Soaring costs of infertility treatments and preservation burn holes in the pockets of patients already dealing with the emotional upheavals of it. Insurance coverage for infertility treatment is scarce and confusing, and is important to thoroughly understand the covered benefits and exclusions. We are talking to Davina Fankhauser, an expert on policy related to benefits for fertility treatment and preservation who advises patients and professionals on how to effectively communicate with insurers, employers, and legislators to increase access to health benefits.
Q: Can someone be denied coverage because they used donor eggs or sperms? What are rules around using a donor?
A: If there is a state law or insurance regulation that includes donor sperm/eggs/embryos, you should have coverage. However, you still have to see what the insurance carrier’s medical criteria are to be eligible for benefits.
Q: How do I best work with you to “argue” for coverage with my employer? My insurer? Could you join a call or meeting with me? How best do I find out about the status of laws in my state? (CA)
A: My best advice is to not “”argue”” at all. You want to Educate – Communicate – Collaborate. You want to approach this as a team player trying to create a win-win situation for the employer and employees or the insurance carrier and patient. I would be happy to join you for a call or meeting. Fertility Within Reach has done this with employers of all sizes, including large companies such as TJX. There are many nonprofits that list the current laws within your state. Fertility Within Reach does, as well as RESOLVE. You are invited to email admin@fertilitywithinreach.org to schedule a time for us to connect. We can help you determine your best strategies to gain insurance coverage for the treatment you need.
How do I best work with you to “argue” for coverage with my employer? My insurer?
Could you join a call or meeting with me?
How best do I find out about the status of laws in my state? (CA)
Can someone be denied coverage because they used donor eggs or sperms? What are rules around using a donor?