Episode 102: Fighting for Fertility Coverage: Supporting Advocay Groups and Companies
It’s National Infertility Awareness Week (NIAW), and Progyny is hosting a six-part series of back-to-back episodes featuring several experts who are fighting for fertility coverage. Our goal is to educate others on how they can advocate for themselves and ask for the support that’s needed from their employer or state to build the family of their dreams.
This episode features Davina Fankhauser, the co-founder and President of Fertility Within Reach. Davina started her organization after struggling with infertility herself. Since the age of 22, she knew she would have trouble conceiving due to an endometriosis diagnosis. Still, once she and her husband started trying, they discovered that male factor infertility was also a contributor. She went through countless treatments, spending all her savings, but eventually had two successful pregnancies. Thinking back on her experience, she felt she had suffered a deep injustice by not having access to sufficient fertility coverage. Her position on RESOLVE’s support line turned into helping Massachusetts change its definition of infertility, opening up coverage to many more people. Her work at Fertility Within Reach helps guide others to develop the courage and access the resources needed to make a legislative change in their state.
Guest: Davina Fankhauser, Fertility Within Reach
Host: Dan Bulger
See RESOLVE’s website for fertility advocacy resources in your state and Progyny’s Talk to HR page for assistance in requesting coverage from your employer.
For more information, visit Progyny’s Podcast page and Progyny’s Education page for more resources.
Be sure to follow us on Instagram, @ThisisInfertilityPodcast and use the #ThisisInfertility.
Have a question, comment, or want to share your story? Email us at thisisinfertility@progyny.com.
Here are some highlights from this episode:
Weighing Cost Over Treatment
10:11 – 12:22
Davina Fankhauser: It was very upsetting to me because I blamed myself. But I also felt like, if money hadn’t been an issue, we would have made different choices. We wouldn’t have just transferred all of the embryos, or we would have had genetic testing done. And we would have embryos leftover maybe to have another one. It was so upsetting to me that instead of the insurance, through the employer reimbursing an IVF cycle, they have now paid nearly a million dollars in health care. And when I say they have, I mean, they have because they are a self-insured employer, which means they pay for the medical costs themselves. And I am just one, I am a spouse of an employee. I can only imagine with this large corporation, how many people there are experiencing infertility, and maybe doing the same thing. So, I just felt very passionate about trying to make sure no one else would have to go through what we did. We made the choice to transfer all of our embryos because we didn’t have the money to do genetic testing. We made the choice to reduce the pregnancy because we didn’t have the money to keep trying to do IVF and I didn’t want to risk losing the entire pregnancy. So, we did selective reduction and there are so many choices that we made, which were all driven by finances.
Why Coverage is Better for Employees and Employers:
16:34- 19:51
Davina Fankhauser: We sat down and broke down how many employees actually received benefits, because some of them were part time. So, we looked at all the full-time employees, then we looked at out of their full-time employees, how many utilized the benefits, then we looked at breaking it down to one in 12. So, then you look at the one in 12 employees, and then you break it down that only 3% of that needs ART, assisted reproductive technology. So, the number keeps getting smaller and smaller. Looking at the cost. This was a shock to the director of benefits. They’re a self-insured employer, they do offer some infertility benefits, but it’s really only enough to cover one IVF cycle. And so we were trying to explain to them why it was important to try to offer more, and how it’s a win-win for both the employer and the employee. And she said the director of benefits was surprised. She said, ‘I was told $15,000 would cover two IVF cycles.’ And I said ‘no, here is the information from the American Society of reproductive medicine. This is the average cost of an IVF cycle. Plus, you have to add medication on top of that. So, you have one, maybe one and a quarter cycle.’ And then I explained how actually having $1 amount, rather than a number of cycles, creates a disparity among their own employees because somebody in New York may not even have enough to cover one IVF cycle. But somebody who’s in Massachusetts could cover one and a quarter, one and a half cycles. So, within a national company, doing a number of cycles is better.
