For anyone experiencing infertility, the emotional toll can feel impossible. But the financial side is just as hard to comprehend. The average cost of one IVF (in vitro fertilization) cycle can range between $12,000 to $15,000 with medication costs adding up to an additional $4,000 to $10,000 depending on the type and amount prescribed, according to Peter Nieves, chief commercial officer at WINFertility.
So, how much does the average couple end up shelling out for IVF and what can you do to offset the hefty price tag? We asked several fertility experts to walk us through it.
First, What Is the Cost of IVF?
As we said above, the cost of IVF ranges from $12,000 to $15,000 per IVF cycle, and with medication, that amount can add up to $16,000 to $25,000 each round. A cycle is typically defined as a single egg retrieval and all the embryos that result from that retrieval. Costs can increase even further if you opt for common add-ons, such as genetic testing of the embryos—to the tune of thousands of dollars.
Most women go through three IVF cycles before having a viable pregnancy, but many others require up to six cycles, per a study published in the Journal of the American Medical Association. This of course adds up, which can put pressure on couples to implant more than one embryo per cycle in order to increase their success rate (which can lead to multiple births, according to the Mayo Clinic).
But there are more costs to consider, says Nieves. For one thing, travel may be required for treatment. And some people might need to take time off work that could result in potential lost wages. “Depending on the unique fertility challenges of the patient and their partner, the treatment path, prescribed medications and the costs can be very different,” says Nieves.
Insurance also plays a huge part. “The costs that are often overlooked may be expenses that are excluded under an employer benefit program, such as out of network providers or facilities. You’ll want to be sure to confirm benefit and provider network status, as well as how the cost sharing within the benefits works, what copays you’ll have to pay, any coinsurance fees and deductibles.” Even if insurance only covers a portion, that can significantly reduce the cost.
How to Get a Quote for IVF Treatment Before You Start
Before you move forward with IVF, the very first step, financially speaking, is to reach out to your HR and benefits department about available benefits and what they cover. “Fertility costs can get very expensive and increasingly employers are implementing programs to assist employees with paying for these procedures,” Nieves explains. “Many employers are also bringing in fertility management companies to provide fertility trained nurses to support the patient and partner as they find a doctor and to help prepare them for their journey and support them throughout.”
If IVF is covered (even partially) you’ll want to ask your insurance provider about the specifics. For example:
• How many consultations are covered? (Useful info if you want to talk through treatment plans with a variety of clinics before moving forward.)
• What about diagnostic testing? (With IVF, there’s quite a bit of blood work and ultrasound monitoring required throughout—even if the actual retrieval isn’t covered, it’s worth finding out if other facets of the process are.)
• Is medication covered? (Again, even if the IVF procedure isn’t something your insurance can help with, medication might fall into a different category. It’s worth asking.)
• Is there a coverage cap? (If IVF is paid for, is there a cut-off or dollar amount for how much your insurance will reimburse you for?)
• What treatments are covered? And is there a waiting period before qualifying for IVF? (Is IUI—Intrauterine Insemination—a process you have to explore first? Do you have to provide documentation of a period of time spent trying to conceive? You’ll want to ask.)
If your employer doesn’t offer coverage, that’s when you’ll have to map out the costs as part of your budget. In terms of affordability, you can of course pay out of pocket, but you can also use credit cards or speak with an available lender that offers loans to couples and singles looking to start a family. Some clinics even offer no-interest monthly payment plans.
Not All Insurance Providers Are Created Equal
The devil’s in the financial details, explains Dr. Peter Klatsky, a fertility specialist and co-founder of Spring Fertility. “We’ve found that while specialty insurers like Progyny and Carrot are able to administer an exceptional experience for our patients, many traditional commercial insurance companies struggle to provide our patients with correct information about coverage.”
This is mostly due to a lack of familiarity with infertility, Klatsky adds. “Patients who are told they have generous IVF coverage are surprised to find large deductibles, coinsurance and co-pay requirements, or find they are excluded from various services. The headaches and heartache incurred by our patients through communication with their insurance companies adds undue stress to a complex and often already stressful period.” That’s why there’s value in leaning on anyone who can be your financial advocate during this time, he explains. (Spring, for example, has a dedicated team tasked with running benefits checks through commercial insurance carriers.) It’s worth asking either your insurance company or clinic if they provide a similar option to help you navigate the financial side of the process.