Women frequently question if their insurance will cover the cost of freezing their eggs. The quick answer is that it is debatable. However, before we look into whether egg freezing also known as oocyte cryopreservation is covered by insurance, let’s take a look at why women opt to do it and what it entails.
Why Freeze Your Eggs?
Women today frequently have to choose between pursuing a profession and starting a family. Society has struggled to recognize these two pursuits as mutually beneficial without one “losing out.” More women are deferring having children in order to focus on their professions.
According to a recent study1, more women are freezing their eggs to prevent choosing the incorrect spouse and to give themselves more time to choose wisely. Women felt more secure in their capacity to have children later in life, according to the same study.
Some women decide for egg freezing in their 20s and early 30s to retain the chance of having children later on, when conception may be more difficult. This allows individuals to start a family in their late 30s or even early 40s, albeit there are significant hazards involved.
How Does it Work?
The technology was originally successfully presented in 1986 by Christopher Chen2, an Australian biologist who was the first to accomplish a successful live birth from egg freezing. It was only recently withdrawn off the market “procedure category “experimental” The procedure entails harvesting, freezing, and storing a woman’s eggs until she is ready to conceive.
Of fact, it’s a lot more difficult than that, and there’s no assurance that this will result in a healthy baby. However, as technology advances, the likelihood of success increases, making this a more plausible alternative.
“Unfertilized eggs retrieved from your ovaries are frozen and kept for later use. In vitro fertilization is when a frozen egg is thawed, mixed with sperm in a lab, and put in your uterus.
How Much Does it Cost?
Treatment and storage costs can range from $30,000 to $40,000, according to Fertility IQ4. This includes retrieval, prescription, and storage costs, and it assumes two treatment cycles (the average is 2.1). Women’s prices rise as they get older; (older women will pay more for more cycles and typically harvest few eggs).
The cost of a cycle varies by area, but the national average is roughly $15,991. Many women prefer to have two cycles of eggs harvested and frozen in order to boost their chances of success.
According to Extend Fertility, a clinic dedicated to educating and counseling women about fertility, storing eggs at a younger age can cut the overall cost of a live baby by over $15,000 when compared to typical fertility procedures at an older age.
Does health insurance cover the costs?
In 16 states, insurance companies are required to cover or give coverage for fertility therapy. Arkansas, California, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia are among the states in question. If you live in one of these states, insurance may be able to assist pay for coverage; however, depending on your plan, you may still be subject to deductibles and out-of-pocket payments.
Even if you don’t live in one of these states, your health insurance may cover some of your medical expenses, such as blood tests or ultrasounds. It’s a good idea to go over the fine print of your health insurance policy so you know exactly what to expect.
Some companies5, including a few in the technology industry, underwrite the costs of reproductive procedures and egg freezing. These perks are provided in order to attract and retain outstanding female talent.
Are there other ways to pay?
Fertility clinics are working hard to drive down costs or assist people discover other ways to pay for services as the practice becomes more popular. However, if insurance does not pay, the most typical payment method is for individuals to pay out of pocket. Financing may also be an option for some.
Next Steps
In the end, more and more women may choose egg freezing as a way to extend their lives and pursue a job while still in their twenties and thirties before starting a family. Instead of listening to their “biological alarm clock,” as the baby-urge is commonly referred to, they will spend more time picking a spouse. With the new finding that storing eggs at a younger age can reduce costs, more women may opt to undergo this process to assure that they have children in the future.
If health insurance isn’t going to cover it, getting a job makes the option of freezing eggs more affordable. It can help those who are in their late 30s or early 40s have a better chance of starting a family. It’s also more appealing to have a prosperous spouse to help pay for the costs of waiting.
Whatever a woman chooses, it’s comforting to know that she has options – that some states, and even some employers, are on her side.
Which insurance company covers egg freezing?
Blue Cross and Red Crescent Societies Blue Shield is one of the major insurance companies in the United States, and their customers are currently covered for egg freezing.
