So it's almost open enrollment and companies still have time to add coverage to their policies. So hurry and submit a simple letter asking for coverage. Use my letter as a jumping off point and add details relevant to your experience at the company. Here are some more of my tips to winning coverage.
In July, I approached the Human Resources department at an “Ask HR” event to request coverage of infertility treatment for [EMPLOYER] employees. I appreciate very much that a committee will review this medical coverage for possible inclusion for 2015. This issue is very personal to me, as I was diagnosed with infertility and being very young in my career, it is difficult for me to finance the treatment recommended for my diagnosis.
As much as this is a personal issue for me, it is advantageous for [EMPLOYER] to help their employees reach their personal goals and overcome medical issues so that they will be more productive at work. I have already met one other women employed here at [EMPLOYER] who financed her own infertility treatments. There are likely others at our large company who quietly struggle with their very private infertility diagnosis, as one in eight couples in the US will not conceive after a year of trying.
Infertility is far beyond a “quality of life issue”; it is a medical issue with known treatments that should be covered
[EMPLOYER] already offers health insurance plans that cover other aspects of family planning such as treatment of male sexual dysfunction, adult sterilization, pregnancy termination, and birth control. Adding infertility coverage to our policy is actually likely to result in reduced costs for [EMPLOYER] and more successful outcomes for employees diagnosed with infertility.
In the U.S., 14 states mandate insurance coverage of infertility treatment. In those states, the rate of high-risk multiples births is lower than those that do not mandate coverage (New England Journal of Medicine, “Insurance Coverage and Outcomes of In Vitro Fertilization,” August 2002). Massachusetts mandated full infertility coverage, including In Vitro Fertilization (IVF), in 1987, and since then, the cost of infertility services as a percent of the total health premiums went down (Griffin and Panak, Fertility & Sterility, 1998). Coverage results in patients receiving timely and effective treatment of their infertility diagnosis.
When couples are forced to cover the costs of treatment themselves, they make riskier
decisions in order to maximize the probability of conception when financing the high cost of a single fertility treatment. Couples often choose to transfer more than one embryo, which can result in high-risk pregnancies, post-pregnancy complications and low birth-weigh multiples- a cost burden that their health insurance providers and underwriters bear. A patient diagnosed with infertility can further try to minimize their out-of-pocket expenses by traveling to countries like India or Thailand for cheaper infertility treatments with more lax regulations about embryo transfer numbers than in the United States. Any infections or complications from sub-par medical treatment to the patient will be covered by insurance upon returning to the US. In states that mandate infertility treatment coverage, infertile couples are more likely to have one healthy child as they are not making medical decisions based on cost alone.
Coverage options for infertility treatment vary widely. Massachusetts and Illinois mandate infertility coverage that includes artificial insemination, IVF, sperm and egg procurement and processing. In Illinois, up to 4 egg retrievals are covered with an additional 2 if a live birth occurs. Other plans, for example have a maximum dollar amount coverage, for example $50,000 in infertility treatment coverage. [EMPLOYER] could also offer employees to purchase an insurance rider that includes fertility coverage, similar to the opportunity that [EMPLOYER] employees in North America have to purchase Pet Health Insurance. I encourage [EMPLOYER] Corporate Medical group to review infertility benefits coverage and limitations adopted by Massachusetts and Illinois.
Infertility is far beyond a “quality of life issue”; it is a medical issue with known treatments that should be covered for the women and men who work for [EMPLOYER]. Admittedly, infertility is not life threatening, but neither are medical aliments that have coverage such as a broken leg or erectile dysfunction. Respectfully, I hope this underlines the healthcare inequity that exists when infertility treatment is a coverage exclusion.
Please let me know if you would like any additional information on this issue. I am happy to help in your research or to provide my personal testimony.
I hope that [EMPLOYER] will consider offering full infertility coverage and support your employees in their family planning efforts. Thank you for your consideration.
YOU- your turn to make a change! Let me know how I can help you in your efforts!