A single in vitro fertilization (IVF) cycle can cost tens of thousands of dollars and for many patients the cost doesn't result in a baby. But, for some patients, the majority of that money gets refunded to them if their cycle isn't successful. Cost is one of the biggest barriers for parents wanting to do IVF since most insurance packages don't cover the procedures or medications.
IVF has exploded in popularity over the years, but insurance coverage hasn't kept pace, so many Americans have gone into debt trying to become parents, and some go through multiple cycles, only to be left disappointed and saddled with bills. However, one program, called a "shared risk" program, helps patients get some of their money back if their IVF procedures don't work. "The fee they are charged is typically 30-40 percent higher than the cost of a single IVF cycle," Dr.
Kaylen Silverberg, medical director, co-founder and managing partner of the Texas Fertility Center, told Newsweek. "If they get pregnant on their first cycle, they may ultimately pay more than the actual cost of the treatment they received because they are 'sharing in the risk.'” Shared risk programs, sometimes called refund programs or money-back IVF plans, allow patients to pay a larger upfront fee that covers multiple IVF attempts rather than paying separately for each cycle. Under a typical arrangement, patients may pay a flat fee covering two to six IVF cycles and related embryo transfers.
If they achieve a live birth during the program, the clinic keeps the payment. If they complete all included attempts without a live birth, they may receive a refund ranging from roughly 70 percent to 100 percent of the original fee, depending on the terms of the program. "The word ‘refund’ can also sound much simpler than the actual agreement," Elana Frank, CEO and founder of the Jewish Fertility Foundation, told Newsweek.
"Patients should understand exactly what is included and excluded, how many retrievals and transfers are covered, what the clinic defines as a successful outcome, what happens if treatment is stopped or circumstances change, and exactly which expenses would and would not be refunded." The programs are often marketed as a way to reduce financial risk for couples who may need multiple treatment cycles. However, it doesn't necessarily make IVF more accessible because they often require people to make a "significant upfront payment," Dr. Christy Lane, co-CEO and co-founder of FLORA Fertility, told Newsweek.
Instead, she said, people need more options to prepare for fertility costs before they face the treatment. There is an important catch: not everyone qualifies. Most shared risk programs require prospective participants to undergo extensive screening before enrollment.
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