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Insurance Often Doesn’t Cover Fertility Preservation Costs

Receiving a cancer diagnosis is traumatizing. Your doctor runs some tests, possibly sends you to a specialist, and then tells you the bad news. Within a few days, you must process this life-changing information, decide on and receive fertility preservation, and start cancer therapy. But what happens if your health insurance doesn’t cover the some of these costs?

Fertility preservation is pricey. Men who participate in sperm banking, or cryopreservation, can expect to pay about $800 for the initial collection and then between $200-400 every year for storage. Treatments for women are much more expensive, starting at a minimum of $10,000 and easily increasing to more than $20,000. Many of us don’t have this kind of money lying around the house and hope that health insurance will cover all treatments associated with cancer. However, that doesn’t always happen.

Insurance companies currently only cover the costs of treating some adverse effects of cancer therapies.  In 1998, the Federal Women’s Health and Cancer Rights Act mandated that when an insurance company covers a mastectomy for a woman with breast cancer, it must also pay for the cost of breast reconstruction. Insurance also often pays for wigs for cancer patients with chemotherapy-induced hair loss. Even precautionary treatments are sometimes covered, such as blood storage for a patient that may need a transfusion of their own blood after cancer treatment.

Then why isn’t fertility preservation covered by health insurance? One reason is bureaucracy. Most insurance companies don’t cover infertility treatments and consider fertility preservation to be in the same category. However, hospitals have successfully covered these treatments by billing fertility preservation as:

1) Cancer treatment

2) Procreative management

Friends of the Oncofertility Consortium recently met with Washington DC insiders calling for an insurance mandate to cover fertility preservation for cancer patients. Though these people were enthusiastic, it may still take years to pass any legislation. We will keep you informed as progress is made on this issue.

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