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Open Enrollment- One Fertility Patient’s Success Story

December 5th, 2018 | 4 min. read

By Illume Fertility Care Team

One infertility patient shares her story about insurance, the open enrollment time period, and being her own advocate. A story of success, hope and empowerment.

I was referred to RMA of Connecticut (Reproductive Medicine Associates of Connecticut), because of problems in conceiving. I did not come to the practice at the time of the referral because my insurance had a high deductible, and, to me, that was an insurmountable obstacle. You may have something similar, with a high deductible plan or a plan offered by your employer that does not cover the fertility treatment procedures you need in order to embark on or continue your fertility journey.

Affording Fertility Treatment Seemed Impossible

I felt defeated. I knew what our issue was, fertility-wise. It was something that should have “easily” been treated, if only I could get to the board certified Reproductive Endocrinologist’s office.

I knew how costly fertility treatment cycles could be, even when medically necessary, and I also knew that our deductible would have to be met before my insurance would kick in.

I felt like I was stuck for almost a year and a half. My husband and I tried everything we could on our own becoming more frustrated with every month that passed.

After a year and a half, during open enrollment, when we heard about our insurance options for the coming year, I felt even more defeated. Our employer’s plan was becoming more expensive and the deductibles were going up even higher. I felt my biological clock ticking and knew I had to do something, and soon! Luckily, there was a situation where misinformation was revealed at work. Our rep who gave us our insurance options accidentally told us about a website where one could look for plans that might be better for us than the company plan. While he said our employer would contribute to these plans, it turned out they would not. It turned out, even without the employer contribution, there were options that were far less expensive for us.

Looking Past My Employers Plan

For $100 more per month, I could get my own plan, and instead of thousands of dollars for my deductible, it would be hundreds. I did my due diligence. I crunched the numbers for a 12-month time period. This premium, plus the deductible vs 12 months with my employers’ plan’s premium plus deductible was more affordable. (I investigated The Affordable Care Act as well, but it didn’t have any plans that were helpful to me because the prices were so high, but your experience could be different.)

That extra $100 a month was not easy for me to come by. Just the increase in premium for my employer’s plan was going to be hard to swing. I got a second job to help pay for the premium, deductibles and copays that went along with this policy. I mention this because I realize that just like for me, the extra money needed, can be very hard to come by for many challenged by the medical diagnosis of infertility.

Understand, I couldn’t afford what I needed from the insurance offered by my company. I won’t pretend that I love the insurance plan that I ended up choosing, because if anyone reading this is saying “I know who this anonymous person is!” they will tell you I shed a LOT of tears and had a lot of stress caused by this very same company. My insurance is far from perfect, but it is good enough that it I have been able to proceed with fertility treatment.

My Research Made It Possible to Undergo Fertility Treatment

Bottom line- had I not done this research about medical insurance for myself, I would not have been able to embark on this fertility treatment journey. I am sharing my story because I know there are others who haven’t yet been able to find a way to get over an insurmountable hurdle with their insurance plan. Maybe that’s even you.

If you’re in the same situation I was in, you’re probably wondering about the website and the insurance plan I ended up choosing. I’d share that with you, but your situation could be very different and it's actually information you can get from any independent insurance agent. You might even be able to pull aside your insurance representative or your Human Resource person and ask about the agent your employer uses. The agent can look at all of the plans available to you. They don’t charge any extra than if you went to the insurance company directly. They cannot by law, from what I was told while I was exploring my options. When you’ve found some plans that look promising, ask to see the benefits documents, so you can be sure that what you assume will be covered, actually is. Don’t be afraid to ask questions and if you get an answer that is unclear, ask another question until you understand what you’re buying- medical coverage for the disease of infertility and your chance to build your family.

RMA of Connecticut has Knowledgeable Finance Advocates to Assist You

Investigating all your options can make the difference between affording fertility treatment or not. Especially during the critical time of open enrollment. Remember you have a powerful ally at RMA of Connecticut- your Finance Advocate. Call them. Ask your questions. Get the help that you need.


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