Is your fertility benefit really enough?

The conversation about fertility benefits is growing every day. More companies are offering fertility-specific benefits, and they’re rethinking their policies to become more family-friendly. But there are still a lot of misconceptions around whether fertility is included in health insurance coverage, and as the number of add-on benefit options increases, it becomes more difficult to sift through the noise. Ultimately, as a benefits leader, it comes down to one question: are the fertility benefits you’re offering actually what your workforce wants and needs?

Here are a few key considerations to think about when weighing your options for fertility benefits.

Infertility diagnosis requirements

Often, when employees come to their employer requesting fertility benefits, the first place people look is at their existing health insurance coverage. Many people think their health insurance offering covers fertility care. And while it’s true that some health plans offer coverage for services like in-vitro fertilization (IVF), it’s actually infertility — not fertility — coverage. And that’s an important distinction.

According to the World Health Organization (WHO), infertility is defined as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”

Typically, an appointment to diagnose infertility includes comprehensive physical exam, medical history review, and diagnostic tests. That means that, before your employee can tap into any sort of insurance coverage for fertility care, they need to document that they’ve been trying unsuccessfully to get pregnant for a year — and then have to undergo additional invasive testing before starting any covered treatment.

That process can take well over 18 months and, especially for employees in their 30s or 40s, that amount of time can lead to more fertility challenges. And for single or LGBTQ+ couples trying to have a child or those looking to preserve their fertility, it excludes them entirely.

LBGTQ+ and single parent inclusivity

Over the last 10 years since fertility benefits first appeared on the market, our definition of what makes a family has changed dramatically. The number of single parents by choice is rising. LGBTQ+ couples have gained the right to marry around the world, including the U.S., Denmark, Brazil, Austria, and New Zealand, among many others. And for both of those groups, the traditional definition of infertility — tied to the idea of a heterosexual relationship — doesn’t apply.

For these prospective parents, the financial burden of becoming a parent, whether through donor eggs or sperm, gestational carriers, adoption, or another method, falls entirely on them without supplemental benefits from their employers. Similarly, fertility benefits that support only IVF, intrauterine insemination (IUI), or other assisted reproductive technology (ART) offerings exclude the majority of methods for single parents or LGBTQ+ couples to add to their families.

At Carrot, gestational carrier services account for 10% of what members use their benefit for, and adoption accounts for another 5% — there’s significant demand for these services. In order to offer fertility benefits that are inclusive of all pursuits of parenthood, it’s important for employers to look at how their offering supports each of these unique paths and ensure that they’re covered.

Fertility preservation

For the first time in history, women in their 30s are having more babies than those in their 20s. And male fertility is also becoming an increasingly common topic of conversation as it declines worldwide and men have children later in life. Understandably, as both men and women delay having children, fertility preservation is becoming increasingly important. 

While traditional health insurance may cover a fertility assessment — tests examining various hormone levels to determine whether or not you have fertility issues down the line — it doesn’t cover anything beyond that. If the results of that test make your employees decide that freezing their egg or sperm is the smart choice, that cost is on them. Similarly, many female-focused fertility offerings on the market right now will support egg or embryo freezing, but do not include sperm freezing. When looking at your fertility benefit options, make sure to weigh the needs of all genders in your workforce.

Adoption & gestational carrier services

Beyond LGBTQ+ parenting, the use of gestational carrier services is on the rise. And adoption has been a steady option for those pursuing parenting for years. While there are tax benefits for those going through the adoption process, the benefits end there where traditional health insurance is concerned. Even many fertility benefits severely limit their coverage when it comes to third-party reproduction. Fortunately, many employers have started to offer adoption benefits, and some fertility benefits vendors offer support for both adoption and gestational carrier services. When considering your company’s offerings, make sure to include coverage for your employees exploring these options.

While providing comprehensive, inclusive fertility coverage, may look daunting, employers do have options. Give your employees the flexibility to use the options that work for them and their lifestyle. At Carrot, our flexible financial benefit allows employees to use coverage to support any pursuit of parenthood from IVF to adoption to fertility preservation and more. Ready to learn more about Carrot and how it might work for your population? Get in touch today.

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