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

rooonilwaazlib

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?

J1006

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. 

prudence9-2

Yeah, I used donor sperm for my IUIs and IVF and always paid for it. 

kerryann124

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!

KLake42

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.)

talesoftwomoms

We have also had to pay for our vials and procedures OOP.

tosh24

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.