paying for fertility

January 28, 2013 by Aaron Leave a Comment

Shared Risk Programs

What are they?

Shared risk programs, aka IVF Refund programs, are an interesting vehicle for reducing the financial risk of having to undergo multiple IVF cycles. Getting pregnant through IVF, despite the best efforts of the brightest physicians and doctors around the world, is still an odds game. Patients trying to get pregnant through IVF are basically rolling the dice for a successful pregnancy. Depending on your age and condition, these odds can vary from under 10% per cycle to upwards of 75/80%, if using donor eggs. As such, it is not uncommon for patients to need several rounds of IVF treatment in order to take home a baby.

IVF is not an inexpensive treatment and the financial burden of having to go through many cycles of treatment can be overwhelming. To help put fertility patients financial worries at ease clinics developed programs that would, for eligible patients, put limits on the potential costs of their treatment cycles. You can think of them as a form of infertility insurance that helps protect the patients from financial loss. And thus shared risk programs were born.

How do Shared risk programs work?

Essentially, these programs offer patients a flat-fee that will cover a set amount of treatment cycles and, if the treatment is not successful, offer a partial or full refund of those fees. These programs are beneficial to both parties. They give patients a clear amount that they know will get them to their goal of getting pregnant, or they will get a refund that they can use to pursue alternate avenues of reaching their goal. For the clinic, there are several benefits: they allow them to collect a larger fee (usually the equivalent of several full IVF cycles) upfront from the patients; since it is a flat fee collected, the clinic stands to make a profit if they can get the patients pregnant on the first cycle with decreasing profits with subsequent cycle. However, the clinics will lose a lot of money if they are unsuccessful and cannot get the couple pregnant. In this fashion both parties share risk. The patient might end up paying a little more for their IVF costs, but have the ability to cycle several times and even get their money back if all cycles are unsuccessful. The clinics have the opportunity to collect a greater fee if they provide quick success, but also balance that with the potential of losing part/all of their fees if the treatment ultimately doesn’t work.

How much do shared risk programs cost?

These IVF refund programs usually cost between 2x-3x the cost of a single IVF cycle, and will usually cover all clinical appointments and procedures required in the cycle. Cycle medications are almost always extra as they are sold by third party pharmacies so be aware there will be additional costs each cycle that will not be refundable. If you are choosing to participate in a shared risk program I would clarify this detail, and make sure you know what is and is not included in the program fees.

What are the eligibility requirements for Shared Risk Programs?

Since the IVF clinics bear a significant financial risk in offering these types of programs, and that the average success rates of IVF range between 10-60% depending on the age group they place restrictions on who can sign up for this type of program. It is in their best interest to offer this type of program to the patients who get pregnant most easily. This means an age cutoff and other medical qualifiers that like normal day three hormonal panels, a normal uterine cavity, and sperm parameters within certain ranges. These will vary clinic to clinic, so if you are interested in this type of option be sure to ask your doctor if you are eligible.

Are Shared Risk Programs Ethical?

Shared risk programs have been reviewed by the Ethics Committee of ASRM (American Society of Reproductive Medicine) and found to be perfectly ethical. They ruled that “that shared risk programs may be viewed as a form of insurance against the risk of failure that might appeal to some couples seeking IVF. The appeal arises from the general absence of health insurance coverage for IVF”. They concluded that as long as clinics were upfront with the costs and benefits of such programs vs regular pay-per-service models, and did not create false expectations, or promises, shared risk programs were an ethical and potentially valuable method of paying for treatment.

Should I use a Shared risk program?

This is not an easy question, and certainly not one I should be answering for you. Shared risk programs offer a great way to control the costs of your fertility treatment, but at a potential higher cost if you are successful right away. You should carefully weigh the benefits and risks the program(s) offers you and make your decision after considering what is best for you and your family.

What is the best Shared risk program in the Pacific Northwest?

Now down to the nitty gritty. This is not an easy question, and as a Seattleite I admit I did not fully research the options in Idaho or Oregon. However, after looking at the programs offered by all the major clinics in the area I have concluded that the Peace of Mind 100% IVF Refund Program offered by Overlake Reproductive Health to be the most comprehensive program out there right now. It rises above the others programs such as Seattle Reproductive Medicine’s Attain IVF Refund program, or Oregon Reproductive Medicines IVF Refund Program in that it offers a complete refund and more treatment cycles! So if you are considering an IVF refund program and live in the Seattle Area then ORH’s is the best one out there right now.

