Affording IVF

by

IVF in the News Feb 27

Today, I don’t have the time to write up a full post so I thought I would share a few infertility news stories I found interesting. I also threw in a IVF blog at the bottom for a little variety. Happy Humpday!

Multiple live births not strikingly high after IVF | Modern Medicine

www.modernmedicine.com11/19/12

Epidemiology. Last Updated: 2012-11-19 16:20:01 -0400 (Reuters Health). By David Douglas. NEW YORK (Reuters Health) – Following in vitro fertilization (IVF) the risk of multiple live births is relatively low, according to …

 

Cost of IVF — Fertility Treatments – Parenting.com

www.parenting.com2/4/13

With the average cost of IVF around $12,000, fertility treatments can drain your savings, even putting parenthood out of financial reach for many. But now some couples are asking friends and family to pitch in. Deposit a Gift …

(I wrote a post talking about this service and a few other similar ones)

Human-rights court orders world’s last IVF ban to be lifted : Nature …

blogs.nature.com12/28/12

The Inter-American Court of Human Rights has ordered the only country in the world that completely prohibits in vitro fertilization (IVF) to lift its ban. (the country is Costa Rica, and good for them for reforming!)

 

Our IVF Journey: All the fun of living life with twins: B’s Egg Sharing …

www.twinmummyanddaddy.com2/20/13

B’s Egg Sharing IVF Journey. Part 3. Hitting a brick wall. Following on from last weeks post, B is back to share with us her egg sharing IVF journey. To read last weeks post, please click here. Well, today has been a pretty bad …

 

Well that is all I have time for today. Happy Wednesday!!

Cheers!

by Leave a Comment

Should I Use My Flexible Spending Account (FSA)?

FSAs can save you thousands of dollars, but can cost you if not used correctly
FSAs can save you thousands of dollars, but can cost you if not used correctly

Does your company offer a Flexible savings account (FSA) as part of your compensation package? Do you utilize it? If you have the option to set up a FSA you probably should do so. I will tell you why, but first I should talk a little about what exactly a FSA is.

FSAs are a great vehicle for accessing pre-tax dollars for a number of eligible expenses, possibly resulting in significant payroll tax savings. However, FSA’s do have their disadvantages. Deciding whether to use your FSA benefit, as with most financial decisions, is all about making the decision that will save you the most money in the long term.

In a FSAs you elect to set aside a fixed amount of your annual salary to fund your account. This amount is then “paid back” through pre-tax deductions from your paycheck. The two main advantages of this type of account is that you are not paying any taxes on the money you have elected to set aside, and that the full amount is available right away.

There is only really one disadvantage of using a FSA account. If you do not use all of the money you have set aside in the plan year you will lose it. Gone. The money either goes back to your employer, or is spread between all the members. As you set the amount you want to fund your FSA with in the beginning of the year, you want to make sure you don’t overestimate your withholding because if you do, that money will be lost.

There are new regulations being discussed that might do away with the “use it or lose it” catch of FSAs, but as of writing this they have not be finalized or approved. Some employers do offer a grace period however, and you should talk to your HR to get the details of your specific plan.

Now that you understand the pros and cons of a FSA, its time to look into whether you should set one up or not. As I said earlier, you want to make the decision that will save you the most money over the calender year. If you have absolutely no medical expenses on average, then I would elect not to fund your FSA. As any money you fund the account with won’t be used and will just go back to your employer. I don’t know about you, but I like my money to stay mine! If you are like most of us, and have some medical expenses each year, then you probably want to choose to fund your FSA account.

The real question is how much money you decide to fund your account with. This is going to depend on what type of account your company offers. All FSAs can be used to cover eligible medical expenses, and some can also be used for daycare expenses. If you have kids in daycare you should talk to your HR rep to determine if their daycare would count as an eligible expense. The concern with funding your FSA is that if you under fund it, you will lose out on some of the tax savings, but if you over fund it – you lose that money. Obviously, it is better to error on the side of caution.

I would figure out the cost of all my mandatory medical expenses in my previous calender year, and use those to estimate what I would need in the coming year. For me these include: checkups/physical, and my yearly supply of contacts. I know I will go to the doctor 2 times a year for my eye health and that I will buy contacts for the year. I am lucky enough not to have any health ailments, nor get sick very often so it is pretty unlikely that I would rack up any more expenses during my year. As such I would fund my FSA account with just enough money to cover my baseline costs.

If you know of any large upcoming medical expenses in the following plan year, it makes sense to maximize your funding to provide you with the most tax savings possible. Talk to your HR rep about plan maximums. Good examples would be fertility treatments, or procedure like lasik. Using those pre tax dollars on your medical expenses could save you thousands.

FSAs are a great way to save money on your health care costs. It is very important not to over fund your account though, as any money left over at the end of the year will be gone forever.

