As health insurance providers cut costs and maximize profits by denying access to care and treatment to their policy holders, one thing is becoming painfully obvious: you get what you pay for. Most employer-provided health insurance policies do not pay for infertility treatments. Their reason for not covering infertility treatments is pretty straight forward. While undergoing infertility treatments, employees will probably come in late a few times, miss some days of work, and if successful, take time off for maternity leave. From the employers point of view, covering infertility treatments is a losing proposition. Some of the more compassionate employers will offer their employees the opportunity to purchase a rider to their policy that covers infertility treatments, but the policy rider may restrict treatment to in-network providers. That brings us to the next problem.
Contracted, in-network healthcare providers (like large IVF centers), have agreed to accept the reimbursement schedule of the health insurance companies. To maximize profits for the health insurance company, the reimbursement the IVF center for each IVF cycle is low. But, the insurance company guarantees the IVF center a large number of patients through their in-network referral system. In this way, the low reimbursement rate can be compensated for by a higher volume of patients. Although this makes sense from a business point of view, nothing could be worse for the patient. To accommodate the high volume of patients, individualized treatment is abandoned for a one-size-fits-all approach. Laboratory procedures are streamlined and embryo transfers occur on Day 3. Communication between the doctor and the patient is minimized and most patient calls are triaged by the office staff. Patients dont see the same doctor throughout treatment. Continuity of care is replaced by the doctor-of-the-day. The patient feels caught up in the whole impersonalized process and rightly so. Welcome to the Fertility Factory.
Out-of-network providers are under no such constraints. They can, and do, provide the level care that they believe to be the most beneficial in treating the infertility patient. However, theres a catch. Out-of-network providers charge extra. But, like most things in life, you get what you pay for. North Hudson IVF is an out-of-network provider and, as such, can provide personalized treatment that has a high probability of success.