For many couples, the pathway to family is very simple. It is not a question of if, but more of when. For others, through no fault of our own, it is significantly more difficult. We have a dream that seems to be perpetually postponed. It can feel as though we are grasping at straws to fulfill what was once a given. One of the most wide-spread, “silver-bullet” answers to infertility is In Vitro Fertilization treatment.
There are many questions to consider before jumping straight into IVF. How much does IVF cost? What are the success rates of IVF? How can we afford IVF? With an average cost of $23,000 in the United States, and a success rate of 22.4%, the decision to pursue IVF or not can be a big decision in and of itself. For many, the decision has already been made, others are not quite as convinced. Either way, we hope to provide as many financial-friendly ideas as possible to help you fulfill your dream and to write your story.
One of the easiest ways to get funding is by letting family and friends know about your situation. Most of us have people in our lives that would love to help us out if they knew that we were struggling. There are a million different crowdfunding websites out there, so make sure to pick a campaign platform that is tax-deductible for the giver, and not just seen as a personal gift.
Everyone wants to see the underdog win the battle and fulfill their dream. In this situation, you are the underdog, the battle is infertility, and your dream is your future family. Make them part of your story. For every donation size, give them a piece of your “Fertility Puzzle” or your “Family T-shirt.” The more involved they are in the process, the more they will want you to succeed.
• Tell family and friends about your infertility struggles; make them a part of the process
• Make sure the campaign platform is tax-deductible for the giver
Grants are a great way to get outside funding without asking your family and friends to donate to your cause. With that being said, it can be a very competitive process to get selected for a grant. In order to maximize your chances of winning a grant, look for local grant applications in your city or state. While these non-profit organizations may have fewer grants to give, they will also have a significantly smaller pool of applicants.
Beyond qualifications, make sure that you verify the source of the grant/non-profit. Do not give your information and application fees to a source that you do not trust. There are fake “non-profits” with fake grants that scam unsuspecting couples looking for infertility grants. Check out our comprehensive guide for both national and local grants.
• Look for grants that limit competition to a small pool of applicants (e.g. local grants)
• Verify the existence of grant and associating non-profit before supplying information
• Check out our comprehensive guide for national and local grants
There are 15 states that have laws regarding the insurance of infertility treatment. Of those 15 states, 13 of them mandate that the insurers cover infertility treatment; these states are Arkansas, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, and West Virginia. The other two states, California and Texas, require that the insurers offer coverage for infertility treatment, but do not mandate that the states cover infertility treatment.
Whether or not you belong to one of these 15 states, you should research infertility insurance in your specific state. Some states have laws pertaining to infertility that are more specific than those mentioned above. For instance, in Utah, if the insurer offers specific, optional, maternity benefits, they must also offer indemnity benefits for infertility under certain circumstances.
Once you have researched your specific state and the laws pertaining to infertility coverage, take a look at your current insurance coverage plan. While the actual cost of the IVF procedure may not be covered, sometimes you can find loopholes that will go toward the medications and/or other expenses related to the procedure. While it may not cover the majority of the expense, any cent you can save is money you can put toward another portion of the procedure. If you can’t find any way for your current insurance plan to help you, talk to your employer about possibly adding infertility coverage to their insurance plan. They may or may not be willing to do so, but you will never know unless you ask.
• 15 states have specific laws regarding the insurance of infertility treatments
• Other states may have laws that provide infertility help under certain circumstances
• Look at current insurance plan to find “loopholes” for expenses (e.g. IVF medication expenses)
4. Flexible Spending Account and/or Health Savings Plan
Flexible Spending Accounts (FSA) and Health Savings Plans (HSP) are a very savvy way to save money towards any qualified medical expenses. In the case of infertility, this can be a big benefit if you plan accordingly. Flexible Spending Accounts and Health Savings Plans are very similar: you put a dollar in pre-tax, and you can use that money toward any qualified, medical expenses. For example, if you make $1,000, and you put $100 into your FSA or HSP, you get taxed as though you made $900, and that $100 of pre-tax money can be spent on future medical expenses without ever being taxed. In order to take advantage of this underrated and underutilized savings method, you need to understand the difference between the two programs, research if your expenses qualify for the account, and plan your treatments to maximize the benefit.
