One fertility savings program proves a useful tool for patients and practices.
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Reproductive Medicine Associates of New York (RMANY) has had to counsel their fair share of patients who have exhausted their fertility benefits.
“Patients may not be fully educated on the medical criteria of their fertility benefits, which plays a vital role,” said Romain Singramdoo, Finance Manager at RMANY.
In “cases where implantation needs to occur within a certain time frame, the patient was not fully educated, and did the implantation past the allowed time,” Singramdoo said. In this instance, the finance coordinator informed the patient that their Global Health Insurance (GHI) policy mandated her to have her frozen embryo transfer (FET) cycle within 60 days of the retrieval. “When the implantation happened past the allowed time, the implantation cycle counted as ‘another try’,” Singramdoo added.
Patients may see a total dollar amount ‘covered’ and want to use the entirety of that coverage as soon as possible to afford fertility treatment without understanding their potential treatment path. “They may need more than one cycle to achieve their goal, based on their individual circumstance”, Amanda Travis, Director of Brand Marketing, US Fertility at EMD Serono, said. “Or that the medication part of the treatment costs may be extracted and paid out of pocket”.
Fertility LifeLines™ enrolled nearly 139,000 patients from 2013-2023, saving them approximately $69 million in total*.
Why Choose Fertility LifeLines™?
In a recent study, perceived cost was the most commonly reported barrier for respondents not seeking treatment (42% of patients (n=207))1. EMD Serono’s Fertility LifeLines™ program offers savings on EMD Serono medications for eligible patients.
Substantial Discounts: Eligible patients can save up to 50% on EMD Serono fertility medications.
Wide Eligibility: Designed for individuals based on financial need or military status.
Quick and Simple: Discover your eligibility in minutes, apply swiftly, and receive a response in 3 to 5 business days.
Help Your Patients Today
Don’t let your patients’ financial barriers hold them back from trying to build a family.
*Data on File, EMD Serono Inc.
1. Domar, et al. Barriers and factors associated with significant delays to initial consultation and treatment for infertile patients and partners of infertile patients, RBMO, VOLUME 43, ISSUE 6, 2021
Often, patients meet with the appropriate staff member at the fertility clinic to ask the important questions: How much will this cost me, and how much will my insurance pay? Typically, at this point, patients have “a minimal understanding of how their ‘coverage’ can be best and most efficiently leveraged”, Travis shared.
By the very nature of fertility treatment, patients experience a range of emotions, not to mention challenges, one of which is the affordability of expensive fertility treatment programs. “Couple these complexities with what a patient seeking infertility treatment may be feeling at the point in time when they’re exploring costs; they are overwhelmed and feeling ‘challenged’ from the start,” Travis said.
The underutilization or misutilization of fertility benefits is devastating for patients, who have to pay the extra costs out of pocket.
But forward-thinking fertility centers like RMANY have also found ways to help patients maximize their fertility benefits efficiently. Whether they “had a specific dollar amount of $25,000 to utilize for IVF”, or other stipulations and amounts, Singramdoo said.
Benefit challenges impact fertility centers and patients
“Insurance and coverage are foundationally complex, regardless of how and where a patient is accessing it,” Amanda Travis, Director of Brand Marketing, US Fertility at EMD Serono, said.
Confusion over how to optimize benefits can also impact patients’ fertility treatments and entitlements. “Patients may be paying more than they should be to achieve the outcome they are looking for,” Travis shared. “They may miss the chance to apply for a manufacturer or pharmacy savings program for their medications if they choose to entirely pay through their insurance coverage or plan,” Travis added.
Limited knowledge of fertility benefits can also impact the patient’s fertility center. “Frustration could lead to bad reviews for the finance team for not giving clarity, or patients may begin to lose trust in the practice,” said Singramdoo. Financial counselors and patient navigators face several hurdles when allocating benefit coverage. “Insurance reps tend to be very vague and inconsistent when explaining benefits, leaving the practice to relay information that may be incorrect,” Singramdoo detailed.
How fertility centers can help their patients get the most from their benefits
Fertility clinics can help their patients properly navigate, optimize, and advise their patients. “Insurance coverage is a good starting point for the financial conversations, but prepare a process and questions to best educate and set the patient up for success,” said Libby Horne, Senior Vice President of US Fertility & Endocrinology at EMD Serono.
Bespoke fertility benefit packages are available to clinics. In today's fertility sector, it's recommended that clinics implement a process that builds in personalization and doesn’t treat all patients with ‘coverage’ the same.
Expanding supply chains to involve pharmacies in patients’ fertility treatment plans can optimize operations for facilities. “If the clinic doesn’t have the process or personnel to do this effectively with every patient, outsourcing to their pharmacy may be an effective idea,” Horne said.
Three-way calls with patients, insurance providers, and fertility practices help clarify benefits. “Asking the patient to get their written certificate of coverage or provide us with a concierge number for their benefits can also assist in clarifying benefits,” Singramdoo noted.
EMD Serono’s savings program saves eligible fertility patients an average of $1,700
EMD Serono encourages all eligible patients to apply to see their potential savings and confer with their EMD Serono network pharmacy if they do not immediately qualify to see if there is potential for other savings.
The biopharmaceutical company hosts a Fertility LifeLines Resource Hub featuring program descriptions, patient materials, program logos, and patient-facing instructional videos for clinics to educate patients on Fertility LifeLines.
Fertility LifeLines is a program for eligible patients who will be paying out-of-pocket for EMD Serono fertility medications. EMD Serono offers a Compassionate Care program to support certain eligible patients’ access to affordable fertility treatment.
On average, eligible patients save over $1,700 on EMD Serono Fertility medication, but some may save more. The savings patients can expect to make are based on several factors, including financial need, number of dependents, and military status.
This News Digest Story is paid featured content. The advertiser has had editorial input and control over its creation. However, the views and opinions expressed in this article do not necessarily represent the views of Inside Reproductive Health. The sponsorship of this content does not imply an endorsement by Inside Reproductive Health.
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