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Negotiating price of IVF?

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  • Negotiating price of IVF?

    Hi all,

    I live in NY, where insurance companies "must" cover IVF. However, there are many loopholes and rules, so my employer-based health insurance does not cover IVF. Does anyone have experience negotiating prices for IVF? I'm wondering if I can take advantage of health insurance-negotiated pricing even if I'm paying out of pocket (since the same health insurer provides policies for employers who do offer IVF coverage).

    Thanks to WCI for everything. Thanks to this site and forum, I have the savings to pay for IVF (I would just rather not pay too much).
    Also, sorry if this has been covered before. The search function thinks the term "IVF" is too short and won't give any results.

  • #2
    I would suspect if the clinic were to attempt to bill your insurance, even if it gets denied then you would get the insurance negotiated price, not the chargemaster price. Alternately they may have a cash discount price


    • #3
      If a provider (facility, doctor) is contracted with your insurance, they are most likely required to bill your insurance before sending you a bill. Your responsibility will be lessened by the "negotiated" fee schedule between your provider(s) & your insurance. So await the word from your provider regarding your portion of the bill. Then request a cash prompt pay discount.

      Alternatively, if you are certain your insurance will not pay any portion of the bill, then at the initial contact inform the provider (facility or doctor) you don't have insurance & will be paying cash & would like to work out a fee schedule of sorts. I do have some patients who "forget" to provide me with their insurance, "they can't remember" which company or the ID #, & we have worked out a cash-pay-time-of-visit fee schedule.
      "Oh look another bajillion point declin-Ooooh!!! A coupon for pizza!!!!" <--- This is what everyone's IPS should be. ✓✓✓


      • #4
        Our state doesn't mandate insurance coverage for IVF, and it's pretty lame there are loopholes to get out of it.

        The place we went to did have a deal where you could pay for a guarantee to have a live birth with up to three tries. If it works on the first try you end up overpaying. If it works on the third try you save some money. If it doesn't work at all, you would get a partial refund.

        Best of luck to you.


        • #5
          I’m sorry you guys are going through this as I know it’s difficult. I would just call the clinic and talk to their financial person. I’m sure they deal with this all the time.


          • #6
            My partner and I did IVF in the Bay Area. In our experience, the prices were high but comparably equal across multiple different clinics. There was no negotiation - the clinics had so many patients and were so busy that there seemed to be no pressure to compete on price. Hopefully the dynamics are different in NY?

            A few of the clinics did advertise "buy three cycles in advance at a discounted price" or "get pregnant after four cycles or your money back" packages, but that was the extent of potential discounts.

            We switched clinics once - from an academic center to a private clinic - due to concerns about the first center's logistics and approach. The private clinic was slightly more expensive but a much better all-around experience (medical, logistical, and personal).

            I wish you all the best as your start this process. My wife is also a physician and is an open book about our IVF experience - if you want to chat with another doc who went through IVF or if we can be of any help, please feel free to reach out.


            • #7
              Thanks for the replies and advice... very helpful.


              • #8
                Good luck with the process.

                My wife is an OB and is familiar with the REI component. We also have close family who has had 2 kids via IVF. Our data points are also that there is no negotiation, demand exceeds supply. I believe the local practice also limits the amount of 'charity care' due to the volume of paying customers. In many regions, there aren't competing practices, just a single option.

                I'd encourage you to take advantage of HSA's and similar resources to get any break that you may qualify for.