Insurance & Savings

Understanding insurance coverage for fertility treatment can be tricky. Every patient at Shady Grove Fertility has a devoted financial counselor to help guide them through each step of the process; which makes the transition into treatment as smooth as possible. We sat down with Angela Tablada, Patient Financial Services Manager, to learn about the most frequent questions patients have about insurance coverage for fertility treatment.

Do you work with my insurance provider?

“It’s likely,” explains Tablada. “Shady Grove Fertility works with a variety of insurance providers across D.C., Maryland, Virginia, Pennsylvania, Georgia, Florida and New York. We find that 90 percent of our patients have insurance coverage for the initial consultation and 70 percent have at least some form of insurance for testing and treatment.”

• Participating Insurance Providers

Once I am a patient, how will I know if I have insurance coverage for fertility treatment?

Upon scheduling a new patient appointment, current insurance information will be collected and our financial team will check your insurance policy for coverage after your new patient appointment. “Our pre-screening insurance benefits team will be able to verify your benefit coverage after your new patient consultation. After meeting with your medical team, you will speak with your dedicated financial counselor either in the office or via phone to review your benefits, insurance requirements, and any Shady Grove Fertility financial programs you may qualify for,” explains Tablada.

To ensure you are getting the most out of your insurance coverage, Shady Grove Fertility diligently re-verifies benefits at the beginning of your coverage year. We want to confirm that we are fully maximizing your insurance for both testing and treatment. In order to obtain the needed verification of benefits and authorizations, this process can take between 2 to 4 weeks.

• Benefit Re-verification: This step generally takes our team 2 weeks to complete. While our team works directly with your insurance provider, we find that when patients are proactive and verify their coverage as well, we are able to confirm the accuracy of insurance plan details and catch any possible misinformation provided by the insurance company.

What are my options if I don’t have insurance coverage?

Although insurance coverage can help ease the cost of fertility treatment, it is not the only option when it comes to growing your family.

“The most popular financial program we offer is our Shared Risk 100% Refund Guarantee Program. This option allows patients up to six fresh IVF or donor egg cycles and unlimited frozen embryo transfers (FETs) for one cost. The result of this program is the same for each participant – either take home a baby or receive a 100% refund,” says Tablada.

Along with unique financial programs we also offer a variety of discount programs for eligible patients. Through these programs such as Shared Help and the military discount qualified patients will receive a discount off the cost of their treatment. Once your discount is determined it can be combined with many of our other financial programs like Shared Risk and the Multi-Cycle Program.

• Financial Options at Shady Grove Fertility

In addition, Shady Grove Fertility has an exclusive partnership with Fertility Finance, a finance company that offers a wide variety of loan options, allowing patients to attain the necessary financing required to make treatment affordable. Each loan program is designed to fit the individual’s circumstances. Once approved, their Fertility Loan Specialists will work closely with Shady Grove Fertility to ensure the funds are secured prior to the start of your treatment.

What is the difference between participating with an insurance plan and having coverage for treatment?

“Nearly all insurance plans have the ability to cover infertility treatment. In order to access those services your employer must opt-in to infertility coverage for their plan members,” explains Tablada. “These decisions are usually made by the Human Resources Department before the open enrollment period every year. If your insurance plan doesn’t have fertility coverage speak with your HR department about getting the coverage added to your company’s insurance policy for the next plan year.”

Editor’s Note: This post was originally published in June 2013 and has been updated for accuracy and comprehensiveness as of February 2020.

To learn more about affording fertility treatment or to schedule an appointment, please speak with our New Patient Center by calling 877-971-7755.

Fertility benefits rank high on the list of valuable benefits that make recruiting top talent, retaining valuable employees, and reducing turnover easier. Providing coverage for family building options has been shown to increase employee retention and loyalty.

According to a recent FertilityIQ survey, 68 percent of millennials consider fertility benefits when choosing an employer, and 9 out of 10 employees with fertility issues will switch jobs for benefits.

