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Delaying Fertility Treatment Because of Insurance ~ A Patient Perspective Blog Feature
Lisa Rosenthal

By: Lisa Rosenthal on December 17th, 2014

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Delaying Fertility Treatment Because of Insurance ~ A Patient Perspective

Infertility | Fertility Treatment | Patient Stories | Affording Treatment

Infertility Insurance ~ Listening to Stories

path-to-fertilityListening has never been my strong suit. It's not what I lead with. Another of the many advantages to aging is that I've learned some new tricks. And you've helped me learn them. All of you. And especially my PathtoFertility readers, Ladies Night In women, and Fertile Yoga students. You all need to talk more than you need to listen, especially to each other and I need to listen more than I talk.

It's a perfect combination. You talk and I listen.

In listening, I heard the story out loud that is below. It's written by one of our now former patients. When I mentioned that it might be helpful to other men and women experiencing infertility treatment and dealing with infertility insurance coverage, she was quick to offer to help by agreeing to write the following blog for PathtoFertility. Sharing her experiences so that someone else might have an easier time. 

What a lovely gift that I accepted with gratitude.

If you have a story, experience or other words of wisdom that you think could help someone else, please email me at FertileYoga@gmail.com ~ All emails and communications will be kept confidential.

Enjoy ~Lisa Rosenthal

Delaying Fertility Treatment Because of Insurance: A Patient Perspective

Lisa (Rosenthal) asked me to share my story because she thought it might be helpful to others.  I was referred to RMACT (Reproductive Medicine Associates of Connecticut), because of problems in conceiving, in 2012.  I did not come to the practice at that time because my insurance had a high deductible and, to me, that was an insurmountable obstacle.  You may have something similar, with a high deductible plan or a plan offered by your employer that does not cover the procedures you need in order to embark on or continue your fertility journey. 

I felt defeated.  I basically knew what our issue was, fertility-wise.  And it was something that should have “easily” been treated, if only I could get to the Reproductive Endocrinologist’s office.  But I knew that fertility treatments were not inexpensive, and I knew that deductible would have to be met before my insurance would kick in.  I felt like I was stuck for the rest of 2012 and 2013.  Hubby and I tried everything we could on our own and became more and more frustrated every month.

Late in 2013, when we heard about our insurance options for 2014, I felt even more defeated.  Our employer’s plan was becoming more expensive monthly, and the deductibles were going up even higher.   I felt my biological clock ticking and knew I had to do something, and do it soon!  But how?  Luckily, there was a misunderstanding at work.  Our rep who gave us our insurance options accidentally told us about a website where one could look for other plans that might be better than the company plan.  His mistake was that he said our employer would contribute to these plans.  They would not, but the cat was out of the bag.  Someone far smarter than me looked at the options, and found that they weren’t so bad, even without the employer contribution.  When she mentioned this to me, I looked for myself.

For $100 more per month, I could get my own plan, and instead of thousands of dollars for my deductible, it would be hundreds.  I did my due diligence.  I did the math for 12 month times this premium, plus the deductible vs 12 months with my employers’ plan’s premium plus deductible.  Obamacare came along for 2014 enrollment, so I looked at my options there too.  It didn’t have any plans that were helpful to me (the prices I saw were very high), but your experience could be different. 

And full disclosure, that extra $100 a month was not easy for me to come by.  Heck, even just the increase in premium for my employer’s plan was going to be hard to swing.  I got a second job to help pay for the premium, deductibles and copays that went along with my journey.  I mention this because I realize it’s not that easy for everyone. It wasn’t that easy for me either.

The reason I share this is that I was very unhappy and couldn’t see a way to get what I wanted, no, needed, from the insurance offered by my company.  I won’t pretend that I love this insurance plan that I ended up choosing, because if anyone reading this is saying “I know who this anonymous person is!” they will tell you I shed a LOT of tears and had a lot of stress caused by this very same company. My insurance is far from perfect, but it is good enough that it I have been able to proceed with fertility treatment.

All of that said, if I had not done this research for myself, I would not have been able to embark on this fertility treatment journey.  I am sharing my story because I know there are others who, like me, haven’t yet been able to find a way to get over an insurmountable hurdle with their insurance plan.

I know you’re wondering two things, if you are in the same situation I was in.  1. What was that website, and 2. What’s this awesome insurance plan?  I’d share that with you, however, it's information you can get from any independent insurance agent.  You might even be able to pull aside your insurance representative or your Human Resource person and ask about the agent your employer uses.  The agent can look at all of the plans available to you.  They don’t charge any extra than if you went to the insurance company directly.  They actually cannot by law, from what I was told while I was exploring my options.  As for the particular insurance company and plan, I know we all have different circumstances and it does affect the prices and plans available to us.  When you’ve found some plans that look promising, ask to see the benefits documents, so you can be sure that what you assume will be covered, actually is.  Don’t be afraid to ask questions and if you get an answer that is unclear, ask another question.

Lots of love on your journey!  

~A fellow RMACT patient, now graduated to a healthy and strong pregnancy

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About Lisa Rosenthal

Lisa has over thirty years of experience in the fertility field. After her personal infertility journey, she felt dissatisfied with the lack of comprehensive services available to support her. She was determined to help others undergoing fertility treatment. Lisa has been with RMACT for eleven years and serves as Patient Advocate and the Strategic Content Lead.

Lisa is the teacher and founder of Fertile Yoga, a program designed to support men and women on their quest for their families through gentle movement and meditation.

Lisa’s true passion is supporting patients getting into treatment, being able to stay in treatment and staying whole and complete throughout the process. Lisa is also a Certified Grief Recovery Specialist, which is helpful in her work with fertility patients.

Her experience also includes working with RESOLVE: The National Infertility Association and The American Fertility Association (now Path2Parenthood), where she was Educational Coordinator, Conference Director and Assistant Executive Director.