Is egg freezing covered under insurance?
You are not alone if you are not yet ready to have a family and want to store your eggs for later usage. Today, a big number of women are using the egg freezing method to ensure that they can start a family when the moment is right for them. Before you go ahead and freeze your eggs, there are a few things to think about.
Cost
The cost of egg freezing is an essential consideration. Medication, treatment, and egg storage are all included in the total cost, which is not inexpensive. However, freezing your eggs can save you thousands of dollars in fertility treatment costs in the future. Because freezing eggs is such an expensive procedure, it’s crucial to know if you may get insurance coverage for it.
Is It Covered by Insurance?
The truth is that insurance rates vary depending on the payment method and the provider. However, oocyte cryopreservation, also known as egg freezing, is usually not fully covered by insurance. However, many insurance companies cover some aspects of this surgery. So, if you’re thinking about acquiring insurance for freezing eggs, you’ll need to figure out which aspects of the process are covered first and then do a cost-benefit analysis.
Cost-Benefit Ratio Analysis
The overall cost of the egg freezing technique, as well as the cost reimbursed by insurance, is compared to the procedure’s favorable feature in a cost-benefit ratio study. This will give you an excellent sense of how much money you’ll have to pay in this situation.
The Bottom Line
Your decision to freeze or not freeze your eggs should not be based solely on financial considerations. You’ll have to weigh the advantages of the procedure against the potential costs of fertility therapy in the future. Once you’ve figured out these details, you’ll be able to find an appropriate insurance company to assist you with egg freezing insurance.
Can I buy insurance to cover IVF?
California, unlike some other states in the US, does not require your health insurer to cover in vitro fertilization. While this is disheartening, there are health insurance plans in California that cover IVF fees on a voluntary basis. Employers who want to provide additional perks to their employees, on the other hand, pay for these advantages. As a result, in California, IVF health insurance is only offered through employer-sponsored health insurance plans and cannot be purchased through individual health insurance.
Individual Health Plan Coverage
So far, we are not aware of any individual health plans available on the ACA marketplace in California that cover in-vitro fertilization. This is unsurprising, given that coverage of in vitro fertilization would raise the cost of health insurance. Advanced fertility services are rarely covered by low-cost health insurance. While only a small percentage of members with fertility issues would be affected, the bulk of other insured members will benefit from cheaper monthly costs. If you live in California, your sole option for obtaining individual coverage for in vitro fertilization is to relocate to a state where fertility services are required to be covered by all insurance policies. Another option is to show that IVF is medically essential, such as in the case of a serious genetic disease. In most cases, low sperm count or obstructed fallopian tubes will disqualify you from those exclusions. One of our patients, a fragile X carrier, was able to convince the California Department of Insurance that advanced fertility procedures, including implantation genetic diagnosis, were medically necessary, forcing the insurance company to pay for them.
Employer sponsored health coverage
The ideal circumstance is to work for a company that offers these perks. Only affluent California firms, such as Google, Apple, Facebook, Tesla, and Warner Bros., are thought to provide health insurance with IVF coverage in California. Not everyone will be able to find work with those businesses. Corporations like Starbucks, on the other hand, may provide fertility coverage to their employees, and acquiring a job there may be easier than at the other companies mentioned. Benefits may be restricted to a higher-level employee group in some circumstances, but each organization sets its own policies. Prior to starting work, phone the HR department to confirm your position’s health insurance benefits.
Kaiser insurance will be available to a large number of Californians. Kaiser Permanente is used by several companies to provide health insurance to its employees. Unfortunately, Kaiser insurance plans purchased on an individual basis do not include fertility coverage; however, many members with employer-sponsored plans do. We’ve created a particular page to Kaiser Permanente members’ fertility coverage due to the significant number of Kaiser Permanente members in California.
