Podcasts

Episode 98: Fighting for Fertility Coverage: State Mandate in North Dakota

Written by ShannonZuber | Apr 5, 2021, 4:00:00 AM

The cost of healthcare can be exorbitant, especially for fertility treatments. There are some incredible grants, funds, and forward-thinking employers that provide support for fertility and family building care, but more and more states are starting to mandate that coverage be offered. While this idea might seem expensive at first glance, providing fertility coverage saves everyone money, not to mention it lessens the stress of fertility treatment for those going through it. This National Infertility Awareness Week (NIAW), Progyny is hosting a six-part series featuring several experts who are fighting for fertility coverage. This first episode focuses on Tara Brandner, the founder of the non-profit, Everlasting Hope, and her fight for fertility coverage in North Dakota.  

Tara Brandner knew firsthand what it was like to struggle with infertility. Her experience involved an endometriosis diagnosis, several miscarriages, three failed IUI cycles, and IVF. Soon after giving birth, Tara reflected on her turbulent experience with fertility treatment. She concluded that people should not have to go through the financial and emotional stress that she did. Tara decided to use her expertise as a doctorate nurse practitioner and veteran fertility warrior to form a non-profit, Everlasting Hope, that would provide community and resources for infertility. The platform has grown significantly, and she has emerged as a force behind advocating for fertility coverage in her state.  Here’s Tara’s story. 

Guest: Tara Brandner, founder of Everlasting Hope 

Host: Dan Bulger 

For more information on Everlasting Hope, check out the website, Instagram, and Facebook. 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: 

The Magical $20,000
4:32– 6:45 

Dan Bulger: Anyone who has been through a journey that included as many different treatment attempts as Tara, knows that the bills can really pile up. But here’s the thing for the early part of that journey, Tara actually did have coverage for fertility treatment. And she knew it was somewhat rare, and at first it felt like a lot of coverage. She had what’s called a limited dollar max benefit, which just means that you’ll be reimbursed for a certain number of dollars for different types of treatment, and Tara had $20,000 worth of that kind of coverage. $20,000 seem like a lot of money. And in real terms, it is a lot of money. But when it comes to fertility treatments and healthcare in general, $20,000 doesn’t actually go all that far. 

Tara Brandner: In the beginning, I always refer to it as “the magical $20,000.” Little did I know how fast that would get eaten up, especially with the cost of medication. I guess I was naive in the beginning to what treatment could possibly be coming around the corner, such as IVF, and the impact and cost that would have. So, I did have the $20,000, however, two years after we started treatment, my place of work switched insurance companies, and I lost that benefit. And lo and behold, there were several others in my small rural office going through this as well. And they lost that benefit, too. I think my place of work has switched insurance plans and companies three times in seven years, so you have it, you don’t have it, you have it. I always say that the price of bread and milk goes up, so does the price of your medical expenses, yet that $20,000 for anybody who has it across the country has never changed. I’ve heard $5,000, $10,000, $20,000, you know, if there is any coverage. So, after the completion of my treatment, we were still $25,000 to #30,000, I had to quit counting. I rounded it to $30,000 in debt above having that $20,000 coverage. 

Talking to Insurance Companies
19:17– 20:47 

Tara Brandner: If 2019 did anything, it taught me how to come back and what to do better next time. So naturally, I had formed this nonprofit, and part of what I did through Everlasting Hope was start working with insurance companies in the background early on. For about the last year, I’ve had a monthly phone call that has turned into weekly with different departments with the two main insurance companies in North Dakota. And it’s really educating them. One of them in particular said, ‘you know what, Tara, thanks for bringing this forward. We had no idea our members needed this. We don’t know what we don’t know.’ Whereas the other insurance company was trying to just say, ‘okay, we met with you.’ And this actually all came from a close working relationship I had formed with the state insurance commissioner during the 2019 session. We have had several meetings with him in regards to how this mandate works, or what we can do here, some other avenues we could possibly take to change the coverage for infertility in North Dakota. I had met with him again, and he said, ‘you know what, let’s get you working with these insurance companies.’ A huge asset to the work I was doing was by having a good close working relationship with our state insurance commissioner and his office. His team has been wonderful as well.