Achieving natural conception can become a problem for many due to various factors.
For such, fertility treatments tend to be the best solution. So, does Medicaid cover such therapies? This will be the main focus of our discussion.
As you read on, you’ll learn about Medicaid coverage and more.
Is IVF covered by Medicaid? Let’s find out.
Does Medicaid Cover IVF?
As a federal and state-funded program, Medicaid covers a range of healthcare services like physician services and federally qualified healthcare.
Others include inpatient and outpatient services, family planning, nurse midwife, rural health clinic, home health, physician services, etc.
Costs Associated with Fertility Treatments
Before answering the question on Medicaid coverage for fertility treatments, let’s first determine the true nature of costs for fertility treatments.
It’s no secret that fertility treatments can be pretty expensive. Without programs like Medicaid and health insurance, it won’t be easy to foot the bill.
Some of the most common fertility treatments include donor eggs, intrauterine insemination (IUI), gestational carrier or surrogacy, and in vitro fertilization (IVF).
There are still other types of fertility treatments involving fertility drugs, as well as egg freezing. So, how much do these procedures cost?
In the case of donor eggs, this is mainly done when IVF cycles have proven ineffective.
It’s ideal for women with low egg counts or poor-quality eggs. The average cost for this procedure is around $15k to $25k. The same applies to IVF treatment.
Egg freezing will cost around $9k to $20k, while fertility drug treatments go for between $900 and $1,500. IUI will typically cost an average of $300 to $1,500.
Here, it’s clear that the most expensive fertility treatments are donor eggs, IVF, and egg freezing.
Does Medicaid Pay for Fertility Treatments?
Medicaid coverage for fertility treatments isn’t uniform across all states.
In other words, while some states will pay for aspects of fertility treatments like diagnostic services, others simply won’t. The most popular fertility treatments, like IVF, IUI, and cryopreservation, have no Medicaid coverage across all 50 states.
States whose Medicaid program covers infertility diagnostic services include Georgia, Hawaii, Massachusetts, and Michigan.
Others include Minnesota, New Hampshire, New Mexico, and New York. Based on this reality, it’s clear that relying on Medicaid to cover your fertility treatments won’t be advisable.
Verify for Yourself
A simple online search on Medicaid coverage for fertility treatments will churn out conflicting information.
While some sources claim that it does, others say otherwise. Based on this reality, you’d do well to research for yourself. In other words, make your findings through inquiry.
Every state has a Medicaid program.
As such, you only need to inquire about your state’s Medicaid coverage for fertility treatments. This is the best way to find out the actual state of things.
Medicaid May Cover these Fertility Treatments
When it comes to fertility treatments, there are several to consider. These include infertility medications and intracytoplasmic sperm injection (ICSI).
Others include IVF procedures, ovulation induction, zygote intrafallopian transfer (ZIFT), assisted hatching, and gamete intrafallopian transfer (GIFT).
i. Infertility Medications
When treating infertility, especially in females, various drugs are used.
Some of these include Milprosa and urofollitropin. Other fertility drugs include menotropins, leuprolide, bravelle, Fertinex, novarel, progesterone, Menopur, Chorionic gonadotropin, and Pregnyl.
More infertility medications that might be covered under Medicaid include femara, clomiphene, and Ovidrel. You may also be given drugs like metformin, letrozole, clomid, etc.
ii. Intracytoplasmic Sperm Injection ICSI
As an advanced assisted reproductive technology, this fertility treatment comes in handy in addressing severe male infertility problems. It involves embryo transfer, sperm injection, sperm collection, pregnancy testing, ovarian stimulation, and egg retrieval.
iii. IVF Procedures
When it comes to IVF procedures, these are typically expensive, with average costs of around $10k to $15k per cycle.
Plus, multiple cycles may be required, with no certainty of getting desired results. So, is this covered by Medicaid? Not exactly! As it stands, there’s no coverage for this procedure across all 50 states.
Having determined the status of Medicaid coverage for IVF, looking at other ways of funding the procedure is necessary. To get cheaper or discounted IVF services, shop for prices.
Grants and scholarships, shared risk programs, and participation in IVF clinical trials are more ways to get discounted services.
iv. Ovulation Induction
Ovulation induction is another fertility treatment that Medicaid may cover. However, this is primarily determined by the state you live.
The state of New York is one whose Medicaid program covers this fertility treatment. For other states, certain conditions may be considered before performing ovulation induction.
v. Zygote Intrafallopian Transfer (ZIFT)
Under this fertility treatment, eggs are fertilized with sperm in a laboratory before transferring to the fallopian tubes.
So, does Medicaid cover this procedure? No, it doesn’t. If you’re hoping to get the ZIFT procedure under Medicaid, you’d have to look elsewhere as there’s no coverage.
With Medicaid not providing coverage for this fertility treatment, you can search for other alternatives. Luckily, there are several of these, such as finding out from your employer if there are fertility provisions or benefits.
Shared risk programs and grants are other possible alternatives.
vi. Assisted Hatching
Assisted hatching is a type of fertility treatment primarily elective and involves implanting uterine embryos.
Due to its expensive nature, assisted hatching is hardly covered by Medicaid. To find out about its availability, consider contacting your local health department.
Borrowing money can be another way to get assistance with the procedure. You might also want to research available grants for these fertility procedures.
vii. Gamete Intrafallopian Transfer (GIFT)
As a non-essential medical procedure, it’s unlikely that Medicaid will cover this fertility treatment.
If you’ve hoped to get this type of treatment, you’ll do well to seek alternatives. Some states might have some provision to offer fertility assistance to needy persons.
viii. Infertility Surgery
Infertility surgery aims to correct anomalies like varicoceles, blocked fallopian tubes, and endometriosis.
As a non-essential medical procedure, it’s understandable why this won’t be covered under Medicaid. You may want to seek alternative ways to lower the cost of fertility treatments.
Does Medicaid Pay for IVF?
It’s now clear that Medicaid coverage for fertility treatments is limited due to various factors that include State Medicaid policies, how expensive the treatment is, and whether the treatment is considered non-essential.
You’ll do well to research your State’s Medicaid program further.