Plan rules for IVF coverage
Even if your health insurance supports in vitro fertilization, there are frequently conditions that must be met before treatment can begin. In most circumstances, you’ll need to go through numerous rounds of intrauterine inseminations before you can use your IVF coverage (typically between 3-6). However, if your sperm quality is low or your fallopian tubes are blocked, you may be able to proceed to in vitro fertilization right away. Some insurance companies will recognize advanced reproductive age as a reason for IVF treatment right away.
How much does embryo freezing cost?
The technique of fertilizing eggs after retrieval and preserving them as embryos is known as embryo freezing.
PFCLA charges $9,000 for one cycle, $16,500 for two cycles, and $22,000 for three cycles for embryo freezing. These costs include the following:
- Testing may be reimbursed by your insurance prior to treatment. This can cost anywhere from $500 to $1,500.
- Insurance may also pay fertility medicines. This will set you back between $3,500 and $5,000.
- The cost of preimplantation genetic screening (PGS) is $5,000 for the first eight embryos and $250 for each extra embryo.
- The cost of an embryo transfer is determined by the quantity of transfers purchased. Intended parents should anticipate to pay roughly $4,500 plus excluding charges for one frozen embryo transfer.
Is elective egg freezing tax deductible?
When it comes to job perks, or what the IRS refers to as fringe benefits, the value of those perks is usually included in gross income and taxed unless otherwise stated. Free flights, vacations, social club memberships, and tickets to special events are all examples of taxable perks. Healthcare benefits, childcare aid, and tuition reimbursement are examples of nontaxable benefits.
Payments or reimbursements for certain medical expenses are typically excluded from income and hence tax-free. That may lead you to believe that funds set aside for a medical procedure such as egg freezing should be excluded – however this is not always the case. Funds used to cover eligible medical expenses in reimbursement programs such as a Health Reimbursement Account (HRA), a Health Savings Account (HSA), or a Health Care Flexible Spending Account (FSA) are not taxable. Qualifying medical expenses, on the other hand, are those that qualify as federal income tax deductions under Section 213(d) of the Internal Revenue Code. Expenses for “the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of influencing any structure or function of the body” are particularly included. In the absence of a particular infertility diagnosis, elective egg freezing would not be a deductible medical expense for this purpose.
The cost of employer-provided healthcare paid on an employee’s behalf as part of a qualified plan is also not included in income. Qualified healthcare plans must generally meet certain minimal conditions in order to be exempt from income, such as coverage for hospitalization, emergency care, prescription medicines, and physician services. Employers may provide additional benefits, but it’s crucial to assess if such advantages would allow the plan to remain a qualified plan under the Code, according to Keith R. McMurdy, a benefits partner at Fox Rothschild NYC.
According to Rochelle J. Petrikis, a Solutions Advisor at Total Benefit Solutions Inc., plan coverage is often set by the carrier rather than the employer. Employers choose plans depending on the level of benefits they want to provide their employees, but they don’t choose individual perks within each plan. Employers can acquire riders to provide for additional benefits in some situations, she said, but they are normally limited to qualifying medical expenses and do not include elective treatments.
If your health insurance plan doesn’t cover a certain benefit that you want or need, you’ll have to pay for the procedure yourself. Your out-of-pocket charges may be deducted on your individual tax return if the operation isn’t a qualified benefit but is a qualifying medical expense. However, unless you have a particular infertility diagnosis, the cost of freezing your eggs is not deductible as a medical expense on your Schedule A under current tax law. If you were to receive such a diagnosis, the standard criteria for medical expense deductions would apply (and allow that you may not deduct an expense which has been previously reimbursed or paid by your employer).
Is there any chance that the perk, if supplied by your employer but not excluded from income as a medical benefit, could qualify for another tax-favored break? It’s unlikely. The perk would certainly not be considered a de minimis benefit at a cost of $20,000. The benefit must be of such insignificant value that “accounting for it would be irrational or administratively impractical.” Because of the costs of egg freezing, it is more expensive than a tax-free fruit basket.