This scenario was very true for millennial, Katie Goad and her husband Adam. They had an 8-year-old daughter and wanted to expand their family. After giving birth to her first child, Katie had surgery that meant she would have to undergo IVF in order to have another child.

Lacking insurance for IVF, Katie was determined to expand her family without going into debt in the process, so she explored her employment options and discovered that Starbucks offered benefits to cover IVF, even to hourly, frontline workers. Starbucks is revered for being among the first to provide fertility benefits to hourly and part-time employees.

“I was honest with them in my interview about what my goal was, and what my intentions were,” Goad said in a recent interview with Benefit News.

She landed the job and started working as a part-time barista.

In a recent survey, FertilityIQ, author of the extensive Family Builder Workplace Index, found that 73 percent of fertility patient respondents felt more gratitude toward their employer because of fertility benefits, 61 percent said it made them feel more loyal, and 53 percent said it influenced them to stay with a particular employer longer.

“In this tight labor market, millennials are entering the family building years and flooding the workforce. Companies eager to recruit top talent know that offering fertility benefits, paid parental leave, and flexible schedules fosters a great sense of loyalty,” said Patty Stull, Chief Marketing Officer of SGF.

Once Katie qualified for health benefits through Starbucks, she began fertility testing and treatment under the care of Dr. Mark Perloe at Shady Grove Fertility Atlanta.

“It was an absolute pleasure helping Katie and her husband expand their family,” says Dr. Perloe. “I was inspired by their tenacity and resourcefulness. We were thrilled to call Katie and let her know that she was pregnant after her first IVF cycle.”

Stories like Katie’s are becoming more common as more employers cover fertility treatment such as intrauterine insemination (IUI), in vitro fertilization (IVF), as well as expanding coverage for egg freezing and even surrogacy. Benefit News reported that employers including Starbucks, Slack, Foursquare, Box, and Samsara all recently updated their benefits.

FertilityIQ’s research found similar results. Of the 30,000 IVF patients who were surveyed on their employers’ (or their spouse’s employers’) 2019 fertility treatment policy, over 400 US businesses and organizations had policies in place to cover the cost of IVF, and 23 percent of the companies on this list offer newly implemented or substantially enhanced fertility benefits compared to 2018.

The good news continues; the gains and progress span many different industries, not just technology and financial, who are credited for paving the way. Retail, insurance, banking, healthcare, and manufacturing all showed enhanced fertility benefits compared to last year.

“Fertility coverage is definitely moving in the right direction,” says Stull. “Seventeen states currently have a requirement of employers to offer fertility benefits, the latest being New York, home to SGF’s newest IVF center. This is great news for patients as it opens up access to care.”

Schedule a new patient consultation to explore your options at SGF. Call the SGF New Patient Center at 877-971-7755 or complete a brief online form.
 

Shady Grove Fertility’s IVF treatment refund guarantee, known as the Shared Risk 100% Refund Program, was the solution that offered Dan and Carina Cottner, financial professionals from Richmond, VA, the opportunity to start the family of their dreams.

“Couples who go through infertility often don’t want to talk about it. And their friends and families are too scared to ask. That used to be us. We didn’t tell our parents what we were going through until our second miscarriage. But once we did, we realized we weren’t alone. In fact, seven of our friends were either going through or had been through the same struggle.”

Dan and Carina recalled very vividly the day they received a call with unfortunate news that their eighth assisted pregnancy attempt had failed. It was devastating news, to say the least. And, to worsen the blow, this was the couple’s last IVF attempt that was covered by insurance.

“We considered ourselves among the lucky ones with generous benefits offered through our employer,” said Dan, Director of Mobile Design with a global fortune 500 financial corporation. “But our luck had just run out, and we were left with the decision to keep going and fund it ourselves, or just accept that biological children were not in the cards for us.”

“This was my low point. We were emotionally and spiritually exhausted. Not to mention, I was physically drained,” said Carina, Senior Manager of Customer Experience Research for the same corporation.

