You may be running out of time. Not about fertility treatment and conceiving, but about changing or amending your medical insurance coverage. Think of Open Enrollment as the days ticking down until on December 15, it’s a done deal.
If you work for a company that offers insurance to its employees, you have until Dec. 15 to take advantage of “Open Enrollment,” the window of time when you can switch to an insurance provider that might offer more comprehensive “infertility” benefits.
If you are planning – or engaged in – fertility testing or treatments, it makes sense to have the plan that does the most at the lowest possible out of pocket costs.
Here are three vital things to investigate with about open enrollment.
1. The deadline is Dec. 15 but don’t wait until Dec. 14 to start your research. You will want to read and understand your current policy as thoroughly as possible and it’s not necessarily easy to understand. You may need to call the insurance company or talk to your employer’s human resources department to get correct and appropriate answers. Then compare against the other available policies. Look for treatments covered by each policy, lifetime limits on infertility treatment and how to get treatments approved for coverage. Examine the formulary – the list of fertility medicines that will be covered. And make sure you are familiar with the annual deductible and additional payments that must be paid for each visit, procedure or prescription. Balance those expenses against the annual premium to determine which is more likely to cost less over the year. Bonus tip: Learn the language of insurance from this RMACT blog.
Patient S.H. recommends, “Here’s something to keep an eye on: Blood work and fertility diagnostics should always be covered by insurance. Otherwise, you can end up paying thousands when you don’t need to.”
2. Congratulations, you have chosen the right policy to help you cover fertility costs next year. Now determine how much of your annual deductible you have spent for this year. If you have gone through the entire amount, ask your doctors what tests you can do now to prepare for procedures in 2019. The results from many tests are reliable for up to six months and your insurance will pay for the bulk of them until the end of the policy year. Your Flexible Spending Account, or other medical spending plans, are also valuable, because you can use those savings to pay for any additional costs. Bonus tip: Learn how different medical spending accounts work.
3. Look into insurance riders if none of the policies offered by your employer provide adequate coverage for infertility treatment. (It may be possible for you to purchase a rider, an option that could be less expensive than paying out of pocket or getting a different carrier.) A rider adds coverage at additional cost but when or if you are planning one or more treatments for intrauterine insemination (IUI) or in vitro fertilization (IVF), for example, the higher premium might be worth it. Bonus tip: Reproductive Medicine Associates of Connecticutguides patients through the process of evaluating insurance and getting the most out of your coverage.