Feature Archive

HMOSs Frugal on Infertility

Coverage comes slowly for those trying to conceive.

WebMD Feature Health plans don't typically cover the cost of evaluation and treatment for infertility. Among health plan sponsors with at least 10 employees, only a quarter provide coverage for infertility services, according to the American Society for Reproductive Medicine -- even though about 10% of all men and women of childbearing age are affected by infertility. (A woman is considered infertile if she has not conceived after one year of unprotected intercourse.)

The reason most often given? Not surprisingly, it's the cost. Adding infertility benefits would jack up premiums too far. So for many infertile women and their partners, having the child they dream of means saving up for years, mortgaging the house, or running up the credit cards.

Surprising Findings

But now researchers from the University of Iowa have evaluated their own university health plan (which is self-funded) and found that the infertility benefits it provides cost each member just 67 cents a month.

In the study -- just published in the journal Fertility and Sterility -- a team of researchers analyzed the university's total health care costs, and those costs specific to infertility treatments, over a three-year period. Total costs over the three-year period were more than $86 million. Infertility treatment costs were $680,000, or about 0.79% of the total.