Hopeless and completely defeated, Dan and Carina didn’t know what to do. “I never questioned whether we were going to continue the journey, I just didn’t know how we were going to pay for it. So based on the options in front of us, we had a big decision to make. Do we gamble on one more shot, or do we pay more and get up to six more tries through SGF’s Shared Risk 100% Refund Program?” said Dan.

Dan adds, “Now, you’re not guaranteed a baby, that’s not how it works. But, you’re guaranteed up to six more tries. And if none take, you get your money back.”

“So this was a no-brainer,” added Carina. “We had to go with option 2. Knowing my track record with miscarriages and failed pregnancy attempts, there was no way I was going to throw all that money at just one more try. What if I miscarried again? That’s more money down the drain, along with our hopes and dreams of a family.”

The couple explored their financial options and, under the guidance of their financial advisor, ended up taking out a 401K loan — an option they didn’t even know existed, ultimately sacrificing some of their long-term retirement savings to start their family right away — to pay for Shared Risk.

Fortunately for the Cottners, one year to the day from their last failed pregnancy attempt—the day Carina described as “the lowest day of my life”—their twins Quinn and Oliver were born.

“Our journey to start our family was emotionally, spiritually, and financially taxing. And while our story has a happy ending, it serves as a constant reminder in both our personal and professional lives that finances are a means to an end, they’re not the end themselves,” added Dan. “We hope our story provides a sense of joy, and we’re so thankful to have found this program.”

SGF’s Shared Risk 100% Refund program was developed 3 decades ago specifically to help patients without insurance who are faced with a difficult dilemma when undergoing fertility treatment—continue with fertility treatment at a high cost and have the risk of being left without a child.

This program offers a unique financial safety net that provides patients with the opportunity to pay a fixed amount for up to six fresh in vitro fertilization (IVF) or donor egg cycles and any subsequent frozen embryo transfers. If the patient does not take home a baby, SGF gives a full refund.*

“Before we found SGF, I remember having to answer the tough questions when it came to paying for fertility treatment, ‘well, how badly do you want a baby?’ and ‘is the risk of it not working really worth your savings, the debt, and the sacrifice?’ Facing those tough decisions felt like a sucker punch I didn’t see coming. My head was still reeling from the first blow that we couldn’t get pregnant on our own, but then to face the fact we’d have to pay a ton just for the chance to try? I felt defeated from the start,” shared one SGF patient who also used SGF’s Shared Risk 100% Refund Program.

“And then we learned about SGF’s Shared Risk Program … and, not to sound cliché, but my hope was restored. I no longer had to grapple with the ‘what ifs’ and weigh what seemed practical in my head against my heart’s greatest desire, to be a Mom. Every other center I researched, to try again, you pay again. That felt cruel to me. But with SGF, we had many chances and the risk of walking away empty handed and with empty pockets was eliminated. Eliminated!!” she added.

If you would like to learn more about SGF’s Shared Risk 100% Refund Program or to schedule an appointment, please call the New Patient Center at 888-971-7755 or complete this brief online form.

*Shared Risk payment is in the form of a refundable deposit. Some exclusions apply.

Patients should have the opportunity to pursue treatment without having to bear the financial burden should treatment not be successful.

Read SGF sister Jean’s powerful testimonial about finding solace after enrolling in SGF’s Shared Risk 100% Refund Program:

Before we found SGF, I remember having to answer the tough questions when it came to paying for fertility treatment, ‘well, how badly do you want a baby?’ and ‘is the risk of it not working really worth your savings, the debt, and the sacrifice?’ Facing those tough decisions felt like a sucker punch I didn’t see coming. My head was still reeling from the first blow that we couldn’t get pregnant on our own, but then to face the fact we’d have to pay a ton just for the chance to try? I felt defeated from the start.

And then we learned about SGF’s Shared Risk Program … and, not to sound cliché, but my hope was restored. I no longer had to grapple with the ‘what ifs’ and weigh what seemed practical in my head against my heart’s greatest desire, to be a Mom. Every other center I researched, to try again, you pay again. That felt cruel to me. But with SGF, we had many chances and the risk of walking away empty handed and with empty pockets was eliminated. Eliminated!!

