Freezing her eggs was the most empowering thing Jamie Rugg says she did in 2020. It was one of the most expensive ones, too.
The single Los Angeles-based certified financial planner shelled out just over $14,000 for one cycle of egg freezing last December, every expense tracked in a tidy spreadsheet. She paid for the procedure with savings, after spending a few years researching the process.
Most women aren't as prepared as Rugg for the price of freezing their eggs, even as the procedure has grown more popular in recent years, brought into the spotlight with the help of celebrities and regular women, like Rugg, who want to preserve their ability to have children until they find a life partner or are more established in their careers.
More than 13,000 women froze their eggs in 2018, up 114% from five years earlier, according to the Society for Assisted Reproductive Technology's most recent data. Anecdotal reports from fertility clinics and related companies suggest demand for the procedure spiked even more in 2020, as many people paused dating and worried about waiting longer to find a partner. The pandemic also allowed women to inject hormones more easily when everyone was confined in their homes.
A single cycle of egg freezing and the required medication can cost anywhere from $8,000 to $15,000, according to FertilityIQ. You’ll also have to pay for annual storage fees. And down the line, should you thaw and use your eggs, you’ll have to pay thousands more to implant them via in vitro fertilization. (And at the end of all that spending, there's no guarantee that freezing your eggs will result in a baby.)
Costs can be hard to understand, particularly because they vary based on where you live; what's more, clinics often present the costs for the various stages in different ways. Many women drain their savings or turn to loans to pay.
"The financial piece is the biggest barrier to get more women access to fertility preservation," says Claire Tompkins, founder of Future Family, a fertility-focused fintech lender that launched in 2017.
But as interest in the procedure has grown, so, too, have the companies offering ways to help pay, from workplace benefit administrators to loan marketplaces designed specifically for financing for fertility-related treatments. Here's what to know:
Find out what health insurance will cover
Many larger company’s health insurance programs do cover some fertility benefits; and in fact, there are laws in 19 states that require certain group health insurance plans to offer some fertility treatments.
But even in states where it's required, coverage is limited, with lifetime maximums ranging from $15,000 to $100,000. Plus, you typically need to have demonstrated that you’re having trouble getting pregnant before fertility treatments will count as qualified medical expenses. That means coverage is often out of reach for LGBTQ couples, as well as women who choose to freeze their eggs for the possibility of using them in the future.
Still, it’s worth digging into your plan’s coverage details or talking with the benefits administrator at your company to see precisely what is covered (and for whom). It’s possible, for example, that some initial bloodwork or doctors visits may be included in your coverage, even if the larger expenses are not, says Trevor Stone, a financial planner with Moneta Group in Missouri. He and his wife had their three children with the help of IVF.
Beyond looking at what types of fertility benefits your health insurance will pay for, ask what sort of pre-authorizations you'll have to get before getting treatment, what the dollar maximums are and whether there are restrictions on the clinics or doctors you can use. (CCRM Fertility, which has locations in 10 U.S. cities, has a more in-depth list of suggested questions here.)
“You don’t want to get in a position where you’re expecting coverage but don’t get it because you didn’t check a couple boxes along the way,” Stone says.
Ask your employer about supplemental workplace benefits
Outside of traditional health insurance coverage, more companies are introducing supplemental fertility coverage as an employee benefit in an effort to attract and retain employees.
Among employers with 500 or more workers, 11% now cover some of the costs of egg freezing, according to a survey from consulting firm Mercer. Another 12% said they’re considering introducing it. (These benefits don't typically require a monthly premium, but they may be considered taxable income.)
The benefits will, of course, range from company to company. Carrot, a start-up founded in 2016, now manages fertility coverage for about 250 companies, with benefits ranging from $5,000 all the way up to $75,000. Some employers reimburse workers for approved costs incurred for fertility-related treatments, while others give employees a preloaded debit card.
You may be tempted to skip over this step if your employer doesn’t offer this type of benefit. But Juli Insinger, Carrot's co-founder and vice president of business development, says it’s not uncommon for her team to be introduced to a company’s human resources team by an employee that’s hoping to get coverage at work.
Surveys suggest that many employees don't feel comfortable talking openly about fertility at work, so try thinking about it this way: Statistically, one in eight couples deal with some type of infertility. Plus, others may simply want the option of preserving their fertility for later. Broaching the issue with your employer could help your colleagues as much as it does you.
“We’ve found that even one person making the ask at their employer works,” says Betsy Campbell, chief engagement officer at RESOLVE: The National Infertility Association. The organization even has a guidebook you can take to your HR department.
Build up your savings if you have time
Even if you’re lucky enough to have insurance coverage or workplace benefits, you’ll still likely be on the hook for some bills.
If your company offers an insurance plan with a health savings account (HSA), consider switching to that. The money you put into an HSA is tax-free, and you can also withdraw it tax-free so long as you spend it on qualified medical expenses. That can lower the total cost of your fertility treatments by 20% or 25%, depending on your tax bracket, says Jim Marrocco, a New York City-based financial planner who's helped clients plan for fertility treatments.
