Addressing Fertility Care Needs

There are steps plan sponsors can take to address reproductive health care needs, including fertility care.

Reproductive health is integral to an individual’s overall health, and access to reproductive health care and education is essential for physical and mental well-being.

Changing fertility dynamics

The decision to begin or expand a family can be one of the happiest times, but also one of the most stressful. Today, 48% of millennials are delaying childbirth due to career and education goals, among other changing dynamics. If they discover they need fertility assistance to achieve or maintain a pregnancy, many of these would-be parents are caught off guard by the cost and complexity of fertility treatments and family planning services as well as the extent – or lack – of benefit coverage.

Who experiences infertility

One in eight women experiences at least one condition that impacts their reproductive health and can cause infertility. These include ovulation disorders, uterine or cervical abnormalities, and endometriosis. And, infertility is not limited to women – 40% of cases are due to male factor infertility.

Receiving a diagnosis of infertility can be a highly charged experience, full of emotions and self-doubt for some. Others may experience relief, as an understanding of barriers to conception can lead to taking proactive steps to achieve family-building goals. 

The increased need for comprehensive fertility benefits

Increasingly, plan sponsors are providing fertility support for their members, which helps to ensure quality of care, reduce complexity for patients undergoing treatments, and drive down the long-term costs associated with fertility, maternity, and newborn care.

Fertility benefits also play an important role in attracting and keeping talent in the workplace. Studies show that 45% of workers say these benefits are an important component when considering a new job and 68% of employees are willing to change jobs for coverage that includes in-vitro fertilization – or IVF – and egg freezing. Our research shows that by 2025 more than 60% of plan sponsors will be looking to increase their fertility offering.

Without fertility benefits, the cost of treatment and care can be a significant barrier for many people when pursuing options to grow their families. The average cost of IVF can range from $15,000-$25,000, leading some individuals and couples to resort to dipping into their 401ks, taking out a second mortgage, or using credit cards to pay for treatments.

A comprehensive fertility benefit usually includes maximum coverage that provides for equitable care, access to a fertility-focused pharmacy, guidance from a care team that specializes in fertility, and a network of fertility providers and labs with quality measures in place.

How to address health equity and fertility benefits

Health equity is an important component to keep in mind when building a comprehensive fertility benefit. Achieving health equity requires reducing health disparities, including those related to sexual orientation and gender identity, so that everyone has the opportunity to achieve health and well-being regardless of social, economic, or environmental circumstances.

Plan sponsors can take these action steps to address health inequities among members in need of fertility care and family-building benefits:

  1. Support inclusivity by extending options to individuals, same sex couples, and other people hoping to expand their families.
  2. Enable fertility preservation for members who will be undergoing a medical treatment, such as radiation, that can affect their fertility. Also, consider fertility preservation for members who need to protect against procedures that may cause sterilization such as gender confirmation surgery.
  3. Provide additional family-building options by offering gestational carrier, donor and adoption services. For many, these are the only options to pursue in their family-building journey.

Together, these benefits help ensure quality of care, improve affordability and accessibility, and make for a happier employee population.

Sign up for our newsletter to get updated when new content is available.

See how our solutions can help
FamilyPath has expanded benefit offerings across family-planning, fertility, pregnancy and postpartum care for employers and health plans. Evernorth is committed to addressing disparities in this category of health benefits and has designed an end-to-end, inclusive benefit in family-planning care for members across both in-house capabilities and new partnership solutions.