The Need for Comprehensive Fertility Benefits: A Patient Perspective

More and more individuals are turning to fertility treatment as a way to start a family. Employers who offer comprehensive fertility benefits provide peace of mind in helping employees reach their personal goals.
The Need for Comprehensive Fertility Benefits A Patient Perspective

Megan always knew she wanted to be a mother, which is why when she reached her late thirties, she made the choice to pursue single motherhood alone. There are a lot of challenges that women face when seeking fertility treatment, but Megan’s employee benefits, fertility pharmacy support and network of friends helped her through the journey to achieve her goal of starting a family.

Megan and Mick


The Need for Comprehensive Benefits

Megan had a comprehensive fertility benefit through her employer that covered both her medication and her treatments, which is uncommon. Approximately 80 percent of patients who underwent fertility treatments in 2018 had little to no coverage.

“I would have pursued fertility treatments even if I had not had access to benefits, but it would have been more of a financial struggle to make it through with the added expense,” Megan said.

In all, she underwent four egg retrievals and two rounds of in vitro fertilization (IVF) before finding out that she was pregnant with her son Mick in October 2017. One round of IVF can cost upwards of $14,000 before the cost of fertility medications, additional testing or other services. So those costs can quickly add up, especially for those who require multiple rounds of IVF. Many individuals turn to credit cards or tap into their 401K to pay the hefty bills.

The Difficulty of Navigating Fertility Medications

Megan says that one of the most challenging parts of fertility treatment was keeping track of and administering her fertility medication regimen.

“I was on the phone with Freedom numerous times ordering my medications, and every single person I spoke with was kind, informative and made the process so much easier,” she said.

She often administered as many as six shots per day – and sometimes didn’t realize she was low on medication until right before she ran out. Freedom Fertility leverages the Accredo pharmacy network to supply couriered, same-day medications from nine locations in order to service patients who need urgent delivery due to dosage change, initiation of therapy earlier than expected, etc. In 2019, Freedom Fertility coordinated 1,400 courier deliveries from these same-day locations – a common need due to the urgency of therapy as an indicator of overall success of the cycle. Freedom Fertility’s support, along with a network of friends who had also experienced fertility treatment, helped support Megan throughout the complex process.

There are two things that Megan would tell others who are considering fertility treatment as a means to start a family: while it’s a difficult process, it is absolutely worth it; and they are not alone in their experience.

If there’s one thing that we know for sure about Megan’s desire to start a family on her own is that it’s emblematic of how the idea of the American family is evolving – in 2018 40 percent of births were to single people or unmarried couples. Fifty years ago, that number was only 10 percent, according to the Centers for Disease Control. A recent Express Scripts study found that over 60 percent of employers surveyed believed they need to increase their fertility benefits in the near term. This is due to a growing demand and the high value that employees place on such coverage.

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.