Despite fertility clinic financial incentive programs and low-interest financing options, multiple rounds of fertility treatments can be quite costly.

The team at GIVF Fertility created this straightforward guide to maximize workplace fertility benefits to help individuals and couples conserve their precious dollars.

Optimizing Fertility Benefits: A Step-by-Step Guide

Here are some simple steps and tips to help you learn where to save – and the best way to spend – to create a fertility treatment plan that’s as affordable as possible.

1. Set an appointment with your HR team

Wading through insurance paperwork is not easy, as the verbiage is not always straightforward. It’s easy to misunderstand important clauses regarding annual and lifetime coverage benefits. Scheduling an appointment with the HR team for more expert analysis of your company’s healthcare benefits and any available fertility benefits is a solid first step in understanding what’s covered – and what’s not – as you begin to create your financial plan.

If you work for a small company that outsources support for insurance and wellness benefits, contact the insurance carrier’s customer service representatives. Speak with someone who can review the plan with you. It’s also a good idea to confirm what the meeting covered in a follow-up email and ask for their confirmation that you’ve understood correctly. This helps to verify everyone is on the same page.

2. Audit the company’s fertility plan specifics

If your company offers a supplementary fertility plan, like Gaia, Carrot, or Maven, you’ll want to dig in and make sure you understand the ins and outs of that policy as well.

Whether you choose to sit down with HR or review the plan on your own, it’s important that you read the policy word by word to understand the extent of the benefits.

Review which fertility treatment options are covered

Read carefully to see which fertility treatments are covered and whether the plan has any limitations around those. For example, most fertility treatment plans include things like sperm/egg freezing and storing, IUI, IVF, the use of a gestational carrier, adoption, etc. However, plans are specific about how many rounds are covered. For example, you may have a lifetime spending cap of $20,000, but the plan may also specify they only cover one or two cycles of IVF or IUI.

Knowing the parameters of your insurance policy helps us to craft a more targeted fertility treatment plan.

Get clear about dollar amounts

Similarly, your plan probably has an annual or lifetime cap on coverage. If this is the case for your plan, be mindful about which appointments/treatments you run through the fertility plan. For example, your plan may have a lifetime fertility cap around the $20,000 mark. While that is a generous benefit, it will be used up quickly if you require IVF treatments or you’re using the funds for fertility preservation.

Gaining clarity around exact dollar amounts and then speaking with a fertility specialist about your situation and long-term goals can help you maximize every dollar spent on family building.

3. Maximize your regular health insurance plan benefits first

Your regular health benefits may cover more than you realize when it comes to general infertility testing, diagnosis, and first-round attempts at fertility treatment. For example, qualifying patients who meet the traditional criteria for infertility may have existing coverage through their general healthcare plan.

Review your current health insurance plan to verify whether they cover things like:

• Sperm testing.
• Hormone bloodwork.
• Genetic screening.
• Ovarian reserve testing.
• Ultrasounds (looking for obvious anatomical abnormalities, fibroid tumors, scarring, or other factors that may cause infertility).
• Hysterosalpingogram (HSG) or similar tests to assess tubal blockages or other potential issues.

Keep in mind: if you use payment benefits for these general diagnostic tests with an OB/GYN and then need to pursue treatment with a fertility specialist, your primary health insurance policy usually won’t cover the tests a second time with your specialist. Careful planning is essential.

4. Consider seeing a fertility specialist sooner rather than later

If financing fertility treatments is a concern for you, you may want to connect with a fertility specialist sooner rather than later. As we mentioned above, your primary health insurance carrier is not likely to cover routine infertility diagnostic tests more than once.

If you and/or your OB/GYN feel you have an infertility diagnosis, being referred to a fertility specialist may be the best choice to optimize your collective benefits from both your primary and fertility-specific policies. Our team can review your benefits and help you create a diagnostic and fertility treatment plan that makes the most of your benefits, especially when combined with in-house packages or special offers.

5. Coordinate fertility treatment with paid leave and PTO policies

Once you’ve been diagnosed and have a clear fertility treatment plan in place, your calendar will be populated with a multitude of appointments that require careful logistical planning. For some, a hybrid live/work model provides just the flexibility they need to strike a balance between work, life, and fertility treatments.

Read your company employee manual and review their policies around:

• PTO
• Flex time
• Medical leave
• Roll-over time/days if unused in the previous year(s).
• Short-term disability/parental leave (for your pregnancy and/or after the baby is born)

If you have a more tried-and-true, 9-to-5, work schedule, plan fertility time off accordingly. Review your company’s paid leave and PTO policies and leverage those to minimize or avoid unpaid time off.

GIVF Helps Patients Optimize Benefits For More Affordable Fertility Treatments

We understand that out-of-pocket fertility costs are expensive. That’s why GIVF works closely with clients, helping them to optimize existing benefits, take advantage of potential treatment offers, and to plan carefully to ensure their payment plan matches their budget.

Contact GIVF Fertility to learn more about how we can help you maximize your workplace fertility benefits.