As I reflect on this journey, one thing that stands out to me is how blessed and “lucky” I have been to go on this journey with resources. As someone employed with health care offerings and being married to someone with the same, this journey has been long and hard, but we at the very minimum had medical coverage to try to start to unpack and investigate what is wrong.
For many roles, there is no or very limited fertility coverage. In our case, we had insurance for fertility diagnosis. This is NOT the same as fertility treatment coverage, so let me explain six key distinctions.
In order to begin a pregnancy, an egg must be fertilized by a sperm.
Fertility diagnosis coverage: Covers medical tests (ex. blood work) and procedures (ultrasounds, semen analysis) to identify fertility issues present within the egg and/or sperm that prevent or hinder conception.
Fertility treatment coverage: Includes medical interventions and procedures (ex. In vitro fertilization (IVF), intrauterine insemination (IUI), and fertility medications) to address fertility issues
Duration of coverage varies for each coverage.
Fertility diagnosis coverage: Treatments continue until a diagnosis is reached.
Fertility treatment coverage: Treatments may extend over multiple cycles during a specified period.
In order to find a “solution”, your body will have to go through different procedures.
Fertility diagnosis coverage: Tests are generally non-invasive to complete. Additional tests would require authorization.
Fertility treatment coverage: Treatments may involve invasive procedures such as egg/sperm retrieval or embryo transfer.
If you are undergoing fertility treatment, the end goal is a child. Both types of coverage define “success” differently.
Fertility diagnosis coverage: Success is measured by identifying issues and causes within egg and/or sperm.
Fertility treatment coverage: Success is measured by achieving pregnancy and/or live birth.
Continuous care involves coordination.
Fertility diagnosis coverage: After diagnosis, there may be a need to transition to different levels of care.
Fertility treatment coverage: Requires coordination of care across multiple providers.
The law can get involved in your treatment to various levels.
Fertility diagnosis coverage: Your diagnosis is primarily focused on privacy and consent with minimal legal considerations.
Fertility treatment coverage: Treatment requires involvement and consent for procedures, parental rights and agreements with parents/donors/surrogates.
In short, our diagnostic coverage told us something was wrong… and then wished us best of luck. In hindsight, I would have asked WAYYYYY more questions about what our insurance covered and truly contrasted the two.
Have you looked at/considered what kind of insurance you have? Let’s talk about it.