Well there you have it. I hope I was able to answer your questions about shared risk programs. As I said in the beginning of this article these refund programs are an interesting vehicle that offers patients a means to help control the costs of their infertility treatment. If you have used a shared risk program before, have any questions or comments, or just want to say hello, please do so in the comments.

Cheers!

December 26, 2012 by Aaron 2 Comments

How Much Does IVF Cost?

Whether you are just curious, or are considering IVF as a treatment to help you get pregnant this post will help explain what the costs of IVF are. IVF prices vary clinic to clinic, and also by state. However, the average price of treatment is relatively constant throughout the United States.

The average cost of IVF in the USA is $12,000 per fresh cycle and is commonly as high as $15,000 or as low as $10,000 depending on the clinic. It is pretty rare that the costs will be lower than $10k, and if you come across a clinic promising rates in that ball park, be very wary of hidden costs and/or lots of services that are not included. Ask them if the quote covers things such as monitoring ultrasounds and bloodwork, fertility meds (rarely covered by quote as you will likely be purchasing them separately from a pharmacy), additional services like ICSI or PGD, or, more importantly, what services they consider “extra”.

Additional Costs

It is unlikely that most IVF price quotes will include services like ICSI, intracytoplasmic sperm injection (implanting a single sperm into each egg for fertilization) or PGD, preimplantation genetic diagnosis (genetic testing of the embryos for either genetic disorders or sex selection.

ICSI can add an additional $1-2k in fees, often depending on the amount of eggs retrieved.

PGD can easily add another $2-5k with fees for both the biopsy, done at the clinic, and the actual genetic testing at an outside lab.

Fertility medications can be a large additional fee and you should plan from anywhere from $4-10k depending on factors such as your age, egg supply, and what protocol the doctors put you on.

Embryo freezing and storage fees can run anywhere from about 1k to 2k depending on what is covered.

Lastly, donor fees can add a hefty amount to your cycle costs. An egg donor will usually add between 10-15k on top of your regular IVf cycle fees. Using a sperm donor is much less expensive and can add anywhere from a few hundred to a couple of thousand when all is said an done.

So there you have it, average costs for IVF and the common additional services that are tacked on. The costs above are all ballparks and will vary depending on where you are in the world and which clinic you go to. For example the cost of IVF in California will be different from the cost of IVF in Texas. Hopefully, you can use these figures to help you plan for the costs of your upcoming infertility treatment. Remember, you often get what you pay for in life, and going with the cheapest option may not be the best idea. Alternatively, going with the most expensive option may not be the best route either. I will touch on how to choose the best fertility clinic in a future post.

Please post your comments or questions below.

Cheers!

December 23, 2012 by Aaron Leave a Comment

Putting a Price Tag on IVF

cost of IVF — Putting a price tag on IVF can be difficult at times

Everybody knows IVF is expensive. But when you want to find out exactly how much the IVF cycle will cost you it can often be very difficult to obtain an accurate quote. However, this is often more of a fallacy of how things are billed than any shortcomings of the clinic you are working with. This post discusses two of the different ways a clinic might bill you for IVF and what each means to you. The most common pricing models that fertility clinics use are either a pay-for-service (what most doctors/practices use in medicine) where you pay for each service rendered, or a grouped model where you pay a global fee for all the services required to undergo treatment and that one fee will cover the vast majority, if not all of services required for your particular fertility treatment.

Many clinics work with a pay-per-service billing model, where they only bill you for the services rendered. The amount of work that goes into an IVF cycle is staggering: all the doctors consultations, blood and diagnostic work, the egg retrieval, the andrology and embyrology services carried out in the laboratory to grow your embryos, the egg transfer, and all the monitoring involved to make sure everything is carried out at the proper time. Whew! Not a short list there, and I was generalizing a lot too. In this model each individual service is marked off on the day the service is rendered. This is great in that when all is said and done – you only pay for what was needed in your particular case. However, if there was a mistake made in billing – it can be very difficult for the patient to sort it out amongst the multitude of different charges on their final bill.

