My wife and I are facing some big decisions. We've been told we'll need fertility treatments to have a baby, but the costs seem overwhelming. How can we decide if we can afford it?
Deciding to have a child is a big financial decision no matter the circumstances. Your situation will likely take even more careful financial planning—along with a lot of patience and perseverance.
Infertility isn't uncommon in the U.S. Recent statistics indicate 1 in 8 couples need treatments to help them conceive. And as you say, the costs can seem overwhelming. For instance, the average cost for one cycle of in vitro fertilization (IVF) is around $10-$15,000, and more than one cycle is usually needed.
Of course, this is a personal journey, so the first thing to do is work with your doctor to understand the types of treatments you may need and the possible cost. Often your doctor or clinic can provide some ballpark estimates of likely costs as well as initial information on financial resources.
Then get ready to dig deep. Because while there may be financial help available—from insurance to employee benefits to grants and scholarships—it often takes a lot of time and effort to sort out your options.
Start with your health insurance coverage
This can be tricky. Many policies cover certain types of fertility treatments but not others. And while currently 19 states have passed fertility insurance coverage laws, those laws vary state by state. So first check to see what is mandated by your state.
Then talk to your insurance provider to get the specifics of your plan. Don't hesitate to ask questions. For instance, are all fertility treatments covered or just some? If fertility treatments aren't covered per se, what about visits to a specialist, testing or medications? Are there limits on the number of treatments? Coverage maximums?
Does your employer offer another plan with better coverage? If your current insurance policy comes up short, you could explore changing insurance providers. Or if you're both covered at work, could one of you switch to the other's insurance if it offered more? But this too can be tricky. While policies under the ACA cover pre-existing conditions, small and independent insurance companies may not, and infertility can be considered a pre-existing condition. Also, specific enrollment periods generally apply, and there may be a waiting period when you switch policies.
My best advice is to assume nothing. Get the details. Make sure you understand them. And get them in writing.
Check your employee benefits
If you’re covered by a work policy, also check with your HR department to make sure you haven’t overlooked any benefits. While fertility benefits may not be common, the number of companies offering them is growing, especially large companies according to FertilityIQ. In the past, tech industries were the leaders in offering this type of benefit, but other sectors are joining in as it becomes more important to potential employees.
Again, benefits vary, with some companies offering fertility assistance to heterosexual couples, singles as well as the LGBTQ community. Ask about types of procedures covered, copays, restrictions and lifetime maximums. Here too, get the details—and in writing.
Look into financial assistance opportunities
You might be surprised to learn that a number of nonprofits offer grants and scholarships to help with fertility expenses. Each organization has its own individual criteria such as state residency, income limits and insurance coverage, but it could be well worth the effort to research what's available and the qualifications.
Explore financing options
Even if you have coverage through some or all of the above sources, be prepared for potentially high out-of-pocket expenses. Here are some other financing options:
- Health Savings Account (HSA)—If you have a high-deductible health insurance policy with an HSA, you can use the funds to pay for qualified medical expenses, including fertility treatments. An HSA is a good way to save in advance. Plus there are several tax advantages, and unused funds roll over year to year.
- HELOC—Although interest on a home equity line of credit is no longer tax deductible except for home improvements, you can use the money however you please. Though not without risk, a HELOC is generally lower interest than other forms of credit.
- IVF loans—This is a type of personal loan specifically for fertility treatments. There are lenders that specialize in fertility financing, and some clinics partner with lenders to create payment plans. Qualification and terms vary so it's important to comparison shop. Resolve.org is a good place to begin your search along with talking to your health care provider
- 401(k) loan—While I generally counsel against borrowing from retirement accounts, your employer plan may allow a 401(k) loan. But understand that it typically must be paid back within 5 years—sooner if you lose your job—and penalties and taxes can apply if you default. On the plus side, rates are generally low and there are no credit checks.
- Your family—Would prospective grandparents or other family members be able and willing to contribute through a gift or loan? You never know until you ask. And the return on their investment could be priceless.
- Credit cards—This is generally the least attractive option. But if you need a short-term financing solution—say a few thousand dollars to handle an insurance deductible—and have examined other options, look for a low- or even no-interest card and have a plan to pay it off as soon as possible.
Be honest about the commitment you're willing to make
We're talking about money here—but so much more. So be completely honest with yourself and each other as you gather information and explore your options. Having a child may be your top priority, but think hard about how much you’re willing and able to extend yourselves, and how much you’re willing to compromise other goals.
Costs and success rates vary wildly for different treatments and individuals, so try to remain realistic at the same time that you pursue your ultimate dream of parenthood. Then you’ll be ready—financially and emotionally—for whatever the future brings.
Have a personal finance question? Email us at firstname.lastname@example.org. Carrie cannot respond to questions directly, but your topic may be considered for a future article. For Schwab account questions and general inquiries, contact Schwab.