It felt too good to be true. And yet, every step of the way, I felt like SGF was in my corner, on my team. Being on a team, to me, means everyone shows up, every single time, and fights like hell to win. And that’s what we got. We were all fighting to achieve the same goal. When we faced setbacks, we faced them together, but we never gave up and we never felt alone … And then , that day, when we got the call … I actually think my doctor was more excited than I was. It’s a feeling I can’t even begin to describe. His optimism and joy for us filled my bucket overflowing. And it was genuine. I am so incredibly thankful for SGF and the beautiful family I have now that wouldn’t have been possible without them. #winningteam

Looking for More Info on SGF’s Financial Programs?

Watch our Financial Options On-Demand Webinar

When in need of fertility care, people often ask, “How will I pay for treatment?” The answer for many patients is either through their existing insurance coverage or with an exclusive Shady Grove Fertility financial program designed to help patients access the care they need to start or grow their family.

During our on-demand event, hosted by Maria Patswald and Jennifer Cockburn, from the SGF Financial Services Team, you’ll learn how thousands of SGF patients each year are affording fertility treatment. Maria and Jennifer will discuss how to navigate your insurance plan or how you can find the ideal financial program based on your treatment plan if you don’t have complete coverage. You’ll also learn about the unique financial programs only available at Shady Grove Fertility including discount and guarantee programs, fertility financing options for self-pay patients, grants, and tips for accessing discounts for medication.

Register today to participate in this informative, free on-demand webinar and watch now or at your own convenience. Schedule a consult online.

If you have questions regarding the Shared Risk 100% Refund Program or would like to schedule a new patient appointment, please call our New Patient Center at  877-971-7755 or fill out this brief form.

What comes to mind when you think of “investments?” Stocks and bonds? Retirement savings plans? Real estate? For most women, egg freezing may not be at the forefront of your financial considerations, however it’s an equally important investment in your future, especially if you’re concerned about your biological clock.  And like many investments, the associated financial component can be intimidating without a proper understanding of its future value in the years ahead. U.S. News and World Report turned to SGF’s Executive Senior Medical Officer, Dr. Eric Widra, to provide a cost-benefit analysis of egg freezing and why it’s important to consider.

Why choose egg freezing?

Before we’re even born, we have as many as seven million eggs in our premature ovaries. At birth, the clock starts ticking and our egg supply drops to around one million. Then, around the time when we’re trying to understand safe sex and how to avoid a pregnancy, our egg count declines again, by half.

“As women get older, they have fewer eggs to work with,” says Dr. Widra. And along with fewer eggs also comes a decrease in egg quality. Egg freezing, also called oocyte cryopreservation, is an increasingly popular solution that prolongs a woman’s fertility by literally freezing her eggs in time, so even when she’s older her eggs remain as healthy as her age at the time she froze them.

SGF Atlanta physician, Dr. Desireé McCarthy-Keith, also contributed to the topic on the PBS program, A Seat at the Table, to further illustrate the benefits of egg freezing.

“Our timeline is very important to think about. Egg freezing is a way for women to capitalize on that. You may not be ready professionally, you may be single, not ready to have a baby just yet, but if you collect and freeze your eggs at a younger age, those eggs are locked into that age. If you freeze your eggs at 30, you can come back at 40 or 45. If you thaw those eggs and fertilize them, your chance of getting pregnant is based on the age when you froze them, not the age when you use them.”

This opportunity is ideal for many women who aren’t ready for children, want to keep their family options open, or for those who haven’t found a life partner. However, any woman who is anxious about her egg reserve or is concerned over her ticking clock should consider the possibility, and with SGF’s available financial options, you can decide what works best for your budget.

The Cost of Egg Freezing

Before you dive into the deep end with comparing costs and programs, you need to consider a few things, which your Provider can assist you in understanding; based on your current age and ovarian screening. These considerations include; how many treatment cycles will it take to produce an ideal number of eggs? And how much will the medication cost each cycle?

