CLEVELAND — Before starting any medical treatment, it's always a good idea to look into your insurance plan - to learn what may or may not be covered. But when it comes to fertility treatments, you may be surprised to learn, there's a very wide range of potential coverage.
"A lot of these insurance companies and a lot of these employers, when it comes to insurance, they view something like egg freezing as optional and not medically necessary," Molly O'Brien, a lawyer specializing in Assisted Reproductive Technology law with International Fertility Law Group said while being interviewed for the 3 Things to Know podcast.
And while there may still be a long way to go when it comes to insurance coverage for fertility treatments, there has been some positive change in recent years – from companies like Google, Facebook and even Starbucks, with its many locations in Northeast Ohio.
"[Now,] there are a lot of employers who are contracting with companies like Carrot or Progyny which specialize in adding riders to insurance policies so that people who work for that company can have certain fertility benefits, and in a lot of cases they really encourage fertility preservation," O'Brien continued.
Erin Sykes has done three different egg freezing cycles - mostly not covered by insurance.
"Ninety percent of it was out of pocket," Sykes said. "Maybe some of my blood work was covered under insurance."
And when you’re paying out of pocket, the cost can be a big obstacle. O'Brien says the cost of egg freezing alone can range between ten and twenty thousand dollars - a huge upfront investment. And that's not counting the costs down the road to use those frozen eggs to try to start a family.
"If you want to use those eggs in the future then you have to thaw the eggs you have to create embryos... then there's the IVF [in vitro fertilization] for the implantation of those embryos and that cost is exponentially higher," O'Brien said. "You're looking at an additional twenty to fifty thousand dollars."
"You know, this is not something that's been done for the last 20 years or 10 years, frankly. I mean, I'm in my mid to late forties. It was not an option when I was in medical school to egg freeze," she said.
And with the changes in the medical field come changes in coverage policies. She explained that many boutique fertility clinics, like hers, now offer financial advisors to help patients navigate costs.
"We always encourage our patients. There’s medicine coverage available. There may be some grants available. So we try to access those for patients," Dr. Maseelall said.
Beyond the cost and coverage, there are also legal issues to consider. Like whether you want a romantic partner, or anyone else, to have the right to use your frozen eggs, or in some cases, fertilized frozen embryos, in the event you don't use them yourself. O'Brien says you should typically expect to sign consent forms at your doctor's office, but you can take it a step further.
"There are other documents that you can have in place like an estate plan for your genetic material that will govern what should happen in the event of a breakup, [or] in the event one of the partners dies," O'Brien says.
It's equally important to make a plan for what you'd want to do if you never end up using your eggs or embryos for other reasons, like if you end up getting pregnant naturally.
"The number one thing is that if you take the time to do something like this you can't just drop it," O'Brien says. "You need to make a decision because these things do become part of your family's estate."
The important thing is to do your homework, and have a plan, so you can feel confident in your choices.
"Definitely talk to a psychologist, definitely talk to an attorney, and interview more than one physician," O'Brien advised. "You want to make sure that the choice you make is something you feel good about."