Transcription:

Caitlin Whyte (Host): One of the biggest obstacles couples face when beginning their fertility journeys is cost. That’s why today we’re joined by Yolanda Guy as well as our usual doctors Molina Dayal and Maureen Schulte from SIRM St. Louis. Yolanda is a financial counselor at SIRM and will help us navigate the money side of fertility. This is All Things Fertility. I'm your host Caitlin Whyte. So Molina, how about we start with you. Can you tell me about your relationship to Yolanda? How do doctors work with financial counselors?

Molina Dayal M.D., MPH, FACOG (Guest):   Well, financial counselors tend to be a very integral part of a practice. So the way we typically rely on financial counsellors is that a physician—let’s say Dr. Schulte or myself—will see a patient. Oftentimes after reviewing their history we come up with a treatment plan. Sometimes we’re not even at the stage of treatment but we’re just at the diagnostic level. Then we rely on Yolanda to reach out to those patients and couples to basically explain are diagnostics covered by insurance? If they're not covered, what are the costs? Certainly for treatment financial counselors go over the same sort of information. So we rely quite a bit on Yolanda and other financial counselors for that.

Host:   Yolanda, from your perspective what is the role of a financial counselor in the fertility setting?

Yolanda Guy (Guest):     The role of financial counselor, we go over and explain insurance benefits and coverage to the patients. Once we have a treatment plan from the doctors, then we go over the costs and if insurance is covered and the financial options for the patient for any treatment.

Host:  So with all the different types of treatment, how do you figure out what the cost of each one will be?

Yolanda:   So everybody’s journey is different. So the costs are driven by the individuals diagnosis and their treatment protocol.

Host:  Now let’s talk insurance. Does it cover costs? If so, what does it cover and what doesn’t it when it comes to fertility treatments?

Yolanda:   So you have some insurances that only cover a patient’s diagnostic testing versus their treatment. Then you have some that cover diagnostic and treatment. So it depends on the patient’s plan and their benefits.

Host:  Are there any states that mandate coverage for infertility?

Yolanda:    Yes, there are many states that provide coverage for patients. In our area, Illinois is one of them.

Host:  Oh, that’s great to hear.  

Dr. Dayal: I was going to say that since the 1980s or so, I believe there’s 16 states that have passed laws that require insurers cover or at least offer coverage for infertility both diagnosis and infertility.

Host:   That’s awesome. Some day we’ll get 50, right?

Dr. Dayal:   Absolutely.   

Host:  So Yolanda, what if more than one IVF cycle is recommended? How does that effect cost?

Yolanda:   So that effects cost in the sense that the patient has to determine if they want to do more than one cycle and how they're going to over the cycle. If they have insurance then there's not a problem. We just contact insurance, verify benefits, obtain authorizations if required. If they are a self-pay patient then we give them financial options. We have a multi-cycle program that we offer our patients that have two or three egg retrievals and transfers. So they have the options to look into those as well for multicycles.

Host:  Now talking money, especially when it comes to medical procedures, is never really anyone’s idea of a fun time. How do you communicate all this information to your patients?

Yolanda:   So once they’ve had their new patient consult or they’ve finished all of their diagnostic testing, then I meet with them either in person or via phone and discuss the treatment plan that the doctor has talked with them and the nurses have talked with them about. I inform them of what their insurance covers or what it doesn’t cover. Then I go over the pricing of the packages with them.

Maureen Schulte M.D., FACOG (Guest):   I think what’s really nice about our office is that we do have Yolanda and our financial counselors available because every patient is different. So some patients want to meet with Yolanda on the same day. Some patients want to wait until their treatment plan is solidified and have a follow up meeting at a different date. Because once you have your initial consultation, sometimes your head is spinning because it’s a lot of information. So some patients prefer just to go home and think about what the physician has recommended and then come back to have their financial consult be a phone or in person. I think that’s really nice that we’re flexible and able to provide them with what suits them best.

Host:  Great. Yolanda, sounds like we have a lot of different options. When it comes to payment, are there any payment plans available?

Yolanda:   Well, not necessarily. We don’t technically have a payment plan. It just depends on what financial option you choose to take.

Dr. Dayal:   There are other options. There are fertility grants that are out there that are available to couples or patients. There are special fertility associated loans that patients can have. It’s through at least the loan structure that they have payment plans. So they don’t necessarily have payment plans through the practice, but they do indirectly perhaps through a loan.

Host:  Yolanda, do you have any more information about those loans?

Yolanda:   So we have three main lending clubs that we recommend to our patients. We have Health Credit Services, we have Lending Club, we have Capex MD. We give our patients that information, and we instruct them to do research on each company to see which one fits their financial needs.

Host:  So Yolanda, is there anything you would recommend to patients who are financial preparing for fertility treatments?

Yolanda:   I think that I would recommend to them to do their research. To see if there are financial options. If they are looking at insurance coverage, make sure to talk with their benefits person at their job to see if this is a benefit that the company could offer or if they do offer it. That way they’ll know as far as insurance goes if they have this coverage or not. If they do not have this coverage through insurance, I would just say that they need to start a—say for instance—an account for fertility to be able to move forward when it’s time to move forward.

Dr. Dayal:   We know that fertility itself is a very stressful situation. Then when you add the financial aspect or component to the entire process, that can definitely add a whole new dimension. In the purpose behind a lot of these sort of plans, whether they're multicycle plans or single cycle—meaning multiple IVF cycles versus one IVF cycle—versus the grants or the loans, they're all there in order to provide the most comprehensive choice to patients to try to make it as easy as possible. We know that it is a very difficult process to go to. It’s people like Yo and financial counselors who try to really help them along the way and kind of guide them in the best way that they think is possible for those patients.

Host:  Well thank you all so much for taking time to break down this side of the fertility process for us. I know it’s never fun to talk money, but it is so important. That was, of course, our doctors Molina Dayal and Maureen Schulte from SIRM St. Louis joined by financial counselor Yolanda Guy. To learn more about the team at SIRM St. Louis or to schedule an appointment, visit stlouisfertilitycenter.com. If you enjoyed this podcast, find more like it in our podcast library and be sure to give us a like and a follow if you do. This has been All Things Fertility. I'm your host Caitlin Whyte. Thanks for joining us and we’ll catch you next time.