One cycle of IVF can cost anywhere between $12,850 and $24,250. Whether or not you have coverage for IVF depends on your employer, insurance provider, and your specific plan. Although an increasing number of health insurance plans cover fertility care, unfortunately, many still do not. This can result in either paying out of pocket, seeking grants or loans, or putting treatment plans on hold.

If you’re struggling to grow your family, the last thing you need is the added stress of wondering how you are going to afford fertility testing and treatment. Even as hopeful new legislation like the Right to Build Families Act is introduced in the U.S. Congress, it’s clear that we have a long way to go before all people have the ability to access the fertility and family-building care they need.

This is the perfect time to explore your options for affording fertility treatment and find the resources you need so you can take control of your future. Other than paying out-of-pocket, here are five common ways to pay for fertility treatments:

Grants

Grants are a great way to help supplement the costs of fertility treatments – you might even find some that pay for it all, top-to-bottom, medicine-to-procedure. Be mindful that grants typically have stipulations, for example, you must use a specific fertility clinic or must live in a certain state.

Loans

Medical loans are another option – these are essentially out-of-pocket, as you’ll ultimately end up having to pay the loan back, plus interest. This might be a better option than just swiping your credit card for every bill, since you can negotiate a predetermined interest rate and payback period.

Opportunity Plans

Oftentimes, a fertility clinic will have financial options that either discount their services, or assist in paying over a particular amount of time. Ask your fertility clinic team to see what plans they might offer before diving into treatment.

Insurance Riders

If none of the policies offered by your employer provide adequate coverage for fertility treatment, it may be possible for you to purchase a rider. This can help defray the costs of treatment and make a big difference.

An insurance rider adds coverage at additional cost, but this option could be less expensive than paying out-of-pocket or getting a different carrier. If you’re planning one or more treatments for intrauterine insemination (IUI) or in vitro fertilization (IVF), for example, the higher premium might be worth it.

While strides are being made to push for more equitable coverage for all, there is still a long way to go. For hopeful parents who are part of the LGBTQ+ community, purchasing an insurance rider can sometimes be the best option for getting the family-building assistance needed to move forward.

Health Insurance & Fertility Coverage

Sometimes, health insurance companies will cover partial or full costs for fertility treatment. Some include a stipend for medication, some give you a lifetime monetary allotment – the coverage can vary.

Here are ways to uncover if your insurance company covers fertility care: start by calling the number on the back of your insurance card.

If your insurance policy does not cover infertility, head straight to your employer’s Human Resources representative with these questions:

• Is there another plan I can switch to that does include infertility? Make sure to understand the grace period before using the fertility benefits. Some insurance companies require a certain amount of time to pass before dipping into benefits like infertility.

• Are there any company-based policies that would supplement my fertility journey? Some employers offer fertility supplementation or reimbursement separate from their health insurance. You may need to purchase a rider to your current plan, or a separate package through another provider.

• Are there any other company policies I could take advantage of to assist my lifestyle as I seek fertility treatment? Maybe there is no opportunity for fertility treatment supplementation, but there’s a possibility they could help you in other ways,  such as a more flexible work schedule, more paid time off, etc.

• If you are on a plan through your state’s health insurance exchange, is there another plan you can choose that does have fertility coverage? Although there may be a higher deductible, in the long run these plans may save you money.

If your insurance policy DOES cover fertility, below are questions you can ask to better understand the parameters of the coverage.

• Do I need to use a particular clinic? Some insurance companies will only cover your treatment if it’s administered by certain clinics. Typically, preferred clinics are ones that report to SART (Society for Reproductive Technologies) or another third party information source with clinic statistics.

• How do you define infertility in order to grant coverage? Some plans require a particular amount of time of trying-to-conceive or other health issues before allowing access to the extended coverage.

• Is all the fertility testing covered? Fertility testing must be done before any treatments are started. Is your HSG, saline sonogram, and genetic testing covered? You should ask about those specifically.

• What specific fertility treatments do you cover? Some insurances will not cover anything more than ovulation-inducing medication. Some will cover the entire gamut of procedures. Make sure to get a detailed list.

• Do you cover fertility medications? Do you cover specialty pharmacies or at-home delivery? Will I need to use a specific pharmacy?

• Do I have any yearly or lifetime maximums on procedures or spend? Some plans place a cap on treatments in a given amount of time. For example, your lifetime allotment might be 3 IUIs and 1 IVF cycle, or 1 IVF cycle per year. Some plans will not put a cap on the type of procedures but will instead grant you a certain monetary stipend to be used on fertility needs in a given amount of time. For example, you could be given a $25,000 lifetime allotment.

Other important questions to ask:

• Is there a particular order to the procedures that I’m required to follow? Meaning, will I need to do something less invasive like an IUI before IVF, or can I choose to do IVF first if my doctor recommends that treatment?

• Will I have a co-pay for office visits? And will all visits have the same co-pay, regardless of the purpose? You’ll be in the office quite a bit between having bloodwork done, an ultrasound or diagnostic testing, or simply a chat with your doctor. Is it all the same co-pay?

• Do you cover pre-implantation genetic testing?  Most insurances will not cover this, but some may, particularly where there are existing genetic concerns.

• Should I need ICSI in an IVF cycle, is that covered? ICSI is a more focused fertilization method (manually placing a single sperm inside one egg) that requires more intensive work by the embryologist.

• Do you cover cryopreservation? You might need to freeze your eggs or embryos, and you’ll want to budget for those costs if they’re not covered. A good follow-up question to ask: is there any coverage or reimbursement for the costs of keeping those specimens frozen year over year?

• How should we communicate from this point forward? Will your insurance company correspond directly with the clinic, or will they be contacting you with any results, approvals, or denials?

• What happens if I make it through my allotted coverage? Is there an additional package you could purchase?

• Do I have a deductible to work through before my fertility coverage is paid for? Ask about all the office visits you’ll have, and if those payments can apply to your deductible, should you have one.

In addition to the questions above, you can also request insurance codes for specific procedures (like IUI and IVF) from your fertility clinic in order to run them by your insurance company. Make sure that by the time you get off the phone with your insurance representative that you are feeling comfortable and understand everything they’ve said. You can also request to get the policy in writing.

It can be quite overwhelming trying to figure out how to pay for fertility testing and treatment in the year ahead. As you work to find answers and search for the best option for you, always remember why you are doing this. This may not be the easiest path to parenthood, but all your hard work, persistence, and courage will give you the very best shot at building the family you dream of.

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Alexander Kucherov, M.D. is a fertility specialist at Illume Fertility, board certified in obstetrics and gynecology, and fellowship-trained in reproductive endocrinology and infertility.