Flexible Spending Account
Flexible Spending Accounts can be used by anyone, regardless of their health plan. FSA’s have a limit of $2,650 in 2017, and they do not roll over year after year (i.e. if you don’t use it, you lose it). They also do not roll over from employer. In other words, if you have money in your FSA, but you switch employers, the money in that account is forfeited. Because of these rules, and others like them, it is important that you plan your FSA payments in accordance with your infertility treatments, so that you do not lose money that you put into your FSA account.
Health Savings Plan
Health Savings Plans are reserved for individuals with a qualified, high-deductible health plan. If you are able to qualify for an HSP, you can submit up to $3,450 of pre-tax dollars on an individual plan, and $6,900 on a family plan. This amount rolls over year after year, and rolls over from employer to employer, as long as you stay on your qualified, high-deductible health plan. As an added benefit of HSA’s, your money can earn tax-free interest, as long as that money is being put toward health-related expenses.
Before you put your money into either of these accounts, make sure to verify that you have medical expenses that would validate the need of either of these accounts. Remember that these medical expenses have to qualify in order to be used as an expense for either an FSA or an HSP, otherwise you may receive a 20% penalty. You may also want to plan when you put your money into your account, with the timing of your treatments, so that you can maximize the use of either account. This is even more pertinent for Flexible Spending Accounts as you can lose money that you put into your account if you do not use it by the end of the year. Either way, spend the time to research more about FSA’s and HSP’s, so that you can take advantage of this free way to save hundreds, and even thousands, of dollars on your fertility treatments.
• Flexible Spending Accounts and Health Savings Plans are free ways to save a lot of money by simply not paying taxes on medical expenses
• Understand the difference between the two methods (FSA vs. HSP), and plan your treatments around getting the most benefit out of your chosen method
5. Tax Breaks
Another great way to save money is to claim your infertility medical expenses for tax purposes. In 2018, you can claim any qualifying medical expenses over 7.5% of your Adjusted Gross Income (this will move to 10% of AGI start January 1st, 2019). These expenses are unreimbursed, qualifying medical expenses. That means that expenses paid for by insurance do not count, neither do expenses paid for using your Flexible Spending Account and/or Health Savings Plan.
For instance, if you have an AGI of $40,000 in 2018, and you have $5,000 in unreimbursed, qualifying medical expenses, then you would take $40,000 times .075, giving you $3,000. You can claim all expenses over $3,000, so you could claim $2,000 of medical expenses as an itemized deduction. This would only benefit you if your itemized deductions were larger than your standard deductions for the year. While taxes can be a daunting and difficult subject, a little bit of research can go a long way in saving you a lot of money.
• Claim a percentage of your Adjusted Gross Income for qualified medical expenses
6. Multi-cycle IVF treatments and Reimbursement Programs
Out of all the infertility, cost-savings methods, this is the most difficult one to give a highly-generalized recommendation, because it largely depends on the couple, clinic, and circumstances. While the idea of getting your IVF experience reimbursed seems like an easy decision, you may want to do a little bit more research before deciding that it is indeed right for you.
For many couples, the idea of doing In Vitro Fertilization treatment can be scary. Not only is it a huge financial commitment, it can also be one of your last “guiding lights” to fulfilling your dream of having your own, naturally-born baby. On top of that, looking at national statistics for live births from IVF treatment can be daunting. Because of this, it is easy to want to “double-down” on a program that gives you a package deal for multiple IVF cycles at a discounted rate, especially if that program promises to reimburse you for the cost of the treatment if you aren’t successful. While it may indeed be a positive experience, please make sure you understand what these programs entail for your specific clinic.
On a general level, both multi-cycle IVF treatments and reimbursement programs are a lump sum of money that you pay upfront to the clinic for several IVF cycles. This lump sum is less money for the package than it would be if you paid for each of the IVF cycles separately. If you pay the lump sum in advance, and then have a bad experience with the clinic, you can’t go to another clinic without losing your money. On top of that, if you pay for the multiple cycles, and then get a child on the first attempt, then the clinic keeps the money you paid for the other cycles.
