Analysis of health insurance cover for reproductive immunology

Abstract

The objective of this study was to document the current state of health insurance cover for reproductive immunology in the USA. A survey of couples who had given birth to a child within the last 2 years while they were being treated with lymphocyte immunotherapy at the Reproductive Medicine Clinic of the Finch University of Health Sciences/The Chicago Medical School (FUHS/CMS), North Chicago, IL, USA, produced 61 completed questionnaires from couples in 16 states, representing a response rate of 55%. The Reproductive Medicine Clinic at the FUHS/CMS is a major centre that treats couples with reproductive immunological problems. These couples had experienced repeated pregnancy losses that were diagnosed as immunological in nature. This prospective study documents the insurance reimbursement of couples receiving lymphocyte immunotherapy who subsequently became parents. The findings indicate that 80% of couples had insurance claims initially denied for reproductive immunotherapy-related services. The most common reason given for a denied claim was that the treatment was experimental. Couples took further action and almost all received cover. Cover for immunotherapy-related services averaged 65% of the cost. The percentage of expenses covered by the insurance was quite variable. The survey indicates that insurance cover is provided if patients are willing to take action.