Four essential components of a successful family-building benefit — Including mental health support throughout the journey

Research has shown that women facing infertility have comparable levels of depression and anxiety to women facing cancer, AIDS/HIV, and heart disease. And although discussing infertility has become less taboo in recent years, there is plenty of work to do to continue destigmatizing it. A more recent study looked at infertility patients’ reactions to treatments postponed because of COVID-19 — 66% reported infertility remained the largest stressor in their lives, causing them more distress than the global pandemic. It is no wonder that therapy calls suddenly tripled as well.

Infertility is emotionally taxing and there are many reasons relationships can get strained. Waiting for results, financing treatment, balancing work and office visits, and dealing with the side effects of medications can all add stress to interpersonal relationships. Sometimes family members and friends don’t understand or aren’t sure what to do. Often, the person going through treatment doesn’t want advice or to hear everyone else’s story, so they try to go it alone.

The truth of the matter is this: infertility is hard – and incredibly common. According to the CDC, one in eight couples in the U.S. are impacted by infertility. The impact is even larger when you realize that this number doesn't include LGBTQ+ couples or single parents by choice, who must also use fertility services to grow their families.  Plus, many people don’t realize that this isn’t just a female issue; male infertility accounts for 1/3 of all cases.

But, the positive news is that more and more organizations are making the decision to carve out fertility and family building benefits to support their employees through family building – all of the ups and downs – including with much needed mental health support. And importantly, though more and more companies are offering these benefits, nearly all are seeing no increase of healthcare costs

Understanding the need for these benefits is the first step. Understanding what best in class fertility and family building benefits look like is the second step. There are four essential components that drive a successful family building benefit: 

  1. Active management of a large provider network that provides outcomes on every treatment. Individuals looking to use their fertility benefit want access to the best providers, close to their home. The fertility process can be daunting, so having a large, qualified network as part of the fertility and family building benefit is essential. A benefit that is actively managed means that providers are held to best practice standards and excluded when performance is subpar, and when outcomes are reported from every clinic, employers know that members are going to quality providers who are providing care that results in superior outcomes – healthier pregnancies and healthier babies. 

  2. A benefit design that provides coverage for a full episode of care to enable equitable access. Fertility is a highly complex medical condition that shouldn’t be capped with a dollar maximum benefit; with a prevalence higher than asthma, diabetes, or cancer, it should be treated as other complex medical conditions and provide coverage for a full episode of care. By doing so, members know they are covered for their entire treatment. This means they don’t have to worry about making cost-based care decisions which can arise with dollar max benefits, and can create the best treatment plan with their provider for their unique journey. Additionally, the benefit should provide access to state-of-the-art treatment options without any barriers or hurdles to accessing care. For example, some traditional fertility benefits have hurdles that prevent LGBTQ+ couples to access their fertility benefits. A best-in-class benefit enables all members, including LGBTQ+ and single parents to use IVF, sperm and egg donation, adoption, surrogacy, and more to build their families.  

  3. Dedicated, concierge member support for every journey to parenthood with mental health support. The fertility and family building journey is different for everyone, and as mentioned, the process can be a huge driver of stress and mental health strain. Having a dedicated support team within the benefit for every member can help alleviate some of the stress and make the journey more supported. A successful benefit will have this dedicated support for members, providing guidance and education along with virtual therapy gorups – helping every member determine the best fertility and family building path for their specific and unique needs. 

  4. Integrated pharmacy within the benefit. Fertility medication is essential to a member’s treatment and can be the most anxiety-ridden part of their journey. Fertility medications must be timed specifically to a treatment cycle, require complex at-home drug administration, and are often overprescribed to accommodate authorization and delivery delays that could impact treatment. A best-in-class fertility solution will have integrated pharmacy to create a seamless member experience that also reduces the administrative burden for providers.  

All four of these components are needed to drive superior outcomes – faster and healthier pregnancies, and healthier babies. Infertility is not something that can be controlled, and medical coverage should not be optional. And, with mental health support at the forefront of every employer’s mind, and fertility clearly impacting employees’ mental health, fertility and comprehensive family building benefits must be a part of the equation when thinking about how to support an employee’s whole wellbeing.  

Julie Hunt. VP, Business Development, Progyny ([email protected])
Rob Luneau, Director, Business Development, Progyny ([email protected])
To learn more about how to support your employees on their family building journey, check out this Fertility and Family Building Worksheet.

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