Fortunately, regardless of the questions above, SGF allows you to save exponentially by paying one flat rate for multiple treatment cycles with our Assure Fertility program, compared to paying a per-cycle fee.

The Assure 20 package program is a one-time fee which guarantees 20 mature eggs, or up to four cycles. For women that may need, or desire, more frozen eggs, the Assure 30 package program is a one-time fee which guarantees 30 mature eggs, or up to five cycles. Though the Assure package programs do not include the cost of ovarian reserve testing and medications, we believe these options provide you with the tools to customize the finances of your treatment, while we customize your care.

Will my insurance cover treatment?

Good news! Ninety percent of patients with insurance have full or partial coverage for fertility testing and their initial provider consult. Without insurance, the cost for testing and consultation is $325. More good news! At an increasing rate, employers are covering the cost of egg freezing as a value-added employee benefit, so check with your employer/insurance carrier to learn more.

Egg Freezing Patient Story: Laura

“Knowing that I was about to start an intense graduate program at 35 years old and would not be ready to start a family for a few years, I decided to look into freezing some of my younger eggs just in case I needed them down the road. I am so thankful I sought a fertility consultation because doing so gave me options! I would have been much worse off if I had waited until graduation. I cannot adequately capture in words just how grateful I am to have found SGF. While I’m not ready to use my eggs yet, I can continue with my education with a sense of confidence that SGF will be ready to continue their magic when it is time.”

Dr. Widra sees patients in SGF’s K Street and Sibley offices. To learn more about egg freezing or to schedule an appointment with Dr. Widra or another SGF physician, please contact the SGF New Patient Center at 1-877-411-9292 or complete this brief online form.

Did you know that approximately 70 percent of our patients with insurance have some level of fertility financial coverage for treatment and close to 90 percent have coverage for their initial consultation? Shady Grove Fertility also has one of the largest insurance networks, which offers our patients many options for coverage. Click here to view our list of accepted insurances.

We encourage you to determine the extent of your fertility benefits before you initiate treatment. You may have out-of-network benefits that will allow you to be seen by our physicians.

If insurance does not cover my fertility treatment, what fertility financial options does SGF offer?

Exclusive Financial Programs

At Shady Grove Fertility, we recognize and understand the financial commitment that weighs into the decision of whether to begin or continue fertility treatment. While many people have some form of insurance coverage for treatment, or live in an area that has coverage provided by the mandate, we recognize there are some without any insurance coverage or benefits. So that cost is not a barrier to seeking care, Shady Grove Fertility has developed six unique fertility financial options, or programs, to ease the cost of fertility treatment.

1. Shared Risk 100% Refund Program for IVF or Donor Egg

Shady Grove Fertility created the exclusive Shared Risk 100% Refund Program, a treatment guarantee, to help alleviate concerns about cost. As part of this plan, you may attempt up to six in vitro fertilization (IVF) or donor egg cycles for a flat, fixed fee, including any frozen embryo transfers (FETs) that result from those IVF cycles. The guarantee states you will take home a baby or receive your money back. If you do not take home a baby or you decide to withdraw from the program, SGF will refund 100% of the fee (some exclusions apply). Click here to see if you qualify for this program.

2. Shared Risk 100% Refund Program for Frozen Embryo Transfers (FETs) 

 Patients who are eligible for the Shared Risk 100% Refund Program for Frozen Embryo Transfers pay a one-time flat fee and receive unlimited frozen embryo transfers (FET) cycles for as many frozen embryos as that patient has available at the time they enter the program. Similar to the Shared Risk 100% Refund Program, the Shared Risk Program for FETs offers patients the security knowing they will take home a baby or receive their money back (some exclusions apply). Click here to see if you qualify for this program.

3. IVF Multi-Cycle Discount Program

Shady Grove Fertility created the exclusive IVF Multi-Cycle Discount Program for patients with no insurance coverage who need IVF treatment using their own eggs. This program includes patients of any age and/or those who may not be eligible for the Shared Risk 100% Refund Program. As part of this program, you pay a one-time flat fee that includes the following: all cycle monitoring, up to two fresh IVF cycles, cryopreservation, and any subsequent FETs. This option provides a 40 percent discount off the cost of two standard IVF cycles and subsequent FET cycles. Click here to see if you qualify for this program.