Reimbursement programs offer the same multi-cycle discounts, but take it a step further and promise that if you don’t have “success” then you will get your money back. With that being said, research what “success” and “money back guarantee” means for your specific clinic before you take them at face value. Sometimes, clinics will define success as something other than having a live baby, such as getting pregnant. In this case, it is possible that having a positive pregnancy test would exclude you from not only the reimbursement, but from even using the rest of your cycles for which you paid, even if that pregnancy eventually ends in a miscarriage. You will want to make sure that your clinic defines success as a live baby, and not merely a positive pregnancy test.
On top of different definitions of success, you may have different understandings of what will actually be reimbursed. Each clinic has different delineations for which expenses are considered qualified for reimbursement. Many times, the list of qualified expenses is shorter than you think. If you are not careful, you may start your reimbursement program just to find that a large portion of your IVF expenses are not qualified for reimbursement.
The last point to mention is eligibility. There are a series of tests that a couple has to go through to make sure they qualify for reimbursement programs. Because the reimbursement program is a “shared-risk” program, couples have to attain a certain level of fertility in order to be considered. This level of fertility will differ for each clinic. The lower the threshold of fertility, the higher the “shared-risk,” leading to a higher premium; the higher the threshold of fertility, the lower the “shared-risk,” leading to a lower premium. This is important for you because only you know your level of fertility. If you have a higher level of fertility, find a clinic that is similar to your threshold so that your “shared risk” is significantly lower, decreasing your premium amount. With that being said, the higher the level of fertility for each couple, the more likely it is that one cycle of IVF would be enough for said couple (i.e. they will pay for several IVF cycles up front, but they will not need all of those cycles). In other words, the couples with the most need for enrollment are often times the couples with the least likely chance of being submitted; the couples with higher levels of fertility “share risk” by paying for several IVF cycles up front with the chance that they will only need one cycle to have a live birth. This is why it is called “shared risk.”
While it may not be right for every couple, multi-cycle IVF treatments and “shared risk” or reimbursement programs can be a cost-savings method as it gives you overall discounts on a per cycle basis, and allows for tax savings through up-front, lump-sum payments. At the same time, however, it can be a very large, unnecessary expense for other couples. In order to know if it is a good fit for you, do more research on the subject generally, as well as how your clinic implements it specifically, before moving forward in any way.
• Multi-cycle IVF treatments and Reimbursement Programs are not for everyone
• Reimbursement or “shared risk” programs usually only take highly-fertile couples to ensure low risk for the clinic. Clinic doesn’t return excess money from unused cycles if “successful”
• Clinics have different definitions for “success.” Make sure that your clinic’s success aligns with your vision for success (i.e. having a live birth)
7. IVF Loans
The decision to take out a loan in order to pay for your IVF treatments is a big one. Do you want to add the financial strain when you are already emotionally drained? How will possible financial strain affect your relationships with those you love? What if you go into debt to do IVF treatments and they fail? How will you pay for the treatments if they succeed and you have a baby to feed and diapers to buy? These are all very legitimate questions to ask before deciding if this is indeed the right way to go.
If you do decide to take out loans, make sure to do your research. Some loans seem to give you very good terms, with very steep penalties if you miss a payment, or don’t pay the amount back fast enough. Try to find low-interest loans with longer grace periods. While taking out money does not seem to be a “cost-savings” method, taking out money the right way with the right company could save you thousands and thousands of dollars in the long run.
• Find loans with low-interest and long grace periods
• Some loans (e.g. medical loans) have steep penalties if not paid back quickly or if payment is missed
Before you go…
We understand how you feel. We have also been on the other side of a computer screen questioning: Is IVF the right way to go? If it is, how can we afford it? If it’s not, where else can we turn? With such low success rates, and such high expenses, IVF treatments are not for everyone. If they do happen to be for you, we hope that our advice helps you along your journey towards your dream of having a family.
Makayla is a founder of Declan Roe, a children's deal site for boutique-style clothing. She is a wife, mother, and infertility survivor. In her spare time she can be found at the cabin or binge watching shows with her husband