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Financing Your Fertility Treatment


a blog by David Kreiner, M.D., F.A.C.O.G., March 23, 2010

I was recently shocked by a complaint from another physician. Apparently, this doctor's patient was offended that I discussed the finances involved with her treatment with her. Her doctor, an Ob/Gyn, agreed with her that it was inappropriate for me to discuss the cost of her options. He told me, “I like you and think East Coast Fertility is an excellent program but I never talk about money directly to patients! It’s not, I don’t know, seemly!” He continued, “Money issues are discussed with the business office, the doctor only discusses the medicine.”

Perhaps it’s unfortunate that fertility doctors have to be so concerned about their patients’ pocket books. But in the case of infertility, only a handful of states having some kind of mandated insurance coverage and, mandates aside, not everybody in the United States even has health insurance! Many fertility patients are in some form or another “cash pay” patients. Most are concerned about financing their treatment. In fact, one of the most popular places patients visit when they go to any fertility clinic’s website is its “finance” page.

For this reason, I’ve developed many programs to create access to fertility care for as many people as possible. But here's the catch! One program does not fit all.

The programs -- grant programs, IVF studies, Micro-IVF, shared risk, and single embryo transfer -- are simply not oversized t-shirts. Each represents a certain course of medical care. And each individual and couple needs the assistance of a caring doctor to help them choose the right program that will fit their own particular medical history.

The most effective treatment and efficient program is always a full stimulation IVF. However, if a patient has insurance coverage for IUI and meds but not IVF, then she may prefer to do IUI. If she doesn’t have coverage for IUI, then it may be more cost effective to do Micro IVF or minimal stimulation IVF. Or the Single Embryo Transfer Program where we reward patients transferring one embryo at a time by making their cryo, embryo storage and unlimited frozen embryo transfers free. A shared risk program in which patients are offered multiple IVF retrievals and frozen embryo transfers for a fixed fee that is refunded if they do not result in a live birth may work best for other patients.

In today’s world of fertility care, a good doctor will help a patient find not only the right treatment but will also help them figure out how to access that care. In order to do that, a doctor may have to do what some may think is unseemly, that is, talk about money.

Comments (2)

As a patient, I directly ask even my general practitioner about how much a test or prescription is going to cost me. When I talked to my regular doctor about trying to have a baby over age 40, he wanted to run the whole series of tests on me- thousands of dollars. (I have a high deductible). We decided instead to start with the $75 sperm test. Turns out that male factor IS a major problem for us and we need IVF. (I eventually had my tests and have no issues). My fertility doctor gave me a prescription for a new, chewable, brand-name birth control pill to start the IVF process. Although I asked about generics, they said the pharmacy would "just give me the generic". When they didn't, I insisted they verify with the doctor that a generic is fine and give me that instead. I saved $50. With the cost of IVF, $50 may not seem like much-but it at least covers a tank of gas to get to all my doctor's appointments. Patients should be REQUIRING their doctors to talk about the costs. .

thanks for this post. i've discussed finances a little with my doctor (but mostly with the business office), and i appreciate his willingness to discuss our options. i live in NY, where fertility coverage is mandated, but my husband's company (a big ad agency) files as a federal company and for that reason does not have to offer IF coverage. i'm in the middle of my first IVF cycle and don't think cornell has a single embryo transfer program, but if they did i would be very interested in it. i will ask. thanks for the helpful information.

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