Transcription:

Deborah Howell: Fertility treatment is now commonplace around the world. But for first-timers negotiating these waters, there's a lot of questions around financing their fertility journey. Let's learn more about Boston IVF Fertility and Finances with an expert in the field. I'm Deborah Howell. And our guest today is Kymberli Seibert, Boston IVF Financial Coordinator at the Women's Hospital. Welcome, Kymberli.

Kymberli Seibert: Hi, good morning.

Deborah Howell: Now, I'm sure the questions you get asked most often: What insurance do you accept and does my insurance cover infertility treatment?

Kymberli Seibert: We accept all insurances that are through employers. We do not accept any state insurance like Medicaid or Medicare. They just will not pay for any of our services. And it just depends on who the employer is. All coverage is employer-driven, so they kind of choose what their employees have coverage for.

Deborah Howell: Okay. And as a patient, how can I check to see if I have infertility coverage?

Kymberli Seibert: You can always call the number on the back of your card for customer service and ask the question to the rep and just see if they would cover any kind of fertility procedures.

Deborah Howell: Easy enough. Here's another question I'm sure you get a lot: Why did you bill my diagnostic testing but not my infertility treatment?

Kymberli Seibert: Well, there's a lot of companies that will actually cover testing to diagnose the problem, but not actually the fertility treatment. So, that would be a reason we would be able to bill testing, just not treatment.

Deborah Howell: How does a person get fertility insurance coverage?

Kymberli Seibert: Like I mentioned before, it's just employer-driven. So, you would have to speak to your employer about having them maybe add that to your coverage or choose an employer that does offer that.

Deborah Howell: Okay. And what employers offer infertility coverage typically?

Kymberli Seibert: We have several. Some of the big manufacturers will cover; Toyota, Evansville School Corporation, Starbucks covers, Tractor Supply, gosh, Berry Plastics now covers. There's just a lot of employees out there that actually will cover infertility.

Deborah Howell: That is wonderful news. And how much do services cost? I know it varies.

Kymberli Seibert: If you're looking to do an artificial insemination without insurance, those fees could go anywhere from $460 to $2,090, just depending upon the treatment plan. For IVF procedures, you would be looking at close to $24,000 to $25,000 once everything is paid, including medications.

Deborah Howell: Okay. And of course, that would lead to my next question. How about financing options?

Kymberli Seibert: We do have a couple financing companies that we work with. One is called Lending Club, the other is called CapexMD. They are essentially just a loan that they would apply for outside of our office. Those companies then in turn pay us and the patient would pay them just monthly payments.

Deborah Howell: Okay. And do you offer any discounts for self-pay?

Kymberli Seibert: No, we have packages like you could do a monitored IUI cycle for $1,540, and that would include all of the monitoring, blood work, ultrasounds, as well as the IUI. But there are no discounts per se for self-pay other than we do give a military discount of 25% for anything that's not covered under your insurance.

Deborah Howell: That's good. You spoke to this a little bit already, but are there payment plans or do people need to pay upfront?

Kymberli Seibert: Right. So if you're not going to use the financing companies that we offer, everything would need to be paid up front in full before nursing could even order any medications. We don't do any in-house financing.

Deborah Howell: Okay, got it. Good to know. My fertility coverage says there's a lifetime max. What does that mean?

Kymberli Seibert: A lifetime max just means that once the employer has paid out that amount, they would not pay for any further treatment. So say an employer has a $10,000 lifetime max and they cover at 50%, they would cover all of your procedures at a 50% up to $10,000. And then once they paid $10,000, you would be self-pay after that.

Deborah Howell: Okay. Got it. Now, will you bill my insurance anyway even if the benefit verification quotes no coverage for infertility?

Kymberli Seibert: We will not. It just causes a lot of work on the backend for the billing department because those are going to typically be denied anyway, so they'll try to appeal or try to get it paid when there really is no coverage. So, we do not do that.

Deborah Howell: Okay. And can I pay online?

Kymberli Seibert: We do not have an online payment portal at this time. We are working on getting one. But at this time, it would be best if you could call and pay over the phone or send in a check until they get that going.

Deborah Howell: Okay. Well, best of luck getting that going. And what if I pay to do a cycle and then get pregnant?

Kymberli Seibert: Any money that is not used would definitely be refunded to the patient. All balances would have to be paid in full. Any patient due balances would need to be taken out of the credit that you had or any insurance balances do have to be paid before we can refund, but definitely any monies that were not used would be refunded back to the patient.

Deborah Howell: Okay. That's good news. Kymberli. Is there anything you want to add to our conversation today?

Kymberli Seibert: I don't think so. I just appreciate the time to get to discuss this with you.

Deborah Howell: Sure. Well thank you so much for being with us. All the good information around fertility and finance will definitely be appreciated. Thanks, Kymberli.

Kymberli Seibert: Thank you.

Deborah Howell: And that wraps up this episode of the podcast series from Deaconess, the Women's Hospital, a place for all your life. For more information, go to deaconess.com/thewomenhospital/services/fertilitycare.

Please remember to subscribe, rate, and review this podcast and all the other Deaconess Women Hospital podcasts. For more health tips and updates, follow us on your social channels. I'm Deborah Howell. Thanks for listening and have yourself a great day.