09/12/2013 10:17 am ET Updated Nov 12, 2013

Trying to Conceive (TTC) with Budget Awareness


Infertility has a great cost that is not only financial. There is an emotional and certainly a physical cost for any individual or couple who endures the process. The purpose of this article is to touch upon some of the things that may reduce the monetary cost of trying to conceive (TTC), whether you are just beginning the journey to parenthood or whether the road has been long and challenging. I do not take the topic of infertility lightly, and encourage those touched by infertility to reach out for support. A great resource for that support is Resolve: The National Infertility Association. There are also online fertility message boards that can provide guidance.

Saving on pregnancy tests and ovulation predictor kits

Pregnancy tests and ovulation predictor kits can be expensive, and they are tools that give you essential information, whether you are pregnant or ovulating. You can find reasonably priced pregnancy tests and ovulation predictor kits here. You can purchase them in bulk and test to your heart's delight without breaking the bank. If you are of an occasional tester, you can either clip coupons to use during store sales and purchase the "name brand" tests at a discount, purchase the store brand generic tests or... wait for it... purchase pregnancy tests and ovulation predictor kits at a dollar store. Dollar store pregnancy and ovulation tests have a reputation for being very accurate. You can choose to use the "cheapies" to test initially and then back up your findings with a more costly brand.

Tackling the task of minimizing your costs if your need a fertility doctor and artificial reproductive technology and you have fertility health insurance coverage

A fertility doctor is also known as a reproductive endocrinologist (RE) and being treated by one takes your TTC journey to a whole new emotional, physical and financial level. If you are headed towards needing an RE, I recommend that you do your research to determine the top two or three REs in your area and do a thorough inventory to learn the details of your fertility coverage. Call each clinic and ask if they take insurance and, if so, the list of insurance companies they accept. Go a step further and ask to speak with the individual who deals with the billing at the clinic and ask what their experiences are getting reimbursed by various insurance companies. Call your insuring employer's human resources and ask for the list of carriers and when open enrollment is. The goal is to cross reference the insurance options and level of coverage available to you and the insurance companies accepted by the REs that you have access to. If you can make a switch in anticipation of needing extensive artificial reproductive technology (ART) to conceive you can save loads of money. For some, this is a lot of work to do in the event that you do not need to use an RE. For others, this is the type of planning that buys some peace of mind.

You've got to fight for your rights!

It's not unusual to have claims denied by insurance companies. If you feel like your claim was wrongly denied, appeal. Read the fine print of your insurance policy to learn about your insurer's appeal process. Maintain a file with your denial letter, individuals with whom you have spoken and any follow up documents about the claim denial. Talk to your doctor to see if you can engage the fertility clinic in supporting your cause. I have heard of doctors writing letters and making phone calls to advocate on behalf of a patient. If the battle feels too hard to fight alone, reach out to a non-profit like the Patient Advocate Foundation for free assistance with your appeal.

Stay on top of paperwork

There are clinics that take insurance, but will not submit any of the paperwork. That leaves the patient in the position of making sure that all of the correct documents are sent in to the insurance company for reimbursement. This is a place where time is certainly not your friend. The sooner you complete and submit insurance forms, the better. As time passes, memories fade and medical records get archived. Everything just becomes more difficult, especially if there is some type of mistake. The best practice to saving money and aggravation is to do all of this in a timely fashion.

Take advantage of the tax code

If you are in the midst of a battle with fertility, you should take advantage of a health savings account (HSA), health reimbursement account (HRA) or flex spending account (FSA). These are different types of tax advantaged accounts that can save you money. Talk to your human resources department or accountant to determine what, if any, of these accounts you can utilize.

Keep all of your receipts and explanation of benefits statements. Be organized and know how much you spend each year out of pocket. If you itemize your taxes, you can deduct certain medical expenses that are in excess of 10% of your adjusted gross income. Again, this is a topic that you should talk to a tax professional about.

A strategy to keep in mind if you have a medical insurance policy that does not include fertility coverage

There are a number of tests that are required for general reproductive health in addition to fertility treatment. Once you are under the care of an RE, find out if there are any required blood tests and procedures that are more likely to be covered by insurance if it was ordered by a gynecologist or an internist instead of a fertility specialist. Request that your RE arrange for your general physician to write the prescriptions for these types of tests to avoid potential red tape, as general reproductive health tests ordered by a participating doctor are more likely to be paid claims.

Inquire with your fertility clinic to see if there are any discount programs or cost accommodations

See if you can find a fertility specialist that has a shared risk program for ART patients. Shared risk programs have varying structures and features, but the common thread is that it allows patients to purchase in vitro fertilization (IVF) cycles in a bundle. Doing so makes IVF more affordable for patients but also has some drawbacks in that if the process works, you could wind up paying more than per cycle. It is certainly an option worth exploring to determine if you qualify and if it is right for you.

It also worth asking if a fertility clinic will consider working out a payment plan or discount price for procedures. Don't be afraid to call around and see what the going rate is at other clinics to include in your conversations. As a rule, information about industry pricing is always good to have whenever you approach a negotiation. They may not be able to match another clinic's price, but it may still save you money.

Do your homework to find the best price on medications

Fertility medications can be extraordinarily expensive. Not all pharmacies charge the same price for these meds. Call around to local pharmacies for the best price and inquire if they have medication that other patients have donated back to the doctor's office for use by patients who have exorbitant out of pocket expenses. These medications are unopened and free, so it can really be a gift to those who benefit.

There are also online pharmacies specializing in fertility medication and mail order pharmacies that are less expensive that the drug store around the corner from where you live. The legwork of price comparisons can save you a lot of cash.

TTC is a full-contact sport (pun intended)

Trying to conceive can be a journey fraught with angst and anxiety. Be ready to use all of your strength and wit. Read your bills, ask questions and stay informed. The hope is that at the end of the road there is a baby. These strategies will ensure that you minimize the tolls paid along the way and have funds for your family's future.

Jaclyn Vargo is a self-trained, self-proclaimed, budget geek. After attending Harvard University and Fordham Law School she worked for eight years a Manhattan prosecutor. She is a problem solver who enjoys helping people. Jaclyn provides personal budget coaching services at Your Budget Builder LLC, where she counsels and inspires people to achieve their financial goals. She lives in Brooklyn, NY with her wife and two children.