37% of LGBT Americans have a child 34
Having a child is expensive in itself, but using fertility treatments to conceive and carry a child to birth can add significant costs above and beyond what is normally incurred. Other costs, such as legal and administration fees, may not be included, and each clinic will have its own prices. Medical insurance may not cover a lot of these costs, except in the case of infertility, which varies from state to state. It's important to check with your health insurance provider and recognize that different companies will have different policies, even if they're in the same state.
Potential Payment Options
Loans: Banks and financing companies may make loans that enable patients to pay for their treatment in manageable monthly installments. Some fertility clinics have relationships with financing companies.
Fertility Clinic Programs: Some fertility clinics offer their patients alternate payment plans as an option for paying for their procedures, including programs that offer multiple cycles for a set cost. Many centers also make more traditional financing plans available to their patients. Also, your healthcare provider can tell you if they offer any payment programs. If you're looking at pursuing financing, it might be useful to compare several options to find the one that best suits your personal financial situation.
Fertility LifeLines offers savings programs for eligible patients.
Some insurance companies cover fertility treatments and surrogacy options for LGBTQ couples, but coverage is by no means universal; it varies within each state and plan. You should consult your insurance agent or human resources department to determine your coverage.
Fertility LifeLines can help you navigate determining and verifying your coverage. Call the hotline at 1-866-LETS-TRY; all calls are free and confidential.
If you decide to study your policy on your own, here are some pointers to think about:
1. Get approval in advance – and in writing. This is called pre-authorization or predetermination. Your coverage may impact what kind of healthcare provider you see, the kinds of tests you undergo, the sequence of the testing, and what treatments will be covered. Download Pre-Authorization Forms
2. Try to get a list of fertility specialists and clinics that are part of your insurance plan and determine that the clinic or office works with surrogates and gestational carriers.
3. Look at both your medical and prescription coverage. Are there restrictions on the type of healthcare provider that can perform fertility services? Are infertility drugs covered under the pharmacy or medical benefit? Also, try to find out in advance what the submission process is, what forms you need, and what the deadlines are for submission.
4. Have you read your policy for the fourth time and still don’t know what is covered? You're not alone. Fertility benefits aren’t always clearly spelled out in policies. What’s not written can be just as important as what is. In most policies there’s usually room for interpretation. If your claim's been denied, you may appeal. In fact, resubmissions are common. The key is to be prepared to address the issues that led to the denial. The more specific information you have, the better you’ll be able to respond to your insurer’s request. It can also benefit you to learn how the medical industry codes treatments. A few digits can be the difference as to whether or not you’re covered!
5. Don’t get discouraged. Being an advocate for your fertility coverage can get frustrating. At these times, it’s important to remember your rights, your state laws/coverage and your goals. It can also be helpful to talk with your healthcare provider in advance about your coverage.
6. Find out if your company or your partner’s company has access to any benefits, programs, or resources that might be helpful, such as Employee Assistance Programs and Health Savings Accounts.
Donor Sperm or Eggs
There are important legal considerations when using donor eggs or sperm or a surrogate, so it’s a good idea to consult an attorney, even if you think you have everything covered. Whether you choose surrogacy, egg, or sperm donation, it’s important to make arrangements in a state where the arrangements are legal and a contract can be enforced. Laws regarding the parental rights of sperm and egg donors vary widely from state to state, so it’s important to fully evaluate your state’s landscape before making decisions.35
There’s no national policy regarding surrogacy and the laws governing surrogacy agreements vary from state to state, and state laws sometimes depend on the type of surrogacy agreement – gestational or traditional.36
- In traditional surrogacy, the woman who will carry the pregnancy contributes her own eggs to be fertilized with the sperm and will share a genetic link to the child. In these cases, conception’s achieved through intrauterine insemination (IUI), in which a healthcare provider places sperm directly into the uterus through the cervix using a catheter37
- In gestational surrogacy, sperm and donor eggs are used to make embryos that are transferred into the surrogate’s uterus. In these cases, the surrogate has no genetic bond to the child. Via in vitro fertilization (IVF), the eggs and sperm are collected and placed together in a laboratory dish to fertilize38
Qualified professionals can help you navigate the emotional and legal issues that LGBTQ couples can face when starting a family.
Defining Parental Roles
You may also want to consider how to divide parental roles before the child is born and to check with a lawyer to determine the laws in your state regarding the rights that come with your specific union or partnership.
Some couples may also consider a co-parenting arrangement. Check with an attorney in your state to determine whether children who are born to or adopted by one member of a LGBTQ couple can have the security of having two legally recognized parents.39