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

My wife and I have conceived a babe with my body and frozen donor sperm through IUI, with medication support (clomid, ovidrel, and injections of progesterone)

IUI #1, #2, and #3: Dec 2017, Jan 2018, and Feb 2018 - all BFN
HSG Test: April 2018 - all clear!
IUI #4: April 15/16, 2018 - BFP!! EDD: Jan 7, 2019 




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

  • 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: 29  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 - 2 Frozen Embryos
    March 2018 - FET #1
    April 2018  FET #1 - BFP! - ended in CP
    Sept 2018 - FET #2


  • 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 - need an extra 12 hours of PIO
    Medicated FET #4: 1/24/2018 transferred 1 embryo 4AA. BFN
    Out of embryos.  :'(
    IVF #2: 03/2018.

    rooonilwaazlib
  • 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.
    rooonilwaazlib
  • @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!

    My wife and I have conceived a babe with my body and frozen donor sperm through IUI, with medication support (clomid, ovidrel, and injections of progesterone)

    IUI #1, #2, and #3: Dec 2017, Jan 2018, and Feb 2018 - all BFN
    HSG Test: April 2018 - all clear!
    IUI #4: April 15/16, 2018 - BFP!! EDD: Jan 7, 2019 




  • 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)

    sheepshepherdess
  • We have also had to pay for our vials and procedures OOP.
  • My insurance covers the full cost of purchasing donor sperm. I don't think that's typical though. I think you just have to call your insurance company and ask what the eligible and ineligible expenses are in terms of fertility coverage. The coverage for donor sperm wasn't in my benefits booklet (neither was a bunch of other specific fertility-related costs) but when I called my insurance company and asked for a list of eligible/ineligible expenses, that's when I noticed it was covered.  
    Me: 35 I DH: 38
    *TW loss and children mentioned*
    DD:2006 | Dx: Unexplained Secondary Infertility | DS: 2011

    TFAS since 2012

    Oct 16: Spontaneous BFP | m/c @ 9w1d (massive SCH) | D&C
    Apr 17: IUI #1 = BFN
    May 17: IUI #2 = BFN
    Jun 17: IUI #3 = Late BFP (18 DPO) | NMC 17Jul17 @ ~6w
    Aug 17: IUI #4 = Cancelled due to premature ovulation | TI = BFN
    Sep 17: IUI #5 = Cancelled due to overstimulation (10+ follies)
    Nov 17: IVF #1 = Cancelled due to non-IF related health issue | TI = BFN
    Dec 17: IVF #1 = Puregon 200, Menopur 75, Orgalutran, Suprefact trigger due to OHSS risk | 22R, 18M, 16F, 10B frozen  
    Feb 18: FET #1 (medicated) = BFN
    Mar 18: FET #2 (natural cycle) = CP (beta 1: 54; beta 2: 0)
    Apr 18: FET #3 (natural cycle) = cancelled due to missed ovulation
    Apr 18: FET #3 (natural cycle) = BFP! Beta 1: 201  Beta 2: 585 Beta 3: 3254 Beta 4: 9715 U/S 19May - one bean measuring on track with a HB of 125! EDD: 07Jan2019
    tinjp78archaeo89
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