Another shortcoming of this model is that it makes it more difficult for fertility clinics to provide you an accurate quote for your infertility treatments. The main problem lies in that the clinic cannot know exactly what services will be needed in your particular case. Every patient is different and might require different care/services throughout the IVF cycle to maximize their chances for a successful treatment cycle- something that all parties deeply want. These uncertainties are usually pretty minimal, and IVF clinics will be able to provide you with pretty accurate quotes in most cases. However, it is not uncommon for for doctors to change the plan half way the through treatment when it is indicated. The most common expensive additional services that can sneak up on you are things like ICSI (intracytoplasmic sperm injection – a fertilization method where the embryologist manually injects a single sperm into each mature egg) when the sperm sample is abnormal on the egg retrieval day, or additional stimulation medications when the female partner is not responding to the fertility medications as planned. It is not uncommon for there to be an occasional additional blood test or monitoring ultrasound on a case by case basis, but those are relatively inexpensive services in the grand scheme of things.

The other common billing method is to batch a whole bunch of services together into one global fee. In this model there might be just one large fee for the whole IVF cycle, and it would cover all the monitoring, diagnostic work, surgical procedures, and, quite possibly, all the lab work that would be needed to get you and your partner through the cycle. This model is often preferred by many clinics and patients in that it puts the myriad costs of IVF into a single figure. Patients have the peace of mind knowing that most/all of their costs are known up front and they can plan accordingly, and it makes the clinic’s job of collecting money and explaining the costs to the patient so much easier.

This model is also suffers from the same downfall as the pay-per-service model in that sometimes additional services will be indicated, care that might not be included in the original quote. This is more rare, as the global fee model often allows for some extra care throughout the IVF cycle. This, of course, presents the issue that you might be paying extra for your services than you would have if you just paid per service rendered. That is simply the cost of offering this type of pricing model – the business has to recoup the costs of the more expensive patients somewhere. This model often makes it a little more difficult for the clinic to ask the patient for additional funds as the patient could think that everything was already included in the global fee. Good communication on the clinic’s part is essential here to reduce these types of issues. Nobody ever wants to be hit with charges out of the blue.

As the patient it is very important that you be proactive every step of the way. Make sure you understand which pricing model the clinic uses, and what is covered by any global fees you might be paying. More importantly, make sure to ask what is not covered by the global fees. Being prepared might not change the cost of your IVF cycle at the end of treatment, but it could save you a lot of stress by making sure you understand the costs every step of the way.

I wish I could provide more detail on this topic, but every clinic prices their services a little differently, and if they have a global fee, what it covers can vary. If you have any questions or comments please use the form below to ask.

Cheers!

December 20, 2012 by Aaron 2 Comments

Financing options for your In Vitro Fertilization (IVF)

IVF financing — Financing your IVF treatment can sometimes be a good strategy.

Today I want to talk a little more in detail about the option of using medical loans to pay for your infertility treatments, or finance them if you want to be a stickler about it. Financing IVF treatment can be a good option if you do not have the cash or liquid assets to fully pay for your treatment. Most fertility clinics expect to be paid up front when they know your treatment will not be covered by insurance, so you will need to come up with the funds from somewhere. While this practice is good business from the fertility clinic’s standpoint, it can be decidedly inconvenient, not to mention stressful, for the patient.

Medical financing or loans have become more common way for people to pay for procedures and treatments that are partially or not covered at all by insurance. These financing companies also tend to add on a healthy interest rate on any money they lend you. As such there are lots of options and companies out there that will loan you money for your treatments, be it for infertility or any other elective procedures you might want to undergo.

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As with all loans: the interest rates and loan maximums are heavily influenced by your credit score and assets. Remember these companies are doing this to make money and they will not lend you more money than they think you can repay, either in money or assets. CAUTION:If you do not think you will be able to repay a loan offered by one of these companies then you should not take their money! Always read the fine print and know exactly what you are agreeing to when you sign for any type of loan.

I do not personally guarantee any of these services, I am merely trying to give you some of the options out there. I can’t stress how important it is for you to do your homework with these companies and make the choice that makes the most sense to you!