4. Shared Donor Egg Program

The Shared Donor Egg Program is designed to increase the accessibility of donor egg treatment for patients. This successful treatment option is costly since insurance does not provide coverage. This program reduces the cost of donor egg treatment by up to 50 percent. If paired with the Shared Risk 100% Refund Program, it offers a six-cycle 100% refund for the exact cost as a traditional donor egg cycle (some exclusions apply).

Two or three recipient couples who are part of this program are matched with one egg donor, essentially “sharing” the cycle and reducing the overall cost for each couple. The success rates for patients in this program are equal to the pregnancy rates of patients undergoing a traditional non-shared donor cycle. There is no waiting list for patients to receive donated eggs. Click here to learn more about this program.

5. Shared Help Program

The Shared Help Program provides discounts to patients for fertility services. Patients are only eligible for this program if their annual household income is $95,000 or less, which is verified by 2 years of tax returns. Services provided at any Shady Grove Fertility location are eligible for a discount. All outside services and insurance fees such as co-pays, deductibles, and co-insurance are not eligible for discounts. Roughly 87 percent of applicants are approved for this program. Click here to see if you qualify for this program.

6. Military Discount Program

Active military or current military reservists who are current or new patients are eligible for a 25 percent discount off of qualifying self-pay rates as part of our exclusive Military Discount Program. Discounts do not apply when the fees are paid to an outside service. To receive the military discount, you must present your U.S. military identification at the time of your first consultation. Click here to learn what services are offered with the Military Discount Program.

7. Medication Discount Programs

Medication is a vital component of treatment, and sometimes a piece that is not covered by insurance. To help, Shady Grove Fertility participates with multiple pharmaceutical companies to reduce the cost of medication.

Shady Grove Fertility designed a Self-Pay Medication Discount Program to reduce the out-of-pocket expenses for self-pay patients. All patients without insurance benefits for medication—or those who choose to waive their benefits—may qualify for this program. Click here to learn more about the benefits of the Self-Pay Medication Discount Program.

8. Financing

Fertility Finance provides patient financing services for all fertility treatment options and ensures that the financial aspects of treatment are not an obstacle to helping you achieve the family of your dreams. With a variety of loan options, fertility finance is designed to fit your unique circumstances.

9. Grants

Shady Grove Fertility is an active supporter of the Tinina Q. Cade Foundation, a non-profit organization dedicated to promoting infertility awareness through educational outreach and financial assistance. Each year, the Cade Foundation provides a Family Building Grant of up to $10,000 to infertile couples to assist them with the cost of fertility treatment or adoption.

How do I know what fertility financial option is best for me?

The financial service representatives at Shady Grove Fertility are integral members of the patient care team and their core mission is to enhance the patient experience. Their goal is to make the financial aspects of the process as manageable, understandable, and transparent as possible.
Click here for a more in-depth look at the role of a financial service representative at Shady Grove Fertility and how they will help patients navigate their insurance and guide them through the process, helping them understand what fertility financial options are available.

Where can I learn more about SGF’s fertility financial options?

To help current and prospective patients navigate understand the various fertility financial options as well as their insurance, we offer a Financial Options On-Demand Webinar, led by members of our financial services team.

During our on-demand event, you’ll learn how thousands of SGF patients each year are affording fertility treatment. Maria and Jennifer will discuss how to navigate your insurance plan or how you can find the ideal financial program based on your treatment plan if you don’t have complete coverage. You’ll also learn about the unique financial programs only available at Shady Grove Fertility including discount and guarantee programs, fertility financing options for self-pay patients, grants, and tips for accessing discounts for medication.

To learn more about your fertility financial options and the exclusive programs available at Shady Grove Fertility, please fill out this brief form or contact our New Patient Center at 877-971-7755.