Will Fertility Services Be Covered by My Insurance?
Answered by Liz Coolidge, coordinator of the LGBT Family and Parenting Services at Fenway Community Health in Boston. Nov. 5, 2002
Insurance coverage of fertility services
Q: Dear Liz,
My partner and I would like to begin a family. There are many different things for us to research, including artificial insemination.
We decided to use the Cryobank in California; however, from what I have heard, our health insurance will cover the procedure only if a doctor determines it is "medically necessary."
How do they determine what is and what isn't medically necessary? Do you have any insight or information on this?
Thank you for your assistance.
Heather & Carol
A: Dear Heather and Carol,
You ask a good question. Health insurance companies generally only pay for alternative insemination when a woman has a diagnosis of infertility - that is, when it is considered "medically necessary." There are different definitions of infertility. The most common and traditional one is when there has been 12 months of unprotected intercourse without conception. Now, depending on a woman's age, some insurance companies are reducing that to six months of unprotected intercourse - or inseminations (performed in a doctor's office, not at home).
If you are uncertain about what your health insurance policy covers, you can call the customer representative and ask:
- What infertility treatments are covered?
- What is the definition of infertility?
- How is it documented?
If you feel comfortable, you can also ask whether the policy covers insemination for lesbian couples.
I know the limitations of health insurance can feel frustrating and unfair, especially when facing the costs of alternative insemination. Some women choose to inseminate themselves at home to reduce the expense. Others choose office inseminations, in part to have the documentation in place if they need infertility interventions. Either way, it is expensive. But whatever you choose, I wish you the best of luck.
Liz Coolidge
Coolidge is coordinator of the LGBT Family and Parenting Services at Fenway Community Health in Boston.
Nov. 5, 2002