This means that when it comes to atypical perks, businesses must step carefully. While it may be advantageous to think outside the box, there are a lot of considerations when it comes to providing these types of benefits to employees, including privacy concerns and whether it is a “fair” bonus to offer when only a tiny percentage of employees will use it. Women who choose not to use egg freezing, for example, may be concerned about how their decision will be perceived: are they sending a message that they are unwilling to put their profession ahead of their family? What about males who don’t want to share their advantage with their partner? Employees rarely discuss their family plans with their employers, but taking advantage of this benefit – or opting out – could telegraph your intentions. Employers may be troubled by this message in the future. McMurdy cautions that it’s necessary to think about the non-tax implications of atypical benefits, such as whether they could expose a company to discrimination lawsuits.
These types of questions will continue to arise as long as the Apples and Facebooks of the world continue to push the boundaries and challenge our perceptions of benefits, remuneration, and what it means to be an employee. The IRS, for example, began vigorously enforcing a 1989 rule that taxed employer-issued cell phones as pay in 2009; however, that position was subsequently reversed in 2011. Similarly, the IRS said in 2002 that it would no longer attempt to tax frequent flyer points acquired as a result of work travel.
The truth is that, as the world of business evolves, so will our tax rules. Big changes are set to come as the “perk wars” in the tech sector heat up, with companies giving anything from egg freezing to gourmet meals as incentives. Employers, Congress, and the IRS may be compelled to reassess how benefits are handled and taxed, while employees will be forced to make difficult judgments about whether those advantages are worth the cost.
Can I freeze my eggs at 40?
Dr. Hill is Associate Professor, Obstetrics and Gynecology, Uniformed Services University, Bethesda, Maryland, and REI Assistant Division Director, OBGYN Residency Assistant Program Director, Walter Reed & NIH REI Fellowship. In relation to the content of this essay, he has no conflicts of interest to disclose.
Dr. Levens is the Director of Research at Rockville, Maryland’s Shady Grove Fertility Science Center. In relation to the content of this essay, he has no conflicts of interest to disclose.
The writers’ opinions are their own, and they do not reflect the official policy or viewpoint of the Department of the Army, the Department of Defense, or the United States Government.
For women who have lost their fertility due to cancer or other medical issues, egg freezing is a popular and effective treatment. Elective egg freezing to postpone childbearing due to “social indicators” is also on the rise. It’s debatable if there should be an age limit for egg freezing.
The first question is if a sufficient quantity of eggs from patients beyond the age of 40 can be produced to justify egg freezing. Patients aged 4144 generate 69 eggs suitable for freezing per stimulation cycle on average, and two cycles are required to bank 16 eggs. 1 Patients aged 3740, on the other hand, generate on average 810 eggs suitable for freezing per cycle and require two cycles to bank 16 eggs. 1 As a result, there is no discernible decline in egg output at the age of 40 to make this age a discriminator.
It is not uncommon for us to offer fertility treatment to women who have a success rate of less than 10% at our clinic. Women over the age of 40 who want to freeze their eggs appear to have a prognosis that is equal to or better than this value and should not be precluded from treatment. Women over 40 who freeze their eggs have a 2 percent3 percent decreased chance of having a live baby than women aged 3740. As a result, an age cutoff of 40 does not appear to be justified in terms of outcomes.
Recent studies have shown that elective egg freezing before the age of 3436 maximizes live birth and is most cost effective before the age of 3738.
1-3 Patients should be informed that elective age freezing is best done at these younger ages. Older patients, on the other hand, have a good likelihood of having a live birth. Egg freezing should not be ruled out for a patient over the age of 40 who has been properly advised and understands the costs and realistic odds of success.
2. Cil PA, Bang H, Oktay K. Individual patient data meta-analysis of the age-specific likelihood of live birth with oocyte cryopreservation. 2013;100:492499. Fertil Steril. 2013;100:492499.
Mesen, T.B., Mersereau, J.E., Kane, J.B., and Steiner, A.Z. When is the best time to freeze your eggs? Fertil Steril 103:15511556 (2015).