Cheers!

by Leave a Comment

How to Find Out How Much Your Procedure Costs

Comparison shopping for medical treatment
The same medical service could be priced vastly different at two medical offices.
With the rise of HSA (health savings accounts) and high deductibles people are paying more attention to their medical bills. When more of the costs of medical treatment are coming out of our own pockets we tend to pay greater attention to the amounts we are paying. One of the better ways to control how much you are paying is to do a little shopping around.

Shopping around for medical treatment is a largely unknown concept as most people find a doctor that they like and stay with that doctor… and I couldn’t agree more. It is worth paying a little extra for your care if you have a good bond and you trust your doctor. However, there are plenty of medical costs and procedures that don’t really need to be done at a certain office. Outside testing and bloodwork is the first thing that comes to mind, although make sure to ask the ordering doctor if the test needs to be performed at a certain facility. No sense in doing any of this if the procedure or test has to be done at a specific facility.

If you do not have any medical coverage, then it more important to make sure your dollar goes as far as it can. When you have insurance you will end up paying the insurance negotiated rate – which will be the same from facility to facility, regardless what their billed price is. Network status of the facility can affect this. In network facilities are preferable to out of network facilities as the rates will be better, and out of network facilities can balance bill you.

Balance billing is the practice of billing the patient the remained of the total price after insurance pays their portion. So this means much more costly. Avoid out of network facilities, if all else is equal.

It can be a daunting task to try and do cost comparisons for procedures/tests. You will often need to have the CPT codes for each procedure/test you need done. If needed, you should be able to get these codes from either the ordering physician or the testing facility.

Hospitals, insurance companies, drug stores, and drug companies may list their prices on their Web sites. Very likely you will have to do a little digging to find the prices out. Call the hospital or clinic and ask for their prices. Financial coordinators/counselors, billing agents, and sometimes the front staff are the best people to talk with to get pricing information. It may not be easy, but perseverance pays off.

Although, doing price comparisons can be a huge pain in the you know what, the dividends could be well worth it. When appropriate, I recommend you shop around to see what the going rate is – the money you save could be your own.

These resources may help some:
Your state hospital association

Your state or territory health department

by Leave a Comment

Should you take an IVF Vacation?

IVF abroad
Make sure you do your homework before taking an IVF vacation!

Taking an IVF vacation, (travelling to a different country with the sole purpose to save on IVF costs) can be a tempting choice for some. By seeking fertility treatments outside the US, patients can save thousands on their IVF costs over what they would pay at home. These women are seeking IVF in places like South Africa, the Czech Republic, or India.

Even factoring in the airfare, a several week stay, and the actual costs of treatment it is still possible to save many thousands of dollars off the typical IVF cycle cost ($12k average) in the US. Sounds pretty good right? Well, there are more things to consider besides cost before you decide to do a little globetrotting for your treatment. Before you decide one way or the other, you should consider the following things

Safety and Standards of Care

One of the reasons IVF is so expensive in the US is the high degree of regulation. This regulation helps ensure that patients will receive a basic levels of quality care no matter where they go. Think of this as a quality control for the field, something that is often lacking abroad. Many of the countries that appeal to US patients have no overseeing body that enforces basic standards of care and treatment. This is not to say the clinic you are looking at will provide unsatisfactory care – just that it has no accrediting body that makes sure it follows any standards of care.

Success Rates Abroad

IVF success rates are reported using standardized methods in the US. This ensures that all clinics report their rates in the same manner. Even with these standardization practices, you will see a whole slew of different stats out there that clinics can use to promote their practice. Clinics abroad may report their statistics in different, more favorable ways. If you are comparing rates abroad with your local clinic make sure you are looking at the same rates. Otherwise you may be comparing apples to oranges.

Also worth noting that, overall success rates in the US are very high compared to other countries. While you may be saving money – less total cycles may be required if you are treated in the states.

Patient Information

All patients treated in the US can be assured a certain degree of privacy and have uniform standards regarding what information is available to which parties. Clinics in the US are required to keep all information about patients, donors, and any children born confidential. If you are looking at an IVF clinic abroad then there are a few questions you should obtain the answers to.

  • What happens to the personal health information you provide during the treatment?
  • Who will have access to it?
  • What happens to the medical information if the clinic closes?
  • If donor materials (sperm, eggs, embryos) were used in your treatment cycle, who will be able to access the information about the donor?
  • Can you get your records transferred to the US?
IVF abroad
Do your homework! An IVF vacation is a whole lot more than hanging out on a beach for several weeks

What happens if something goes wrong?

The field of medicine is extremely regulated in the US. All doctors and facilities may not be created equal, but you can rest assured that they all answer to strict guidelines regarding ethics and standards of care. If something were to go awry with any medical treatment in the US, an unhappy patient would have methods of recourse. If something were to happen overseas, you may or may not have any recourse. It is advisable to do a little research on these worst case scenarios to see how complaints and concerns would be followed up on in the country you are looking at. You may also want to look into obtaining legal advice to clarify how enforceable the contracts or agreements between you and an outside clinic are.

