The mandate to cover laws are not federal mandates; they apply to health insurance plans, but only to certain insurers, treatment services, and patients. Moreover, they do not affect self-insured employers, which generally bear the risk for the health care of their employees. Despite the high costs of these procedures, some large employers have begun to add infertility treatments to their health plans.
Infertility causes psychological symptoms in both men and women, including anxiety and depression
The cost of these services is often so high that health insurance companies are hesitant to cover these treatments. According to a recent study, half of women and fifteen percent of men rated infertility as the most upsetting event of their lives. Infertility caused men and women similar emotional and psychological symptoms, including anxiety and depression. In fact, infertility is recognized as a disease by the World Health Organization, the American Society for Reproductive Medicine, and the Department of Health and Human Services. In the United States, Blue Cross Blue Shield and Medicaid only issue coverage for infertility treatments when they are required by state law or if an employer group requests it.
Narrow for low-income people, including health insurance
Some states require group health insurance plans to cover infertility treatments, such as in vitro fertilization and ovulation insemination, for medically necessary reasons. But in many states, the coverage gap is wider. While this coverage gap is narrower for low-income individuals with health insurance, it is still wide for people with higher incomes and no other type of insurance. Consequently, it is important to check your policy and ask your employer if they will cover infertility services.
Health insurance plans should cover infertility treatment
Should health insurance plans cover infertility treatments? Currently, 15 states require health insurance providers to cover these procedures. However, they do not mandate employers to provide coverage. In addition to a higher level of coverage, the mandates have been successful in extending access to these services. Some studies even suggest that patients with infertility insurance will transfer fewer embryos per procedure. These laws also increase the chances of having multiple births, which is a desirable outcome for many infertile couples.
Compulsory coverage reduces the cost of infertility procedures
There are a number of benefits to mandated coverage. By mandating the coverage, infertility clinics have a strong incentive to increase the live birth rate of their patients. In addition to increased live birth rates, mandated coverage also lowers the cost of infertility procedures. As a result, these treatments are becoming more affordable and accessible to more people. They are also cheaper to obtain.
Conclusion
The law prohibits denial of coverage for pre-existing conditions. It states that an insurance plan cannot exclude a patient for a pre-existing condition. Similarly, mandates do not apply to large employers. Therefore, employers should ensure that they offer infertility benefits to their employees. But in some cases, these mandates do not require coverage for infertility. Some employers may choose not to include coverage for infertility treatments.