Before you accept any loans make sure they will work with your clinic. some financing companies prefer to pay the clinic directly and might not work with some clinics out there. Just save yourself the headache and make sure all the pieces fit :)

Ok, now for a few of the medical financing companies out there:

Springstone

This site offers an array of medical financing options, with an easy online application. Approval is often instantaneous. (they want to make it as easy as possible to take their money) Highlights of the service are below.

interest rates ranging from 3.99% to 17.99%
loans up to $40k
Payment schedules ranging from 6 months to 84 months, with no prepayment penalties
Interest free loans available
Monthly payments as low as $25 or 4% (whichever is greater

Medicalfinancing.com

This site promises to make obtaining medical financing easy, with a simple online application that you can fill out. They will then contact you and discuss the details on what they are willing to offer you. Highlights of the service are detailed below

Low rates starting at 7.24% to 22.99%

Payment schedules vary from 12 to 84 months, with no prepayment penalty
Interest free & Same as Cash options available
Loans up to $30k
Payments as low as 1% of your balance
1% cash back rewards program

United Medical Credit

Another service catering to all sorts of medical loans. They offer an online application, although don’t say anything about instant approvals. They are quite vague with the details of their loans – saving those juicy details till they get you on the phone. More details below:

no mention as to what their interest rates are, although they call them “competitive”
Multiple loan term plans to choose from, with no prepayment penalty
Loans up to $20k
Same as cash financing options
Interest free financing options

CosmetiCredit

Another service that doesn’t provide a whole lot of information on its website. They offer:

Convenient minimum monthly payments
Quick and simple application process
Instant credit decisions
Accepted by Physicians Everywhere: The CosmetiCredit program is available in all 50 states
Physician Pre-Payment: Cosmeticredit can pay the doctor up to 2 weeks prior to your procedure

American Benefit Credit

A well known financing company that offers both secured and unsecured loans for a variety of reasons. The secured loans offer much better rates, although with more risk if you were to default. They offer:

24, 36, 48, 60 & 72 month plan options
We finance from $1,000 to over $100,000
Interest rates from 1% APR* (Secured Loans offer lower rates)
Low Monthly Payments and affordable rates

MedLoan Financial

MedLoan offers loans for a variety of different services, including infertility. Their benefits include:

Amounts from $500 to $100,000
Lowest Interest Rates Available
6-21 Months Interest Free
No Pre-payment Penalty

Your own bank may also offer medical financing – although this will most likely be in the form of a secured loan (backed by some form of your capital assets: house, car, ..etc). If you have an existing mortgage you may be able to leverage that for an additional line of credit, or loan to use for your fertility procedures. As I said above, just be very careful with what you sign!

I hope this list was of some use to you. If you have any questions or comments please let me know below.

Cheers!

December 15, 2012 by Aaron 3 Comments

IVF Grants and Financial Aid Programs for Infertility Treatment

Paying for IVF can be a daunting task, especially when combined with the common plight of inadequate insurance coverage for infertility treatments. There are many ways to earn money for your IVF cycles, including crowd sourced fund raising and IVF grants. There are more than a few non-profits that offer grants for IVF cycles these days. Don’t expect something for nothing, however, if you are lucky enough to win one of these grants expect to be used for publicity purposes. If you have no problems with this then apply away. Factoring the probable amount of time you will asked to give in return for the grant – it makes one hell of an hourly rate :) As in most giveaways your chances of receiving one these grants is low, but as they say, “you cant win if you don’t play.” So without further ado below you will find a list of IVF grants with descriptions and application instructions for each. Good Luck!

Current IVF Grants

INCIID (InterNational Council for Infertility Information Dissemination)

They provide IVF scholarships to couples with financial and medical need. You must be a member of INCIID to apply ($55/annually) and . You must be medically and financially in need, and they ask for pays tubs, tax returns, and doctor’s notes to verify your eligibility.

Fertile Dreams – The Embracing Hope Grant

This org selects two to three couples each year to receive up to $10,000 that can be used for fertility treatments at any fertility clinic in the country. The couples must have medical insurance but lack coverage for infertility.They ask for proof of income through paystubs, and recent tax returns. If selected you will be asked to sign away full media release giving Fertile Dreams full rights to publish and photograph your story throughout your fertility treatments.

Contact info: Fertiledreams **UPDATE – THEIR WEBSITE IS CURRENTLY DOWN**

Pay It Forward Fertility Foundation

This non-profit offers a range of grants from partial to full coverage. They used to only offer grants to NC residents but have recently opened up their grants to all states and they state the money can be used at any fertility clinic as long as they are a member of SART (dont worry, most fertility clinics are members of SART or the Society of Assisted Reproductive Technologies). They award several grants throughout the year to couples where the women is under 40 and they have no income requirements.