Yes. The likelihood of success is too low and cost too high
Dr. Rhoton-Vlasak is an Associate Professor at the University of Florida College of Medicine’s Division of Reproductive Endocrinology and Infertility in the Department of Obstetrics and Gynecology in Gainesville. In relation to the content of this essay, she has no conflicts of interest to disclose.
I believe that elective oocyte cryopreservation should be limited to people above the age of 40. Oocyte cryopreservation was initially approved as non-experimental by the American Society for Reproductive Medicine in 2013. 1 Egg freezing is optimal for women in their 20s and 30s, and it is not suggested for women above the age of 38. 2 Preserving fertility in patients receiving gonadotoxic therapies for cancer or other diseases, in certain genetic conditions, in situations where there is a failure to obtain sperm for IVF, for couples who cannot or do not want to cryopreserve excess embryos that are not transferred in a fresh cycle, and for elective oocyte cryopreservation to defer or protect child-bearing potential (ie, for “social indications”) were among the proposed applications of this technology.
Oocyte cryopreservation to increase future reproductive possibilities should be provided for nonmedical reasons, according to recent European Society of Human Reproduction and Embryology committee remarks.
3 As more women wish to postpone parenting in order to pursue their educational, career, and other aspirations, “social” egg freezing has become more accessible. Apple and Facebook, two of the country’s greatest technology companies, have established a $20,000 employee bonus to cover oocyte cryopreservation. 4 Single women or career-oriented women who want to protect their fertility from age-related decline may find oocyte cryopreservation to be a realistic option. However, this cutting-edge technology will not protect against the natural drop in fertility that comes with age.
Allowing women beyond the age of 40 to have their oocytes cryopreserved has emotional, economical, and cultural ramifications. In general, women will require greater doses of fertility medications for optimal stimulation, resulting in increased egg cryopreservation cycle expenses. Given the far reduced success rates, this will offer little hope or value. According to data from the 2013 Society for Assisted Reproductive Technology in the United States, the percentage of cycles ending in live births for fresh embryos from non-donor oocytes drops from 21% at ages 3840 to 11% at ages 4142, and then drops to 4.5 percent after age 42. Despite an increase in the number of embryos transplanted per transfer at the age of 40, this decrease persists. 6 Instead of “how can I develop my practice this quarter,” healthcare policy should be founded on the Hippocratic principle of “primum non nocere.”
Elective egg freezing should be available to women of all ages, but I recommend a 40-year-old restriction due to poor pregnancy rates, higher costs, similar surgical risk, and a desire to avoid giving patients false optimism. Every procedure in medicine has its limitations and contraindications, and we certainly need to set an age restriction for oocyte cryopreservation. It makes sense to have some guidelines in place when patients seek our help. “Primum non nocere” takes over as our best guiding principle as the risk:benefit ratio approaches zero.
1. The American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology’s Practice Committees. A guide on cryopreservation of mature oocytes. Fertil Steril, vol. 99, no. 3, pp. 3743, 2013.
3. ESHRE Task Force on Ethics and Law, Dondorp W, de Wert G, Pennings G, et al. Cryopreservation of oocytes for age-related infertility. 12311237 in Hum Reprod. 2012;27:12311237.
Optimal timing for elective egg freezing. Mesen T, Mersereau J, Kane J, Steiner A. Fertil Steril 103:15511556 (2015).
Does insurance cover fertility treatment?
- Many people need help with their fertility. This group comprises infertile men and women, numerous LGBTQ people, and single people who want to start a family. Approximately 10% of women say they or their partners have ever sought medical assistance to become pregnant.
- Despite the necessity for reproductive services, many people in the United States cannot afford them. Fertility services are frequently not covered by public or private insurance. Although fifteen states compel some private insurers to cover some forms of reproductive treatment, there are still major coverage gaps. Only one state’s Medicaid program supports fertility treatments, and neither artificial insemination nor in-vitro fertilization are covered.
