June/July 2010
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Infertility: How much will your baby cost? Part 2: Budgeting for Infertility and Tips for Saving Money Along the Way by Amy Moll L.Ac., Dipl. Ac. 
One of the most difficult aspects of infertility is the sense of powerlessness over the situation. Working out a fertility plan and developing a budget helps couples move forward with a greater sense of calm regarding their decisions; see it as a road map. There are many paths to the same destination, and having alternate routes greatly decreases the stress when encountering a road block. This article is Part 2 in a series (read Part 1 here) focused on understanding the costs of infertility treatments and how to navigate the four billion dollar per year fertility industry.
Elena and Chris tried to conceive naturally for 1 ½ years before seeking medical help. Elena was diagnosed with Polycystic Ovarian Syndrome, which often impedes healthy ovulation. She began taking a fertility drug and after 2 months became pregnant. Joy quickly turned into sadness when she found out it was an ectopic pregnancy. Abdominal surgery was required and her right fallopian tube was removed. Four more months of using fertility drugs yielded no results. The couple then sought out the help of the Oregon Reproductive Medicine Clinic in Portland. It was there Elena discovered she had a tubal defect in her remaining fallopian tube, as well as endometriosis. There was no way she would be able to conceive without in vitro fertilization. Elena and Chris lived 6 hours from Portland and 3 ½ hours from Bend. Not only were they looking at the cost of IVF — a procedure that can cost anywhere between $10,000 and $15,000 for one cycle (often more are required), but also additional expenses including driving long distance for appointments, overnight accommodations, and missing numerous days of work. A diagnosis of infertility can be devastating to a couple. Understanding that "infertility" can be a temporary condition with many solutions helps to keep a cool head and focus on how to move forward. By developing a fertility plan and creating a budget for managing the financial burden, couples can decrease a large part of the stress involved in trying to conceive. Important questions to discuss when creating a plan of action include:
Budgeting for infertility first requires budgeting for everything else. Couples need to have a clear idea of where all of their money is going before making decisions about what they can afford, and where they can cut back on spending in order to save. Make a date to sit down and go over your collective income and all expenses. An ideal budget has 60% of pre-tax income paying for necessities (shelter, food, clothing etc.) the other 40% is divided between retirement investments, savings, emergency funds, debt repayment and spending money. Where do your numbers fall? Money for fertility treatments can be a percentage of that 40%, but should not overextend into the 60% for basic necessities. Remember, good financial planning includes short-term planning and long-term planning. Before pursuing fertility treatments, it may be wise to discuss and look into disability insurance and your medical insurance policy's maternity benefits. The ability to obtain these may change once you become pregnant. Understanding your Insurance Policy In the state of Oregon, insurance companies are not required to cover infertility treatments; however some will cover a portion. Elena and Chris were able to get their insurance company to pay for testing, monitoring, and medications equaling $4,000. The ins and outs of any insurance policy are never easy to understand. Do not rely on the fertility clinic you are working with to tell you what is covered and what is not. First, obtain the most recent version of your policies Evidence of Coverage. Under the benefits section, look to see if infertility is covered in part or full. If so, are there procedures that require a pre-authorization? Do you have to work with a specific type of health care provider in order for the service to be covered? Is a referral required in order to go to a fertility specialist? Are there limitations written into the plan regarding fertility procedures? If you have a pre-existing condition that is affecting fertility, your insurance may cover certain procedures or medications aimed to correct the underlying problem. Many will also pay for diagnostic testing of infertility and even limited coverage for procedures or medication. Once you have read through your policy, write down your unanswered questions and call your company for further details. If the insurance company states in your policy or over the phone that they will pay for diagnostics, other procedures, or the cost of drugs, the best thing you can do to protect yourself is to get it in writing. You will have to write the insurance company a letter requesting pre-authorization. Send the letter certified mail, which means, it can't be addressed to a post office box. Look in the back of your policy booklet under Appeals to find the actual address of the company. You can find sample letters in the appendix of the book Budgeting for Infertility to use as a guide. Fertility Drugs Fertility drugs make up a large portion of the cost for in vitro fertilization (IVF) procedures, totaling $2,000 - $5,000 per cycle. Once you know what medications you will need, call around to different pharmacies to compare prices. Some pharmacies have discount programs or preferred customer accounts that can save hundreds of dollars. You can also call the drug company directly and ask for samples or coupons. Both Serono (1-866-538-7879) and Ferring (1-888-337-7464), two fertility drug manufacturers, offer limited financial assistance programs to those that qualify. The popular drug Clomid (clomiphene citrate) that typically runs $50.00 a prescription is now on the $4.00 menu at Wal-Mart along with Metformin and certain antibiotics. Bring an updated medications list from Wal-Mart to your fertility appointments so you know which ones you can get for less. Working with Fertility Clinics Whether planning an intrauterine insemination (IUI), IVF, or any other procedure, have the clinic provide you with a list of specific costs for each consultation and procedure to get a rough idea of your grand total. Keep track of all your appointments and procedures as they happen, so when you get the final bill, you can go through and make sure everything is accurate. Some consultation and procedure prices can be negotiated with the clinic. If you are a savvy negotiator, you may want to exercise those skills and see where it gets you. Embryo freezing is becoming more widely used and can save lots of money on repeat cycles called frozen embryo transfers (FET). If you have more than 1 or 2 embryos successfully fertilized in the lab, the rest can be frozen and used for another cycle. FET's cost between $1,000 and $3,000, plus the cost of medication. Ask your IVF clinic if they freeze embryos. Find out what the initial cost is to freeze them, and the annual cost to store them. Chinese Medicine & Acupuncture For those who choose not to use western fertility methods, Chinese medicine can provide a great alternative. Chinese Medicine and acupuncture are often used to treat infertility in a number of ways. A skilled practitioner will examine the patient's diet, lifestyle, and emotional, spiritual, and physical health and factor all these elements into a treatment plan. This plan may include acupuncture, herbal medicine, supplements, diet modifications, and stress reducing activities. Call around to local practitioners to check on prices for treatments and average prices for herbal therapies on a monthly basis. Find out it they offer a free consultation so you can meet the practitioner, see the clinic, and assess how they would work with you. Getting Creative One couple in Bend, Sherry and John, took a home equity line of credit to help pay for their IVF. They were also able to save $5,000 in a stroke of luck when a friend donated all her fertility medications. She had an IVF procedure planned, but conceived naturally right before. Joining an infertility study or clinical trial is another way to save on costs. Ask your fertility doctor to see if any studies are happening in your area. Also check out www.clinicaltrials.gov for more specific details. Elena and Chris found a Capital One Fertility Treatment loan offering reasonable rates. The couples total out-of-pocket expenses for their IVF was $10,000. However you get your funding, remember that all the medical expenses and traveling expenses including hotel costs and mileage can become a tax write-off. Your accountant can help you decide whether to itemize your expenses or take a standard deduction, so make sure to save all of your receipts and bills. Conclusion Stress can be a key component to infertility. Faced with such large expenses, it is important to address the financial aspect of stress that goes along with infertility treatments. Work closely with your partner on creating a plan, and agree on what to sacrifice in order to save up money, budget for medical bills, or pay off a fertility loan. Elena offers this piece of advice, "We talked about every penny spent, and made shopping more creative. It is very easy to become overwhelmed with all the emotions. Also, it isn't just the women who feel the defeat of having to go through IVF, so don't forget your partner's feelings." She and her husband are currently preparing their home for the arrival of their first baby boy. |
