Thursday, July 12, 2012

Tell Your Employer To Offer Fertility Coverage In Their Insurance Plans




Those of you that have read my blog before know that I am dealing with fertility issues. Unfortunately, I'm one of millions Americans that has insurance that doesn't offer any fertility coverage. As a result I'm paying for all my treatments out of pocket. This is extremely expensive! Many people are literally going broke just trying to what comes naturally to most. If you or anyone you know works for a company that doesn't offer infertility coverage then here are a couple of letters that you can customize and send to your boss. Hopefully, this will help to open their eyes to the necessity of this coverage. Please share and pass these letters along to anyone that might need this information. 

Letter #1

Please consider personalizing this letter and then giving it to your employer. It is estimated that at least 1 in 6 people deal with infertility at some point in their life; this means there's a good chance that someone you love deals with or will deal with this disability. 

Many of them suffer in silence due to the hurt, shame, and stigma of infertility. 

One of the hardships of infertility is affording testing and treatment.

Dear [employer or HR rep's name],

I am writing on behalf of the 10% to 15% who struggle conceiving or carrying a pregnancy to term. These people/We deserve equal treatment by way of insurance coverage for our medical needs.

In 1998 The US Supreme Court defined infertility as a disability under the American's with Disabilities Act (ADA). In subsequent Court rulings they said it was okay to deny those with this disability equal treatment. I consider this to be an unjust ruling on a minority group and hope you do too.

Often employers believe that adding an infertility coverage benefit will increase health care costs. However, recent studies indicate that including comprehensive (including IVF and FET) infertility coverage in a health benefit package may actually reduce costs and improve outcomes. 

For example, a recent employer survey conducted by the consulting firm William M. Mercer found that 91 percent of respondents offering infertility treatment have not experienced an increase in their medical costs as a result of providing this coverage.

As also proven in the following studies, the perceived cost of infertility treatment is typically overstated. 

In states with mandated infertility insurance, the rate of multiple births is lower than in states without coverage. (New England Journal of Medicine, “Insurance Coverage and Outcomes of In Vitro Fertilization,” August 2002). Fewer multiple births has proven to provide huge savings as couples with insurance coverage are free to make more appropriate decisions with their physicians based on medical necessity rather than financial considerations which often result in multiple births and a high rate of complications during and post-pregnancy; the cost of these pregnancy exceeds the cost of fertility treatments. 

Comprehensive infertility coverage may actually reduce premium expense by as much as $1 per member/per month. According to The Hidden Costs of Infertility Treatment in Employee Health Benefits Plans (Blackwell, Richard E. and the William Mercer Actuarial Team, 2000), many insurance premiums now indirectly provide coverage for “hidden” infertility benefits such as surgeries to remove scarring in the fallopian tubes for women or varicose vein removal for men. The "hidden infertility benefits" pay for procedures that are often needless and ineffective yet done in the place of less expensive fertility treatments such as ovulation induction, intrauterine insemination, and even in vitro fertilization.

The cost of infertility services as a percent of the total health premiums went down after the 1987 Massachusetts Mandate which made infertility coverage mandatory. (Study by Griffin and Panak, Fertility & Sterility, 1998).

According to a 2003 Harris Interactive Poll, 80% of the general population believes infertility treatment should be covered by insurance. (Harris Interactive Inc., Survey, 2003).

In vitro fertilization accounts for less than 3% of infertility services. According to the American Society of Reproductive Medicine (ASRM), 85%-90% of infertility cases can be treated with conventional medications. (ASRM website, Quick Facts About Infertility).

Please let me know if you would like any additional information on this issue, I am confident I am in contact with someone who can answer them if I cannot answer them myself. I hope my company will consider offering infertility coverage and support family building efforts. Thank you for your consideration.

Sincerely, [your name or "a concerned employee]


Letter #2: 

Dear [employer or HR rep's name],

I am writing on behalf of the 10% to 15% who struggle conceiving or carrying a pregnancy to term. These people/We deserve equal treatment by way of insurance coverage for our medical needs.

In 1998 The US Supreme Court defined infertility as a disability under the American's with Disabilities Act (ADA). In subsequent Court rulings they said it was okay to deny those with this disability equal treatment. I consider this to be an unjust ruling on a minority group and hope you do too.

Often employers believe that adding an infertility coverage benefit will increase health care costs. However, recent studies indicate that including comprehensive (including IVF and FET) infertility coverage in a health benefit package may actually reduce costs and improve outcomes. 

For example, a recent employer survey conducted by the consulting firm William M. Mercer found that 91 percent of respondents offering infertility treatment have not experienced an increase in their medical costs as a result of providing this coverage.

As also proven in the following studies, the perceived cost of infertility treatment is typically overstated. 

In states with mandated infertility insurance, the rate of multiple births is lower than in states without coverage. (New England Journal of Medicine, “Insurance Coverage and Outcomes of In Vitro Fertilization,” August 2002). Fewer multiple births has proven to provide huge savings as couples with insurance coverage are free to make more appropriate decisions with their physicians based on medical necessity rather than financial considerations which often result in multiple births and a high rate of complications during and post-pregnancy; the cost of these pregnancy exceeds the cost of fertility treatments. 

Comprehensive infertility coverage may actually reduce premium expense by as much as $1 per member/per month. According to The Hidden Costs of Infertility Treatment in Employee Health Benefits Plans (Blackwell, Richard E. and the William Mercer Actuarial Team, 2000), many insurance premiums now indirectly provide coverage for “hidden” infertility benefits such as surgeries to remove scarring in the fallopian tubes for women or varicose vein removal for men. The "hidden infertility benefits" pay for procedures that are often needless and ineffective yet done in the place of less expensive fertility treatments such as ovulation induction, intrauterine insemination, and even in vitro fertilization.

The cost of infertility services as a percent of the total health premiums went down after the 1987 Massachusetts Mandate which made infertility coverage mandatory. (Study by Griffin and Panak, Fertility & Sterility, 1998).

According to a 2003 Harris Interactive Poll, 80% of the general population believes infertility treatment should be covered by insurance. (Harris Interactive Inc., Survey, 2003).

In vitro fertilization accounts for less than 3% of infertility services. According to the American Society of Reproductive Medicine (ASRM), 85%-90% of infertility cases can be treated with conventional medications. (ASRM website, Quick Facts About Infertility).

Please let me know if you would like any additional information on this issue, I am confident I am in contact with someone who can answer them if I cannot answer them myself. I hope my company will consider offering infertility coverage and support family building efforts. Thank you for your consideration.

Sincerely, [your name or "a concerned employee"]

4 comments:

Shawn Ann said...

I know where you are coming from! We struggled for several years TTC our first son, due to me having PCOS. Thankfully I was able to get the treatment I needed and our insurance covered it. But I know there are many that do not have that privilege.

Erica Muddled said...

I am sorry to hear of your troubles. My fiance and I have started trying to conceive. I'm over 35 and over weight. So my odds are stacked against me. We're in cycle one and I'm wondering how long our journey might be.

I liked your letters and think it's a great idea!

(stopping from the blogger resources and opps page off Facebook!)

Monicas Mom Musings said...

So sorry that you are having so much trouble. Hopefully you don't have to go through too many rounds of treatment.

Amy Cape Cod Mommies said...

I'm so sorry you are going thru all of this. I'm sure you are going to be a great mother. Thank you for sharing these letters. It i s ludicrous that they won't cover more on insurance plans, yet we pay for people to have children that don't even want them. I wish you tremendous luck in your journey!

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