12.30.2008
IVF Due Date and Fetal Development Calculator
This handy calculator spits out dates relating to a prospective pregnancy when you enter your egg retrieval (or ovulation) date. Click on the image below to get started, and let the obsession begin!
12.29.2008
Deduct Your Medical Expenses
If you're reading this, you may already know that infertility treatment is not covered adequately by most health insurance plans. If you are a tax-paying resident of the United States, there's something you can do to offset this injustice! You may be able to deduct the hundreds (thousands?) of dollars that infertility has cost you from your federal income taxes.
You do not need to be a financial mastermind nor do you need to hire an accountant to deduct your medical expenses. You do have to be organized; being organized made me feel more in-control of the whole situation. You also need to be able to itemize your deductions. I have used several online tax preparation applications, and deducting medical expenses was as simple as entering a few dollar amounts (I think these were categorized as transportation, prescriptions, treatment, etc.) The 2008 paper tax form provided by the IRS simply asks for one value "Medical and dental expenses".
You should be able to deduct the cost of tests, treatment (including acupuncture), over the counter medications, prescription medications, home pregnancy tests, insurance premiums, mileage (to and from your many appointments), and hotels (if you had to travel for treatment).
For more details on what can be deducted, go to www.irs.gov, and search for the current copy of publication 502. This document explains everything you need to know about deducting your medical expenses from your taxes. Here's the 2008 version of publication 502. You should make a note of the current standard mileage rate (for 2008, it is 19 cents per mile from January 1 through June 30 and 27 cents per mile from July 1 to December 31). Also check the list of what medical expenses can be deducted. If you traveled to a fertility clinic away from home, make note of the allowable deduction for hotel stays; in 2008, you can deduct up to $50/night per person for hotel stays.
The first thing you should do is to start tracking all of your expenses. I did this in a spreadsheet (I will try to provide a template version that you can use, so check back later). This may sound like a tedious task, but it's a manageable one if you can remember to make an entry in your spreadsheet when you return from each appointment. A spreadsheet like this allows you to easily track the miles you travel to and from each appointment. Designate a special place (a folder, basket, or box) in your house or workplace to store your medical receipts.
The IRS recommends that you keep the following information: the name and address of person you paid and the amount and date of each payment. Invoices are more helpful than simple credit card receipts, since they show the information the IRS wants you to track (what medical care was received, who received the care, and who the expenses were for). To simplify your life, ask your medical providers and your pharmacies for a report of your medical expenses for the calendar year. You can do this at the end of the year, just to make sure you've captured each expense.
Unfortunately, you can only deduct expenses that exceed 7.5% of your annual income. Since this is the case, it is helpful to file your taxes separately (instead of jointly). I have heard of people timing treatment so that it falls within a certain year for tax purposes (to exceed this 7.5% limit, for example). So, maybe you don't want to take a month off from treatment, if you can squeeze one more cycle into the calendar year.
Tip: If you are taking an over-the-counter prenatal vitamin, you may ask your doctor to prescribe one for you, since your prescription co-pay may be less than the over-the-counter cost...plus the cost will be tax deductible.
If you are participating in an FSA or HSA program through your employer, you will not be able to deduct costs that you have already submitted to your FSA or HSA administrator for reimbursement.
Deducting your medical expenses is just another way to feel more empowered when facing infertility. Infertility is not fair. Take advantage of the little things. You can do it!
Please note, that I am by no means an expert on federal income taxes. If you have any questions, please discuss them with your accountant.
You do not need to be a financial mastermind nor do you need to hire an accountant to deduct your medical expenses. You do have to be organized; being organized made me feel more in-control of the whole situation. You also need to be able to itemize your deductions. I have used several online tax preparation applications, and deducting medical expenses was as simple as entering a few dollar amounts (I think these were categorized as transportation, prescriptions, treatment, etc.) The 2008 paper tax form provided by the IRS simply asks for one value "Medical and dental expenses".
You should be able to deduct the cost of tests, treatment (including acupuncture), over the counter medications, prescription medications, home pregnancy tests, insurance premiums, mileage (to and from your many appointments), and hotels (if you had to travel for treatment).
