Infertility

Health Insurance and Donor Sperm (or Other Tissue) - Would they ever pay?

Has anyone ever heard of health insurance companies contributing to at least some of the costs for donor tissue? 

As I sit stressing about how to meet my ridiculously high deductible for my medicated IUI starting in January, I can't help think that I'd reach the max OOP threshold sooner if my health insurance company would contribute to the cost of the donor sperm, which my wife and I have bought our first 6 vials at a whopping $900/vial!  It's medically necessary for us...basically the most important part of the equation for my wife and me to conceive.  I know this requirement is not unique to LGBT couples. I just doesn't seem fair, but I can also appreciate the nuance of it which would would make it difficult for health insurance companies to develop a coverage policy on this.

Google searches are proving pretty fruitless, which makes me think no, but I figured it didn't hurt to reach out to this awesome group of people who are smarter about the ins and outs of fertility treatments than I am. Has anyone had experience with something like this?

2 wanna-be moms-to-be
trying to conceive using my body, frozen donor sperm, and IUI

Re: Health Insurance and Donor Sperm (or Other Tissue) - Would they ever pay?

  • J1006J1006 member
    Fourth Anniversary 100 Love Its 100 Comments First Answer
    It thinks it is extremely rare for it to be covered. We did four IUIs with donor sperm and had to pay OOP for all vials. The sperm bank didn’t even have an option to run it through insurance. 
    Me: 28 DH:29
    Married: 10/6/2012
    TTC#1 since May 2013
    April 2017 - IUI #1 - letrozole, Pregnyl - BFN
    May 2017 - IUI #2 - letrozole, Pregnyl - BFN
    June 2017 - IUI #3 - letrozole, Pregnyl - BFN
    July 2017 - IUI #4 - letrozole, Pregnyl - BFN

    September 2017 - IVF Consult
    January 2018 - IVF

  • Yeah, I used donor sperm for my IUIs and IVF and always paid for it. 
    TTC history in spoiler box:
    Me: 42, single
    Hysteroscopy: 2013
    IUI #1-2: 2013 BFN
    Surgery 10/2015: Planned to start trying again but had a surgery. (Not related to fertility)
    Surgery 5/2016: Planned to start trying again but had another surgery. (Not related to fertility)
    IUI  #3-5 (with Clomid): summer 2016 BFN
    IVF #1: 11/2016. 30R; 21M; 20F; 8B (6 day5 & 2 day6); 4 normal after PGS
    Medicated FET #1: 1/31/2017 transferred 1 embryo 3AA. BFP. Embryo stopped growing at 6w 1d. MUA at 9w 3d.
    Medicated FET #2June 2017 - cancelled...
    Hysteroscopy #2: June 2017
    Medicated FET #2: 8/7/2017 transferred 1 embryo 5BB. BFP. Ended in CP.
    Medicated FET #3: 10/11/2017 transferred 1 embryo 3AA. BFN
    ERA: December 2017?

    lazyornghousecat
  •     
  • Yes, our insurance covers donor sperm with no requirement for diagnosis. I think it is pretty rare though. I work in tech, so my company has to compete for people with the awesome benefits of Google, Facebook etc.
    lazyornghousecat
  • @kerryann124 ; @prudence9-2 ; Really?! I'm impressed just to hear that you know of this even happening.  Do you know what the process is to get it covered? Have you had experience with this? I'd love to hear what you both have to say on this, if there's any more to say.  TY!

    2 wanna-be moms-to-be
    trying to conceive using my body, frozen donor sperm, and IUI
  •     
  • Insurance covered nothing for me, but the costs of sperm (along with everything else) did count as a health expense tax deduction (in the US). You have to itemize deductions, and health costs had to exceed 10% of income, but it did make a difference for me. (This deduction may be short-lived, depending on how the tax code gets rewritten.)
    Me- 39 (turning 40 in April), TTC for the first time ever (since Jan 2015), low ovarian reserve
    Married 3/14/14 to my wonderful wife, but her sperm count is rather low
    TTC with frozen donor sperm and science

    7 IUIs, 7 BFNs.
    2 IVF attempts, both cancelled and converted to IUI, both BFNs.
    Decided that my tired old ovaries are ready to retire.
    Next step- reciprocal IVF, using my wife's eggs, my uterus!  
    fresh 5 day transfer (2 embryos) 4/17/17- BFP! 
    Identical twins "due" 1/2/17 (but anticipated arrival sometime December)

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