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Provision of insurance coverage for IVF by a large employer and changes in IVF rates among health plan enrollees

JAMA Nov 21, 2019

Dupree JM, Levinson Z, Kelley AS, et al. - In view of the fact that insurance plans with in vitro fertilization (IVF) coverage are now being provided by some employers, researchers focused on the link of employer-sponsored coverage with the use of IVF. For women aged 42 years or younger with an infertility diagnosis, IVF coverage was offered by self-insured plans at the University of Michigan, commencing January 1, 2015, including a 20% coinsurance and need of single-embryo transfer for women younger than 35 years. For women aged 22 to 42 years registered in the self-insured plans, they gathered claims data from October 2012 through January 2017. Overall, 18,282 women were included (mean age, 32 years; 70% white; 57% regular staff). Among all women, a rise in regression-adjusted IVF use was evident from 34.3 cycles per 10,000 women prior to 2015 to 92.6 cycles afterward—a ratio of 2.7. Findings revealed the link of employer-sponsored IVF coverage with the increased use of IVF among all women, with a large proportional rise in low-salary women. However, high-salary women demonstrated the highest absolute IVF use, which may indicate that the 20% coinsurance discouraged use for some women.
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