For more details on what can be deducted, go to www.irs.gov, and search for the current copy of publication 502. This document explains everything you need to know about deducting your medical expenses from your taxes. Here's the 2008 version of publication 502. You should make a note of the current standard mileage rate (for 2008, it is 19 cents per mile from January 1 through June 30 and 27 cents per mile from July 1 to December 31). Also check the list of what medical expenses can be deducted. If you traveled to a fertility clinic away from home, make note of the allowable deduction for hotel stays; in 2008, you can deduct up to $50/night per person for hotel stays.
The first thing you should do is to start tracking all of your expenses. I did this in a spreadsheet (I will try to provide a template version that you can use, so check back later). This may sound like a tedious task, but it's a manageable one if you can remember to make an entry in your spreadsheet when you return from each appointment. A spreadsheet like this allows you to easily track the miles you travel to and from each appointment. Designate a special place (a folder, basket, or box) in your house or workplace to store your medical receipts.
The IRS recommends that you keep the following information: the name and address of person you paid and the amount and date of each payment. Invoices are more helpful than simple credit card receipts, since they show the information the IRS wants you to track (what medical care was received, who received the care, and who the expenses were for). To simplify your life, ask your medical providers and your pharmacies for a report of your medical expenses for the calendar year. You can do this at the end of the year, just to make sure you've captured each expense.
Unfortunately, you can only deduct expenses that exceed 7.5% of your annual income. Since this is the case, it is helpful to file your taxes separately (instead of jointly). I have heard of people timing treatment so that it falls within a certain year for tax purposes (to exceed this 7.5% limit, for example). So, maybe you don't want to take a month off from treatment, if you can squeeze one more cycle into the calendar year.
Tip: If you are taking an over-the-counter prenatal vitamin, you may ask your doctor to prescribe one for you, since your prescription co-pay may be less than the over-the-counter cost...plus the cost will be tax deductible.
If you are participating in an FSA or HSA program through your employer, you will not be able to deduct costs that you have already submitted to your FSA or HSA administrator for reimbursement.
Deducting your medical expenses is just another way to feel more empowered when facing infertility. Infertility is not fair. Take advantage of the little things. You can do it!
Please note, that I am by no means an expert on federal income taxes. If you have any questions, please discuss them with your accountant.
12.28.2008
How to Appeal for IVF Coverage
In the United States, many infertility patients find it difficult to pay for treatment such as IVF, especially since IVF is not often covered by medical insurance. Some states mandate infertility coverage. You can check this list or this one to see if your state mandates coverage.
In 2004, my insurance company covered the rarely used GIFT and ZIFT treatments, but did not cover IVF. Since GIFT and ZIFT are uncommonly used, more invasive, less effective, more expensive, and more risky than IVF, I was able to appeal to my insurance company for IVF coverage.
I am providing a kit that can be used to make a similar appeal. These instructions are specific to residents of the United States, and for those whose insurance covers GIFT and/or ZIFT, but not IVF; if you do not fit into this category, perhaps you can still use these steps as a starting point for your own tailored appeal. Here are the steps to follow:
1.) Call your insurance company and specifically ask which infertility tests and treatments are covered. Be sure to make a note of the date and time of your call, and the name of the customer service representative that you talk with. You may need this information as part of your appeal. Some insurance companies require that you file the appeal within a certain number of days after you learn that coverage is not provided.
2.) Visit the website of your health insurance company or call them to determine the appeals process.
My appeals process consisted of three steps:
3.) Be prepared to send a simple letter to the appeals committee. I know, trying to conceive is one cruel waiting game after another...but wait! While you are waiting for the appeal letter to be answered, there are other things you can do:
a.) Look at the latest CDC ART report to get a listing of the IVF clinics in your area. Find an email address for each one (you will need to locate a web site for each clinic to get the email address). Send an email to the clinic asking if they perform GIFT or ZIFT, and if they no longer perform these procedures, why not? You will need this information for your appeals letter, so save each response. I made a special folder in my Inbox for the responses.
b.) Download my appeal letter and start filling in the blanks with information specific to your appeal (enter your name, your address, and the address of the appeals committee.) I am also providing a PDF version, in case you are unable to open the Word document. There's also a section for IVF success statistics for clinics in your area. Visit the CDC ART report statistics again for this information. Enter this information in table 1 of the document.