Multiple Birth Rates

Multiple birth rates are a significant health risk associated with fertility treatments like IVF. In the US there are strict regulations regarding how many embryos that can be put back (thanks Octomom!). Many clinics might transfer additional embryos in an effort to boost the rate of success, however this also increases the risks for both the mother and baby(ies). There may not be any regulations in the country you are looking at so make sure the clinic in question has standards in place to reduce the risk of having multiples.

There can also be legal and ethical issues surrounding donor and surrogacy cases (I will get into those a different time).

Researching your IVF Vacation

Even though there are many potential issues with seeking medical treatment overseas, it doesn’t necessarilty mean that it is not a appropriate course of action for your particular case. If you decide you want to look into a specicf clinic a little more there are some guidelines you can follow to help you make an informed decision.

If possible, try to speak with someone who has been treated at the clinic, or the country in question. You will be able to find out a lot about the quality of care through their experiences, although, take it with a grain of salt. Look at the clinic’s website, and see what kinds of information and statistics they provide. Check the qualifications of the staff and if the clinic is accredited in any way. If it is accredited, look into the accrediting body to make sure it is legitimate, and not just a pay-for-entrance type of organization. Other things, like if they have English speaking staff, and how much time they will spend with you discussing their treatment can also be telling of the type of establishment it is. Be wary of any clinic that is not interested in your medical history. A good clinic will want to see all your relevant tests and medical history.

Some questions you should ask the IVF clinic

  • What type of fertility regulations are present in their country? Are there regular inspections?
  • What is the clinic’s record of safety, and do they follow any standards?
  • Does the laboratory follow set procedures?
  • How is patient’s medical confidentiality kept?
  • Are there any possible language barriers to communication?
  • What degree of travel is require? How many trips, and how long will you need to stay to complete your treatment?
  • Does the clinic offer the treatment you desire?
  • What are the clinic’s success rates and how are they calculated? You should get a few year average for your age group and also donor eggs.
  • What is the multiple birth rate at the clinic? Do they follow any guidelines to reduce the risk of multiples?
  • Does the clinic store embryos? If so, for how long?

As you can see, choosing to take an IVF vacation is not an easy choice to make. On one hand you will probably be saving money, on the other hand you will have to do a lot of investigating to make sure you will be receiving the quality of care that you deserve. If you are thinking about having your IVF done overseas make sure you do your due diligence to be certain that you are making as an informed decision as you can.

Cheers!

by Leave a Comment

How IVF Costs Could Reduce Your Tax Bill

IVF costs tax deductible
Your large medical bills might be tax deductible!

A lot of people might not know that they have the option to deduct a portion of their medical expenses from their yearly taxes if they choose to itemize their deductions. The expenses must pass a certain threshold in order to be deducted.

This limit is based on your yearly income. For the this tax year (2012), any medical expenses that exceed 7.5% of your adjusted gross income (AGI) can be deducted. The limit is higher for those of you who are subject to the alternate minimum tax. Only medical expenses that fall under the IRS guidelines can be deducted. So make sure you double check if you are unsure something qualifies.

Let me give you an example to help straighten things out. First off, let’s say that your AGI for last year is $50,000, so 7.5% of that is $3,750. If you happened to spend $3,500 on medical expenses last year you wouldn’t be eligible to deduct any of those expenses as they do not exceed the 7.5% threshold. However, if you spent $10,000 on medical expenses last year you could deduct $6,250 of those expenses as that is the total amount of the expense over 7.5% of your AGI. Which would be some serious tax savings.

Be aware that these limits will change with the passing of the Affordable Care Act last year. Next year (tax year 2013) the threshold will be increased in to 10% of your AGI.

So what does this mean for you?

Fertility expenses, like IVF, are a covered expense as of writing this article. So if you cycled last year, or are going to cycle this year and your expenses exceed the threshold set by the IRS you can deduct those expenses from your taxes! Now this is hardly free money, but it should save you a few bucks! Another tactic you can utilize to bunch a few medical expenses together in one year to maximize your tax savings. For example, if you know you want to get laser eye surgery, but are not in any hurry to get it done, you could either get it done sooner if you already had a bunch of medical expenses this year. Or you could wait until next year in order to try to push your medical expenses over the limit for the next calender year.

Fertility treatments are expensive, and insurance coverage is spotty, so they make the perfect example of when this deduction could kick in. Especially when considering sharing risk programs that usually make the patient pay a large fee upfront (the cost of several IVF cycles). Since you paid this entire amount at one time, you would be able to claim it on your taxes , even if they treatment stretched out over until next year. If you end up getting a refund from the clinic be aware you will have to update your taxes and will owe some additional money.

Hope this helps!