Fertility and Insurance

You may be wondering if your insurance will pay for fertility preservation procedures. Unfortunately, this is a new niche in medicine and therefore, coverage is limited.

Some fertility preservation methods may be covered, like ovarian shielding or radiation shielding of gonads, because they are considered part of radiation treatment. Others may not be covered.

In some cases, standard infertility coverage can be applied to fertility preservation. However, there is a loophole in the definition of infertility that can exclude cancer patients. You may be denied coverage because you do not meet the strict criteria of the definition of infertility.

Typically, infertility is defined as the absence of conception after at least one year of regular, unprotected intercourse. Most newly diagnosed cancer patients do not meet this definition. They are in a unique situation because they know they may become infertile from their treatments, but they aren’t infertile at the time they need the services.

Petition Your Insurance Company

Some patients have petitioned their insurance companies and received coverage, but this is rare. The process can be time consuming, and you may want to request reimbursement for services for which you’ve already paid. To challenge a denial of coverage, it may be helpful to have your oncologist and reproductive endocrinologist explain to your insurer why your fertility preservation treatments are medically necessary.

This sample letter and supplemental documents may also be helpful if you decide to file a petition.

Livestrong Fertility

The financial costs of cancer can be very high and difficult to manage. Livestrong Fertility can help men with discounted rates for sperm banking and women with discounted rates for egg and embryo freezing. Read more about these options in the Fertility Preservation Options for Men and Fertility Preservation Options for Women articles.