adding health insurance that covers infertility treatments as a benefit for their employees. Thus, this Shortlister article explores the importance, benefits, and financial implications of taking that step in the workplace.
Why Health Insurance that Covers Infertility Treatments?
Infertility is a medical condition affecting men and women, and the WHO recognizes it as a disease. In fact, it ranks fifth on the list of serious disabilities in women globally.
Many factors contribute to it, meaning there are also different treatment methods, from hormone treatment to Assisted Reproductive Technology (ART).
Some of the most common forms of ART are:
- IUI, short for Intrauterine Insemination
- IVF, short for In Vitro Fertilization
- Cryopreservation or egg, sperm, and embryo freezing
Depending on the treatment type, many of these can be costly, time-consuming, and stressful for those trying to conceive.
One research exploring the impact of infertility reveals that patients experience the same psychological symptoms as those suffering from other severe medical conditions. Except for chronic pain, the levels of anxiety and depression were the same as those in patients with hypertension, HIV, cardiac rehabilitation, and cancer.
Yet, despite the severe implications, this disease remains underrepresented in healthcare plans.
The U.S. doesn’t offer equal access to insurance coverage and care for this condition, and paying out of pocket is often impossible. Although the mental toll might be similar, the economic implications are not, further reinforcing the healthcare inequity in the U.S.
For minorities, it’s even more difficult to access such care. Many studies have shown that African American and Hispanic patients are less likely to seek care than Caucasian men and women, despite being linked with higher infertility rates.
Health insurance that covers infertility treatment should be more accessible to reduce the financial and psychological burden of those struggling to conceive and start a family.
Which Health Insurance Covers Infertility Treatments?
Although it’s a widespread medical condition that affects people’s lives, not everyone treats its seriousness equally. Thus, answering which health insurance covers infertility treatments depends primarily on three factors:
- State laws or where the person lives
- Type of insurance, or private or state insurance
- The employer or the benefit packages it offers
According to the National Infertility Association “Resolve,” as of June 2022, 20 states have passed fertility insurance coverage laws. Of those, 14 include IVF, and 12 laws cover medically induced infertility. This only applies to private health insurance.
However, access to such care is not 100% guaranteed, even in these states. It further depends on the employer and whether they offer fully insured or self-insured plans. The laws only apply to the first kind and exempt small employers with less than a set number of employees.
As of 2023, federal employees also have insurance coverage for fertility preservation and four ART-covered plan options as part of their Federal Employees Health Benefits (FEHB) benefits package.
Those with public insurance coverage typically don’t get access to infertility care since Medicare and Medicaid usually don’t cover it.
Benefits of Offering Insurance That Covers Infertility Treatments
Pregnancy, childbirth, and family planning are costly as they are, let alone when people have a hard time conceiving.
What’s even more concerning is the stigma around this condition, especially in women, even though it’s affecting millions.
Employers can offer health insurance that covers infertility treatments to effectively address both issues. Whether as a standalone benefit or part of a health plan, this would make it easier for workers to access available care and treatments.
Furthermore, companies could provide educational resources or counseling services to help those struggling with infertility and alleviate the mental toll associated with the condition.
Reducing The Stress Toll & Increasing Productivity
Stress is just the tip of the iceberg.
Only people who deal with infertility understand how strongly it can impact every aspect of their lives, including their work.
Although family planning is supposed to be a positive experience, for those that struggle with conceiving or carrying a pregnancy to term, it can be an emotional process paired with anxiety and depression.
For employees, easy and inexpensive access to treatment can alleviate the mental toll of infertility.
Hence, employers who want to invest in the well-being of their workers should offer health insurance that covers infertility treatments.
There’s considerable evidence that stress levels impact employee productivity. Thus, one of the direct benefits is that this approach can lower absenteeism and presenteeism and create a less stressed workforce. Ultimately, the ROI of this investment will be more engaged and productive.
Increasing Employee Retention
For employers, one of the most significant benefits of offering insurance coverage for infertility treatments is that it can be an incredible tool for attracting and retaining top talent.
According to a Resolve survey, employees who needed IVF and had fertility insurance to cover it were less likely to seek a new employer.
Companies worth working for are those that prioritize work-life balance and employee well-being.
Thus, workers are likelier to pick a job or stay in one that supports their needs. In fact, one Forbes article ranks promoting work-life balance as fourth on the list of crucial retention strategies for businesses, right after salaries, remote work, and reduced workdays.
Promoting Diversity & Inclusion
Supporting employees regardless of gender, race, or socioeconomic status promotes diversity and inclusion in the workplace.
Although the data clearly shows that women of color are more likely to experience infertility than white women, they are still less likely to receive treatment. Providing easy access to this can help bridge the ongoing gap.
However, fertility benefits can also help support LGBTQ+ couples who want to conceive and single intending parents. The LGBTQ Family Building survey reveals that 63% of LGBTQ people planning families expect to use ART, foster care, or adoption to become parents.
Overall, offering health insurance that covers infertility treatments can increase DEI initiatives in the workplace and support all employees in their family-planning goals.
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Cost for Employers
For patients, infertility diagnosis and treatment can be costly. They could end up paying thousands of dollars out of pocket, even with some form of insurance. Without one, however, the cost of one IVF cycle alone would be between $15,000 and $30,000.
Seeing how expensive it gets, it’s not surprising that offering inclusive health insurance coverage can benefit companies to retain and attract talent.
However, the price is an aspect most companies struggle with just as much as their workers.
Predicting the cost for employers is difficult since actual prices can vary significantly. Ultimately, it depends on several factors, including:
- Company size
- Insurance plan type
- Level of coverage
Mercer National Survey of Employer-Sponsored Health Plans reveals a growing trend in family-forming benefits, as 61% of employers with over 500 employees offer some form of fertility care. But fertility packages are not as standard as 401ks or other types of health insurance, so it’s easier for larger companies to afford it.
Other small to medium-sized employers usually have difficulty adding “extra benefits” to health plans they already have a problem covering. That’s why some fertility services coverage laws exempt small employers.
Regarding the type, employers can expect to pay higher premiums for more comprehensive coverage, such as plans that cover IVF. However, they may be able to negotiate lower rates with insurance providers by offering infertility insurance coverage as part of a larger benefits package.
It’s important to note that not all plans offer the same coverage, and even those that do may have limitations or exclusions for specific treatments or procedures.
Overall, to reduce the financial implications on their business and workforce, employers should carefully review and compare infertility insurance plans before offering them in any form to their employees.
On a Final Note
One study shows that for most Americans, family is the primary factor that makes up their identity. For a nation bound on family values, there’s a significant discrepancy in providing the resources for those trying to start one.
However, the positive shift in recent years as governments and organizations recognize the importance of fertility treatments gives a promising outlook on this matter.
Ultimately, employers must realize that health insurance that covers infertility treatments is more than a strategy to win the talent war. Instead, they should use it as an asset against the prevalent stigma and drive inclusivity and equality in and outside the workplace.
- Infertility, WHO
- The Psychological Impact of Infertility: A Comparison with Patients with Other Medical Conditions
- Disparities In Access to Infertility Services in a State with Mandated Insurance Coverage
- Insurance Coverage by State
- Office of Personnel Management Expands Fertility Coverage
- Workplace Stress and Productivity: A Cross-Sectional Study
- The Potential Cost of Not Offering Fertility Insurance Benefits
- Infertility and BIPOC (Black, Indigenous & People of Color) Women
- LGBTQ Family Building Survey
- New Survey Finds Employers Adding Fertility Benefits to Promote DEI