- The majority of individuals pay for reproductive therapy out of pocket, which can cost well over $10,000 depending on the services provided. As a result, many people are unable to obtain fertility treatment due to a lack of insurance coverage.
- Black and Hispanic women are less likely than White women to have used medical services to become pregnant. This is due to a variety of variables, including lower average wages among Black and Hispanic women, as well as hurdles and misunderstandings that may deter women from seeking fertility aid.
- Access to fertility care is also more difficult for LGBTQ people, as they frequently do not fit the standards of what it means to be gay or lesbian “They would be eligible for covered services if they had “infertility.” Transgender people receiving gender-affirming treatment may also fail to meet eligibility requirements “They would be eligible for covered fertility preservation if they had “iatrogenic infertility.”
Introduction
Many people seek fertility treatment in order to start a family. This could be due to an infertility diagnosis, being in a same-sex relationship, or being single and desiring children. While there are numerous types of fertility help, many of them are out of reach for the majority of people due to financial constraints. Fertility treatments are costly, and insurance typically does not cover them. While some private insurance plans cover diagnostic services, treatment services like as IUI and IVF, which are more expensive, are rarely covered. The majority of people who seek fertility treatment must pay for it out of pocket, with expenses often running into the thousands of dollars. Only one state mandates infertility services to be covered by private insurance policies, and only one state requires coverage under Medicaid, the low-income health-care program. Even if they have health insurance, this deepens the gap for low-income people. This brief looks at how state rules, insurance types, income levels, and patient demographics affect access to fertility services, both diagnostic and treatment.
Diagnosis and Treatment Services
Infertility is most frequently defined1 as the failure to conceive after one year of regular, unprotected heterosexual intercourse, and it affects about 10-15% of heterosexual couples. Infertility is caused by both female and male factors, including issues with ovulation (when the ovary releases an egg), structural problems with the uterus or fallopian tubes, sperm quality or motility issues, and hormonal factors (Figure 1). Infertility is caused by more than one factor approximately 25% of the time, and infertility is unexplained about 10% of the time. Estimates of infertility, on the other hand, do not take into consideration LGBTQ people or unmarried people who may require fertility treatment to start a family. As a result, there are a variety of reasons why people seek fertility treatment.
Does insurance cover fertility testing?
Services linked to infertility testing are frequently (but not always) covered by health insurance programs. Many insurance plans, on the other hand, state that after a diagnosis has been made, they will no longer pay for fertility-related therapies. This is most likely owing to the fact that diagnostic testing is quite inexpensive for them.
When it comes to test coverage, there may be some murky areas. For instance, a lady who is attempting to conceive has heavy periods and excruciating menstrual pains. The fertility center performs a hysteroscopy on her to evaluate the matter. Regardless of the test’s results, the insurance company may pay in full or deny payment, claiming that infertility is not covered. Was the test performed because she was bleeding and in agony, or because she was infertile? What if that was done for every single one of them? It can be a little difficult and complicated at times.
Infertility treatment and insurance
Treatment for infertility is far less typically covered by insurance than testing. When there is coverage for infertility treatment outside of a state required condition (see below), it is fairly typical to exclude IVF or have a lifetime maximum benefit.
We frequently see health insurance plans with a lifetime maximum of $10,000 to $25,000 on the market. The insurance company’s potential costs are thus limited. In other circumstances, insurance will cover testing and treatment up to and including intrauterine inseminations, but not IVF. The “monitoring” of IVF ovarian stimulation (blood and ultrasound tests) is occasionally reimbursed, but not all of the (expensive) IVF codes are.
State insurance mandates for infertility and IVF services
There are now 15 states with some form of infertility mandate. In terms of what is covered how many IVF rounds, for example the mandates are significantly varied. Some of the mandates are somewhat extensive, while others are not. Other states’ mandates are not explored in detail here.
How do you pay for IVF?
Here are some of the finest ways to pay for IVF treatments if you need them.
- A loan from a fertility professional. Who it’s best for: Those looking for a lender who works closely with their reproductive clinic.