Couples struggling with infertility apply for health insurance in North Dakota

Rachel Booth and her husband have been trying without success for the past three years to have children.

Like many couples in that situation, Stores turned to fertility treatments. There were two rounds of in vitro immunotherapy. All were unsuccessful.

Booth and her husband have exhausted the $20,000 their health insurance pays for fertility treatment. The Fargo couple—who works as a high school teacher and whose husband is a police officer—could not afford the expensive treatment themselves.

Booth testified in support of a bill that would legalize drug therapy and save drugs for cancer patients in North Dakota. Public Employees Retirement System, or PERS. Nearly 60,000 current and retired government employees and their dependents are insured through PERS.

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In North Dakota, before private insurance is legalized, it must first be tested through public employee insurance, so that the sign and a step towards private health care management.

House Bill 1146 health care coverage is required, including diagnosis and treatment. There was the review and the first reading before the Committee on Industry, Business and Labor of the House of Representatives at the beginning of this month.

“I want to let you know that I am not the only person dealing with this disease. The truth is, there are many men and women who struggle with infertility,” Booth told the committee, citing research showing that one in eight North Dakota couples struggle with infertility. not having children.

“The impact of mental health and the damage it can do to a marriage is serious and disturbing,” he said.

Tara Brandner, a nurse in Bismarck and advocate for coverage of treatment and conservation, said that there is an idea that the treatment always includes the expensive in vitro fertilization, or IVF.

“It’s not always IVF,” she said. Brandner performed IVF treatments and in her practice cared for women struggling with infertility.

In fact, he said, less than 3% of cases that are not born require treatment, but 97% can be treated with drugs, surgical procedures, ultrasound or emergency procedures.

For those who need IVF treatment, however, one cycle can eliminate the $15,000 or $20,000 limit on most insurance policies, Brandner said. And as Booth’s example shows, sometimes couples have to make several rounds.

The bill does not impose a dollar limit on prenatal care but limits the number of treatments covered.

The bill will need to be shared for three completed rounds of the vaccine. Covering will also be required for maximum availability of eggs with restrictions on fresh or frozen transport. The bill also authorizes funding for medical services and laboratories to reduce the number of pregnancies through egg preservation and thawing “in accordance with a person’s religious or moral beliefs.”

A lobbyist for the Sanford Health Plan testified in opposition to the bill and was the only person to submit written testimony against the proposal.

“We have concerns about the broad scope of the bill in terms of the financial impact on payments,” said Dylan Wheeler, head of public affairs for the Sanford Health Plan.

Because of the broad nature of the bill, he said, “it’s difficult to estimate the exact impact at this time.”

Of the financial information attached to the bill is an estimated two-year cost to the NDPERS insurance program at $13.6 million, or 2.1% of the budget.

Estimated cost of prescription drug addiction treatment ranges from $1.98 per member per month to $24.85, but purchased by Advising the benefit to $2.38 per member per month, Wheeler said.

The national budget for infertility treatment is $1.39 per member per month, and the $100,000 average life expectancy shows a cost of $1.29 per person per month. months, according to Brandner.

Brandner’s experience with fertility treatments led him to become an advocate for insurance to help couples struggling to conceive.

“It’s quite difficult,” he said. “I wanted to do something about it.”

Patty Hulm, of Mandan, a mental health counselor and leader of the infertility advocacy group, testified in support of the bill. He says he has received fertility treatment.

“I have worked with couples and individuals over the years dealing with the emotional and physical struggles of infertility throughout the state of North Dakota, thanks to telehealth options and virtual meeting platforms,” ​​he said. this.

“The financial barrier couples are facing in building their families has put a big problem in their relationships. It’s not their fault that they are dealing with these medical conditions, but they are being penalized for not having insurance because they are diagnosed with infertility,” said Hulm.

Although emotional struggles will remain, the burden for couples will be eased knowing that parts of the expensive treatment will be covered, he said.

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