Because plans with an HSA typically have much lower monthly premiums than other insurance plans, switching may even free up some money in your monthly budget that you can put into savings. (The tradeoff is that HSAs are paired with high-deductible health care plans and tend to require higher out-of-pocket costs for medical care, so it may not be a good option for someone who has medical issues.)
If you don’t have access to an HSA, put away as much money as you can in a dedicated savings account. Even if you only have a few months' time to save, any down payment you can muster at the time of the egg retrieval procedure will mean a smaller total bill in the long run.
"The more you can do up front, the better that’s going to end up being for how much you have to pay back in interest,” Rugg says.
Borrow money or set up a payment plan to pay for the rest
A cruel reality of many people’s experience with egg freezing (and other fertility treatments) is that you may not have the time to spend years saving up. That’s one reason that borrowing is the most common way to pay for fertility treatments, egg freezing included.
Surveys from Resolve's community suggest credit cards are the most popular form of debt. But that might not be your best option. Loans from a company that specializes in fertility financing are typically more affordable than credit cards, which carry an average APR of about 16%, and more convenient, since they're designed for fertility procedures in particular.
CapexMD, which partners with 260 clinics and calls itself a one stop shop for fertility financing, offers loans with interest rates ranging from 6.5% to 12.5%. Most loans are 48-month terms, though most are paid off in about half that time, CEO Jules Segal says.
CapexMD doesn’t instantly deny anyone, Segal says. Instead, you’ll get a call from one of its loan specialists — they’ve all gone through IVF themselves — after applying. Segal says the company ends up funding about 70% of applicants and it will lend to people with FICO scores as low as 580.
Future Family, a startup founded in 2017, offers a similar service, with a network of about 140 clinics around the country. The company can offer real-time quotes for egg freezing because it partners with the labs and clinics.
“If you can go into the fertility clinic knowing what you’re going to pay, there’s a peace of mind,” Tomkins, with Future Family, says.
Unlike a personal loan, where you'll have to borrow a set amount and then dole out your various payments to different providers, CapexMD, Future Family, and other fertility-focused companies partner directly with fertility clinics to offer simple, streamlined packages. The companies then handle sending payments on your behalf to the lab, clinic, storage facility and pharmacies, and you'll pay it all back in monthly installments over a period of years.
FutureFamily, for example, has an egg-freezing package that starts at $150 a month for 5 years, for one cycle. Rates range from 5.99% to 15%, and the company asks for a minimum 680 credit score, though co-borrowers are welcome. Each borrower is paired a coach who’s a registered nurse trained in fertility.
Most installment plans are financed through a third party like Future Family or CapexMD, but a small number of clinics do offer their own in-house payment plan. These typically require a down payment and do not include the price of medication.
Any time you borrow, you should, of course, shop around to compare fees, terms and interest rates. And in this case, you should weigh what a fertility-focused lender is offering versus a general personal loan from a company like SoFi or Lending Club.
Look for centers or companies that offer financial assistance
If saving or borrowing to pay for egg freezing isn’t practical, you might be able to qualify for help. There are non-profit organizations that offer financial assistance for fertility benefits, including egg freezing. Many of these focus on cancer patients who often choose to freeze their eggs ahead of receiving chemotherapy. But there are a few focused on helping lower-income women afford egg preservation treatments as well. Start by looking through these lists from RESOLVE and Fertility Within Reach.
Remember, costs don’t end after your first round of egg freezing
Keep in mind that even if you do significant research ahead of time, you’ll likely need to prepare for a range of expenses, particularly with pharmacy costs, which can change quickly. When Rugg went through the cycle, her clinic told her that medication costs could range from about $2,000 to $6,000. Based on her bloodwork, her doctor told her she’d likely come in on the lower half of that. But she ended up needing more hormones than anticipated, and her total pharmacy portion was about $3,300 on top of the $10,200 for the freezing procedure.
After the egg retrieval, you'll have to pay up to $1,000 a a year in storage costs; that's another place where you can take advantage of an HSA.
Most fertility clinics have a financial coordinator. Take advantage of their experience working with fertility patients. You can even ask them to review your insurance plan or workplace benefits to help make sense of them and to map out your likely out-of-pocket costs.
“It can be complicated and overwhelming,” Marrocco says of mapping out the true price of fertility treatments. “Just be very clear and triple check what all the costs are. If something isn’t clear, ask more questions.”
Finally, it's common for women to have to go through multiple freezing cycles in order to get enough viable eggs to have a high chance at a pregnancy down the line. Some clinics, including USCFertility, where Rugg went, will offer a discount if you need multiple cycles, something she expects she'll take advantage of.
Since Rugg started researching egg freezing for herself, she's become a resource for friends, family members and increasingly, her financial planning clients — including older women, who ask with future grandchildren in mind.
“I just would love to see us democratize this process and make it more affordable and attainable to more people.”