As you receive email responses from the various clinics you wrote to, you will also need to replace the clinic responses in Appendix A with the responses you received. (I left the responses in my template letter, just so you can get the idea. Please remove my responses.) Enter the name and city of each clinic, along with the date you received the email response.
4.) Once you receive your response from the appeals committee, follow the rest of the steps of your appeals process. If your appeals process includes an in-person meeting, be prepared to provide the cost of IVF at the clinic you plan to use.
Through the appeals process, I was awarded coverage for one IVF treatment up to $7000. My IVF actually took placed during the appeals process, so it happened that they provided me with a check to reimburse the cost of treatment. My friend followed the same process (she actually gave me the idea), and I believe she was awarded coverage for multiple IVF cycles, because that's what she requested. So, I guess it doesn't hurt to specifically request coverage for multiple cycles. You may also consider asking for coverage of your prescriptions if they are not normally covered.
If you are able to successfully appeal for coverage, please let me know. It is a very empowering feeling! Do it, today!
In 2004, my insurance company covered the rarely used GIFT and ZIFT treatments, but did not cover IVF. Since GIFT and ZIFT are uncommonly used, more invasive, less effective, more expensive, and more risky than IVF, I was able to appeal to my insurance company for IVF coverage.
I am providing a kit that can be used to make a similar appeal. These instructions are specific to residents of the United States, and for those whose insurance covers GIFT and/or ZIFT, but not IVF; if you do not fit into this category, perhaps you can still use these steps as a starting point for your own tailored appeal. Here are the steps to follow:
1.) Call your insurance company and specifically ask which infertility tests and treatments are covered. Be sure to make a note of the date and time of your call, and the name of the customer service representative that you talk with. You may need this information as part of your appeal. Some insurance companies require that you file the appeal within a certain number of days after you learn that coverage is not provided.
2.) Visit the website of your health insurance company or call them to determine the appeals process.
My appeals process consisted of three steps:
- First level appeal: I sent a simple letter asking that IVF coverage be substituted for GIFT/ZIFT coverage.
- Second level appeal: I sent a fact-filled, more detailed letter to the appeals committee.
- Meeting with the committee: I presented my case in-person to the committee (I simply read my letter and answered some questions).
3.) Be prepared to send a simple letter to the appeals committee. I know, trying to conceive is one cruel waiting game after another...but wait! While you are waiting for the appeal letter to be answered, there are other things you can do:
a.) Look at the latest CDC ART report to get a listing of the IVF clinics in your area. Find an email address for each one (you will need to locate a web site for each clinic to get the email address). Send an email to the clinic asking if they perform GIFT or ZIFT, and if they no longer perform these procedures, why not? You will need this information for your appeals letter, so save each response. I made a special folder in my Inbox for the responses.
b.) Download my appeal letter and start filling in the blanks with information specific to your appeal (enter your name, your address, and the address of the appeals committee.) I am also providing a PDF version, in case you are unable to open the Word document. There's also a section for IVF success statistics for clinics in your area. Visit the CDC ART report statistics again for this information. Enter this information in table 1 of the document.
As you receive email responses from the various clinics you wrote to, you will also need to replace the clinic responses in Appendix A with the responses you received. (I left the responses in my template letter, just so you can get the idea. Please remove my responses.) Enter the name and city of each clinic, along with the date you received the email response.
4.) Once you receive your response from the appeals committee, follow the rest of the steps of your appeals process. If your appeals process includes an in-person meeting, be prepared to provide the cost of IVF at the clinic you plan to use.
Through the appeals process, I was awarded coverage for one IVF treatment up to $7000. My IVF actually took placed during the appeals process, so it happened that they provided me with a check to reimburse the cost of treatment. My friend followed the same process (she actually gave me the idea), and I believe she was awarded coverage for multiple IVF cycles, because that's what she requested. So, I guess it doesn't hurt to specifically request coverage for multiple cycles. You may also consider asking for coverage of your prescriptions if they are not normally covered.
If you are able to successfully appeal for coverage, please let me know. It is a very empowering feeling! Do it, today!
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