Around 12% of couples in the US report difficulty in conceiving a child or sustaining pregnancy until birth. Many couples therefore require IVF to conceive. But IVF is expensive, and this creates a barrier for uptake.
IVF in the US is not typically covered by health insurance packages
However, some employers DO offer insurance plans with IVF coverage. It has now been shown that when insurance covers IVF, more women will use it. This includes women who only have access to limited financial resources.
Researchers at the University of Michigan looked at what happened when their own university, offered employee coverage for fertility treatment. They Not only that, but it increased by more than nine-fold among employees and dependents in lower-salary brackets found that use of technology nearly tripled overall.
Dr. James Dupree, study leader said “It’s important to realize that infertility is a disease. Unlike many other diseases, historically it has not been well covered by health insurance. Infertility does not appear to discriminate based on how much money you have or what kind of job you have. But people are not using IVF in the same way. Insurance can help mitigate those disparities.”
For Dr. Dupree it very much comes down to a question of fairness. He commented, “As a urologist, I see the heartbreak, anguish and stress all the time. I tell people we have this great treatment that will allow you to have children with your DNA. Then they start asking how much it costs. When they say they can’t afford it, it’s heart breaking.”
The University of Michigan have offered IVF to women under 42 since 2015
This includes a 20% coinsurance and a requirement for single-embryo transfer for women younger than 35 years. Dr. Dupree and his colleagues saw an opportunity to study how big of an impact insurance coverage might make. The team looked at claims data from October 2012 through January 2017 for 18,202 women.
- IVF use increased among all women: about three times higher than prior to 2015
- Use of IVF remained highest among women in the high-salary group
- Women in the low-salary group had the largest proportional increase in IVF use, around 9 times higher than before 2015
There were some limitations to the study. The researchers didn’t look at household income, which is a better indicator of wealth than salary.
The researchers were confident in claiming that:
- Employer-sponsored IVF coverage was associated with increased use of IVF among all women.
- Employer-sponsored IVF coverage was associated with a large proportional increase among low-salary women.
- However, absolute IVF use remained highest among high-salary women, which suggests that the 20% coinsurance discouraged use for some women.
The problem is that when IVF isn’t covered, patients often spend more time and money trying with less effective treatments. They then decide they have to somehow raise the money to pay for IVF. And by then, biologically, the woman’s clock may be against her.
So, insurance companies and employers in the US can certainly play a strong part in increasing access to IVF. At the moment, about one-quarter of employers offer a health benefit coverage to employees for IVF. Hopefully this will change in the future.
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