Health Insurance for IVF

Do you cover in vitro fertilization? My friends’ current insurance covers all the procedures needed up until the actual insertion of sperm and egg. She lives in NH and I am researching possible insurance companies that would cover this for her.

We are actually not an insurance company. We are an online health insurance directory and consumer advisory resource. We are asked quite frequently about insurance companies that provide coverage for IVF. Finding an individual health plan is not likely, unless your state has regulations that specifically require the insurance companies to provide this benefit. More and more states are adopting such regulation, but New Hampshire is not one of them. According to the American Society for Reproductive Medicine, there are only a few states that have infertility insurance laws, and most of those only provide coverage for the diagnosis and treatment of infertility, and exclude IVF.

Your friend is fortunate to be on a health plan that provides some infertility coverage. Most plans do not. Even if you were able to find an individual health plan in New Hampshire that provided this benefit, they would probably exclude it from her coverage because she has already been diagnosed as needing this treatment. New Hampshire insurance regulations allow the insurance companies to medically underwrite applications of insurance and place elimination riders on pre-existing medical conditions. She would need to disclose this condition on the application, and the insurance company would have the right to decline the application, or offer coverage with an elimination rider that excluding infertility treatment from the policy.

If your friend is on an employer-sponsored group plan, she might try speaking with her employer to find out if their current insurance company offers an IVF Rider. Some insurance companies, for large groups, will offer supplemental coverage to the group at an increased monthly premium. This IVF rider would be added to the coverage of all employees insured under the group health plan. Amendments to the policy won’t take effect until the open enrollment renewal of the plan, but it might be worth checking into if the employer is open to modifying the current policy.

You might also try contacting the New Hampshire Insurance Department to see if there are any infertility insurance laws currently in legislation. We are not aware of the pending insurance regulations in all states, so perhaps they will have legislation that applies to this issue soon.

2 Comments

  1. I would like to submit a question.

    I am a great candidate for reversal tubal ligation. I would like to know if there are any insurance companies out there that would include this procedure in their benefits package.

    Comment by Tamara — February 8, 2009 @ 6:37 am

  2. Okay, so I have a question for you. I began in my now position last year in June and my health insurance by Humana started in October. I was happy to find out that the policy included in vitro fertilization coverage. Well, so today at work I get a phone call from a woman who wants to ask about my insurance. Apparently it turns out, she has the exactly the same insurance plan that I do. So she told me to go and check tubal reversal and that they used to cover that, but not anymore. She then told me that she was asked by the insurance company if she was a new or old employee, so maybe this means that old employees are still covered under that plan? I thought I would be told if my insurance changed? Wouldn’t there be mention of something like that changing?

    Comment by Ann — June 15, 2009 @ 10:20 am

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