Friday, January 25, 2013

Multiple Embryo Transfer Hidden Costs: Embedded Deductibles and More

Multiple embryo transfer is a common practice for couples undergoing In Vitro Fertilization. Several viable embryos are implanted to increase the odds of conception, and decrease the need for subsequent IVF cycles. One motivation is cost. IVF treatments are often self paid and most insurance plans limit the number of cycles covered, or more frequently cover nothing at all.

Multiple-pregnancy occurs more frequently when multiple embryos are transplanted. And these pregnancies can cost far more than an additional IVF cycle ever could. These costs are often hidden or ignored by couples desperate to have a baby: lost income, hospital deductibles, out of network costs, and amounts over usual customary and reasonable are all terms any couple should know before undergoing a multiple embryo transfer. A little advance planning can minimize costs.

Multiple Transfers Mean Multiple Pregnancies

Multiple transfers mean a higher rate of multiple pregnancies. The logic is simple. If more than one viable embryo is implanted in your uterus, more than one embryo may develop. Roughly one-third of multiple embryo transfer pregnancies IVF result in twins or triplets.

Multiple Pregnancies High Risk

Twins and triplet pregnancies are more likely to experience complications: incompetent cervix, placenta previa, iron deficiency anemia, gestational diabetes, and pre-eclamsia are all more common in multiple pregnancies than in singleton pregnancies. Mom may be ordered to stop working to take bed rest: meaning months of unplanned lost income.

Pre term labor occurs in approximately 50% of twins, and 90% of triplets. Premature infants are at a higher risk of hearing loss, vision problems, and developmental delays. Pre term labor is also the leading cause for infants to spend time in Neo Natal Intensive Care, and this is where the hidden costs reveal their ugly head at the worst possible time.

Surprise Hidden Costs

Parents sometimes learn about left over hospital bills the hard way when infants require specialized care in the hospital. At a recent comment brings home the point: "I was born weeks premature, and my family finished paying the hospital bills on my 25th birthday". These hidden costs come from three places: embedded deductibles, out of network fees, and amount over customary and reasonable.

Health insurance plans commonly contain a deductible. An embedded deductible contains two components: and individual deductible and a larger family deductible. With health insurance premiums rising rapidly, the most common method of keeping premiums in check is the introduction of larger hospital deductibles. A couple may plan to pay one individual deductible for mom's hospital stay. But when multiples are born prematurely and require NICU care there may be two or three extra deductible to satisfy.

Health insurance plans may also contain co-insurance for out-of-network care. People are most likely to go to an out-of-network provider when specialized care is required. High risk multiple pregnancies and deliveries are a common reason for out-of-network utilization. This may mean bigger bills than expected for co-insurance: sometimes 20% to 40% of charges.

Couples may face an even bigger surprise: amounts over usual customary and reasonable. In network providers agree to cap their fees according the insurer's contract. Look at any explanation of benefits and find the providers charges. Listed below are the allowed charges. They are usually 50% less or more. Guess who is responsible for the difference when using an out-of-network provider? The unsuspecting couple who emptied their bank account to pay for the IVF cycles needed to get pregnant with twins or triplets gets left with the bill.

Plan Ahead

Couples should anticipate these unexpected costs and purchase supplemental maternity insurance before getting pregnant. Short term disability insurance replaces mom's income if bed rest is required, and hospital indemnity insurance covers mom's normal labor and delivery, and pays an additional benefit for each infant confined to the NICU.

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