There is currently no law in the Commonwealth that requires employers and their insurers to offer coverage for infertility diagnosis and treatment for those who wish to have children but need the assistance of reproductive technology.
While some employers will not offer insurance with infertility coverage simply because they do not have to, many employers offer varying levels of coverage.
Insurance company representatives and your employer’s human resources personnel can be useful sources for determining what is and what is not covered. You may find, for example, that an insurance plan covers diagnostic testing to determine the cause of the infertility, but does not cover the fertility treatments to try to conceive.
Here are some questions to ask:
- Is there a time period requirement of being unable to conceive that must be met before diagnostic infertility testing is covered?
- Does the plan require treatment only with an approved list of hospitals, doctors and/or laboratories?
- Does the plan cover cryopreservation and associated storage? Many plans cover the procedure of cryopreservation; however, the storage of sperm, eggs, or embryos is not typically considered a covered health benefit and is therefore not covered.
- Does the plan cover individuals who have had a tubal ligation or vasectomy?
- Does the plan cover IVF? Egg donation? Multiple reduction procedures?
- What mental health services are covered under the plan to help an individual suffering from infertility and/or undergoing ART procedures?
If your insurance does not cover infertility treatments, that does not have to be the end of the line. Fertility clinics and reproductive specialists are keenly aware of the high costs of their services and do their best to offer financing options. If insurance coverage is important to you, reach out to your local representative and tell them you want Pennsylvania to join the 15 other states that require infertility treatment coverage.
All this week, KingSpry’s ART Law Practice Group is marking Infertility Week by summarizing related legal issues. #StartAsking – and stay posted.
heARTbeat is a publication of KingSpry’s Adoption Law and Assisted Reproductive Technology Law Practice Group. It is meant to be informational and does not constitute legal advice.