Contact: www.payitforwardfertility.org/

Gift of Life Foundation

The Madeleine Gordan Gift of Life Foundation offers grants up to $10,000 to eligible couples in the greater Cincinnati area. Their requirements include: no children, have never undergone through IVF, combined income of less than $70k, and documented medical need for IVF.

Contact info: www.gordongiftoflife.org

The Tinina Q. Cade Foundation

This foundations Building Family grant provides up to $10,000/ family to fertility treatments or adoption costs. The number of grants varies depending on the amount of available funds. The only restrictions are: 1) medically diagnosed as infertile, and 2) Legal US resident. They also have a “Savannah Grant” available only to Shady Grove Fertility patients. Applications are currently open for the 2014 grant. Be aware there is also a non-refundable $50 grant processing fee.

Contact info: www.cadefoundation.org

B.U.M.P.S Inc by Bringing U Maternal Paternal Success

This Florida based non-profit gives out grants to couples who are in need both medical and financial, with preference given to those without children. Couples must be medically diagnosed as infertile . The grants can be used for a variety of infertility treatments. ***They are not currently accepting applications. Their website states they are currently fundraising***

Contact info: www.yourbump.org

Angels of Hope Foundation

This foundation provides two grants a year to locals within 24 miles of Morris, IL. Couples must be married, have little or no insurance, and be a medically appropriate for treatment. They favor couples with higher chances of success, as evidenced by your doctor’s notes. If you are interested, you must complete an application and include a letter from their doctor, a medical records release, and a financial statement. Application deadlines are March 31 and August 31.

Contact info: www.angelsofhopeinc.org

BabyQuest Foundation

This foundation offers three grants a year to couples who cannot afford infertility treatments. They accept applications from heterosexual couples, same-sex couples and singles. Once awarded you may use the funds at the clinic of your choosing. Funds are dispersed soon after their March, July, and November deadlines.

Contact info: www.babyquestfoundation.org

Sparkles of Life

This non-profit dedicates itself to helping couples become parents. They offer one grant a year in the amount of 33% of 1 IVF cycle. The cycle must be undergone at the Houston Fertility Institute. Applicants must submit a short statement of need, a complete application and a $100 non-refundable processing fee (Paypal).

Contact info: http://sparklesoflife.org

Sharing Hope Financial Assistance Program

This programs offers financial assistance to couples in need of fertility preservation before undergoing treatment for cancer. They are a part of the Fertile Hope organization and do not offer grants to applicants directly. Instead, they work with fertility clinics and companies to provide discounted treatment and medications. To be eligible patients must make under $75k single/ $100k combined income, have an eligible cancer diagnosis and must not have already started fertility-reducing cancer treatments.

Contact info: www.fertilehope.org

New York DOH IVF grants

NY state created a series of grants to help reduce the cost of fertility treatments to residents of the state. This program works with a series of fertility clinics throughout the New York state to help defray the costs off treatment. Patients will receive from 2.5% to 97.5% off their treatment costs, depending on household income. Since the grants are made available to patients of the fertility clinics that signed up for this program you will have to apply through the clinic of your choice. Eligibility might vary a little from clinic to clinic, but patients must be residents of the state, between ages 21-44, have a private health insurance (not medicare..etc), and fall below a certain income threshold. Some patients will need to undergo IUI treatments first to be eligible, and patients with a very low likelihood for success will not be accepted.

Here is a list of clinics that participate in the program.

FertileHope

is a a national LIVESTRONG initiative dedicated to providing reproductive information, support and hope to cancer patients and survivors whose medical treatments present the risk of infertility.

For more information

Fertile Action

is a cancer charity working to ensure fertile women touched by the disease have he option to preserve their fertility prior to receiving cancer treament that can cause infertility. Fertile Action’s Parenthood After Cancer Treatment (PACT) Grant was established to provide financial support for female cancer surviors. It is not a cash award but is aimed at significantly reducing the cost of IVF, egg donation and surrogacy for cancer survivors through fertility specialists that have been recruited to offer their services at a discount or donate their services to the grantee.

For more information

Did I miss any IVF grants or scholarships or get the details wrong on something? If so please let me know in the comments so I can add them to the list. For those of you thinking about applying for any of the above grants I wish you the best of luck. Remember, you can win if you don’t try.

Cheers!