More companies help with fertility care, but it is still out of reach for many

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Coverage of fertility treatments remains hard to find in many corners of health insurance even as it grows briskly with big employers that see it as a must-have benefit to keep workers.

Jessica Tincopa and her husband, Rob Tran, stand for a portrait in Orange, Calif., Friday, May 5, 2023. Tincopa may leave the photography business she spent 14 years building for one reason: to find coverage for fertility treatment. After six miscarriages, Tincopa and her husband started saving for in vitro fertilization, which can cost well over $20,000, but the pandemic wiped out their savings and the state's health insurance marketplace doesn't cover things like IVF.

“It is still primarily for people who can afford to pay quite a bit out of pocket,” said Usha Ranji, associate director of women’s health policy at KFF, a nonprofit that studies health care issues. Many businesses that offer the coverage extend it beyond those with an infertility diagnosis, making it accessible to LGBTQ+ couples and single women, according to Mercer.

“It’s pretty wild. You could work a county away and have coverage,” Mason said. “There’s nothing regulating it … both government jobs.” The state and federally funded Medicaid program for people with low incomes limits coverage of fertility issues largely to diagnosis in several states, according to KFF, which says Black and Hispanic women are disproportionately affected. States also can exclude fertility drugs from prescription coverage.

Spokeswoman Mary Ellen Grant noted independent analysis has shown that bills like this could increase premiums by as much as $1 billion in the state. She also said it would create a coverage gap because it wouldn't apply to the state's Medicaid enrollees.

 

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