Why health insurance companies should cover the cost of fertility treatment

After we married, my wife and I tried to conceive naturally for six months. When that didn’t work, we visited a fertility specialist who confirmed we would be unable to have children without the help of clinical intervention.

Our initial fertility exams were covered by insurance. But as we were about to learn, the most promising fertility treatment, IVF, was not. We were on our own.

Most recently, the California Legislature considered what is now a two-year bill, Assembly Bill 767 by Assemblywoman Buffy Wicks, an Oakland Democrat. The legislation would recognize that infertility is a disease and require that large insurers not just offer, but pay for IVF. 

This means that in 2020, when the state insurance benchmark plan that determines the baseline coverage that insurance plans must provide and pay for is decided upon, IVF could potentially be among the benefits.

I am fortunate to be able to celebrate this positive step with my wife and young son. However, I cannot help but remember a challenging era in my life when my wife and I were among the countless others who could not conceive. 

In our case, our insurer covered testing to confirm the suspected diagnosis, but refused to cover treatment. That seemed doubly cruel, like covering a diagnosis of diabetes but not insulin, or the cost of a lung scan without chemotherapy or medication for a diagnosed cancer.

As I think about our experience, an inner voice reminds me that I am obligated to keep fighting for better infertility options for those still trying to conceive. This includes advancing healthcare policies that will benefit thousands of people in similar, or even more despairing, situations.   

Yet we were not alone in our struggle to find a solution. We joined a local support group of other would-be parents, which emotionally, was enormously helpful. 

We shared information, referrals, and advice, and formed a network where we could speak about our struggles without stigma.

I found it interesting that in the large group setting, men rarely spoke or expressed their emotions candidly. However, when out for a beer afterwards, away from our wives, we shared conversations around the emotional and financial stress of infertility flowed easily.

In those conversations, men described the challenge of staying optimistic and upbeat as their wives emotionally and physically struggled. 

We had to maintain the role of cheerleader when our spouse was ready to give up. We created financial plans with our partners to scrape together funds for the next medical exam, test or procedure, and pay the bills. We vented our frustrations that our expensive insurance offered little or no help. 

My wife and I tried six rounds of intrauterine insemination (IUI) and six rounds of IVF. We were desperate to find a solution before we were financially tapped out. Most people do not know the out-of-pocket costs for couples with infertility is prohibitively expensive. 

The cost regularly exceeded $15,000 a session, which is why only about 5% of couples with infertility seek IVF. We drained our savings and lived frugally. I am a good saver and we postponed saving for our future including retirement. In total we expended more than $300,000 in personal costs.  

The vast majority of people who suffer from infertility (which is affirmed as a disease by the World Health Organization and the American Medical Association) have few options simply because insurance will not cover the expenses, and are forced to abandon their dreams of conceiving. 

Most slip into the routine of everyday life without protest that insurance will not cover medical treatment for this disease.  

Although insurers warn of cost increases to justify their opposition to infertility coverage mandates, research shows the costs to policyholders are, in fact, minimal. 

When Connecticut required infertility coverage, including IVF, for basic and advanced infertility treatment, premiums increased only slightly, less than 1% total. And a recent analysis by the California Health Benefits Review Program estimated costs in the California large employer market to increase by less than half of one percent when infertility treatment is covered.  

After we exhausted our financial options in the U.S., we saved and sacrificed until we were able to travel to the Czech Republic for IVF treatment, where the cost of care was much lower than paying out-of-pocket for treatment in the U.S.  

Luckily for us, one of those treatments worked. A day does not go by in our house without reflection and gratitude.

I look forward to the prospect of new policies next year that make IVF a reality for the thousands of would-be parents who otherwise will be left out and left behind.

 —

Ryan Haight is part of a support group for RESOLVE: The National Infertility Association,, and lives in Carmel Valley, clmbs05@yahoo.com. He wrote this commentary for CalMatters.