Infertility rates in Canada have doubled in the last 30 years, rising from under 8% in the '80s to roughly 16% now.
That means that approximately 1 in 6 couples are experiencing conception challenges. Chances are, you or someone you know has had to deal with the impact of infertility. For those who have tried everything else, in vitro fertilization (IVF) is the last resort.
Unfortunately, the treatment is expensive and not guaranteed to work. In 2019, at the time of this publication, IVF treatments alone cost an average of $10,000. In January of 2022, when this article was revised those treatment costs have increased to approximately $12,250. The related drugs can run upwards of $7000. These combined costs are per treatment and can double or even triple should a couple require multiple rounds.
Manulife is one of the Canadian insurers that offer plans to cover fertility drugs associated with IVF treatments. However these benefits are only available in their group benefits products. Keep reading to find out more about Manulife benefits and information surrounding IVF coverage in Canada.
Is IVF Covered by Insurance in Canada?
IVF is not a treatment that is available Canada wide. There is currently no national plan for a country wide program. Rather, the treatment is varied across each province in the country. Here we detail the provinces that offer some IVF options and the eligibility requirements for each.
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IVF Treatments in Ontario
The province of Ontario covers one IVF treatment per lifetime, however will offer one additional cycle if the pregnant woman is carrying a child for someone else (surrogate) Eligibility requirements in Ontario are as follows:
- For IVF, the candidate must be under the age of 43
- Must posses a valid Ontario Health Card
- Have a medical diagnosis of fertility issues from a licensed practitioner
Unfortunately for Ontarians, the government does not provide any subsidies for the drugs related to IVF treatments. Private health care options are available through Manulife.
IVF Treatments in Quebec
Tax credits were offered in Quebec up until changes were made in 2016. Quebec now reimburses a portion of the cost for up to nine rounds of artificial insemination but no longer reimburses for IVF. As of January 2022, residents of Quebec could see some entitlement to a refundable tax credit for related costs pertaining to not only invitro fertilization, but to artificial insemination also. The following criteria must be met:
- The treatment is specific to you or your spouse making efforts to have a child
- Your Provincial Health Care Plan does not cover the cost
- You must have been a resident of Quebec on December 31, 2021
IVF Treatments in Manitoba
Manitoba offers a tax credit of 40% towards the cost of fertility treatment costs, including IVF, up to a yearly maximum of $8000. This tax credit can be claimed on a yearly basis. These numbers have remained the same between 2019 and 2022. Eligibility requirements for Manitoba are as follows:
- Must be a resident of Manitoba
- Must posses a valid Manitoba Health Card
- You may only claim $20,000 in annual eligible costs, up to the previously mentioned yearly Fertility Treatment Tax credit of $8,000
IVF Treatments in New Brunswick
Another province currently offering a grant for coverage for IVF treatments, including artificial insemination, is New Brunswick. The province of New Brunswick offers a one-time grant, allowing qualified residents to claim 50% of incurred costs up to a lifetime max of $5,000. This benefit is provided through the Special Assistance Fund. The criteria for approval is:
- Must be a full time resident of New Brunswick possessing a New Brunswick Medicare card
- Have a medical diagnosis from a licensed physician stating that fertility issues are present.
- Must have received infertility treatment after April 1, 2014
IVF Treatments in Prince Edward Island
The newest province to offer IVF treatment and artificial insemination is Prince Edward Island. As of January of 2021, Islanders can now receive financial support through the Fertility Support Program. PEI's eligibility criteria however, is laid out a little differently. It is based on income and looks like this:
- Family income under $50,000 will receive a maximum of $10,000/year
- Family income over $50,000 but up to $99,999 will receive a maximum of $7,500/year
- Family income over $100,000 will receive a maximum of $5,000/year
- Must be a resident of Prince Edward Island
- Must posses a valid Prince Edward Island Health Card
Representatives in Alberta and Nova Scotia say they are considering implementing some form of IVF assistance, but nothing is in place yet.
The remaining provinces require patients to pay for treatment out of pocket. But the costs are high and fertility-related prescription drugs are not normally covered either. So any little bit helps. That's where Manulife comes in.
Manulife FlexCare Plans
Manulife Insurance offers various FlexCare plans covering health, dental, life, travel, and prescription drugs. The plans range from starter to enhanced coverage and are separated by dental, drug and combination plans.
All FlexCare plans provide core benefits for basic vision, health, accidental dental, psychotherapy, physiotherapy, and ambulance. Plus numerous other forms of what they consider to be basic healthcare needs.
Manulife's best plans for fertility-related drug coverage are either the DrugPlus Enhanced plan or the ComboPlus Enhanced plan. Which one you should pick depends on whether or not you want to include dental coverage.
Both the ComboPlus and DrugPlus Enhanced plans provide 90% coverage for prescription drugs on the first $2,222 and 100% on the next $8,000 per year. This includes brand name prescription drugs for birth control and fertility.
Monthly premiums for the DrugPlus Enhanced plan range from $120 to $165, depending on the patient's age and province of residence.
If you want to include dental coverage in your plan, you can expect to add roughly $100 per month to the monthly premium for the ComboPlus Enhanced plan.
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Important Things to Note
It's advised to sign up for a plan before you actually need the coverage. Medical questionnaires are required for all Enhanced plans. It is mandatory to state whether or not you have a condition that currently requires prescription drugs.
The amount of medication you currently take and for what .
People often don't think about needing drug coverage when they're young and healthy. It's just not on their radar. But actually, when you're in good health it's the best time to apply for coverage.
In the future, if you get diagnosed with a condition or wind up requiring medication for any other reason, you might not be eligible for a premium drug plan. Best to apply now, while you're young and healthy. Plus, premiums will be a lot lower.
It's also important to note, some drugs related to IVF treatments aren't actually considered to be fertility drugs. So in some cases, the drugs you need won't be covered.
Manulife, unfortunately, does not provide coverage for the actual in vitro fertilization treatments. But the good news is that their above-mentioned FlexCare plans can offer some breaks on the cost of treatment-related drugs.
Take Preventative Measures
With infertility rates rising higher each year, it's useful to know what causes infertility and what can be done to prevent it. There are some causes that are within your control and some that are not.
Infertility in women rises with age. To avoid having trouble conceiving, it's advised that women should start trying to have children before the age of 35.
Excessive tobacco and alcohol use can cause infertility in both men and women. With smoking in mind, for women, the toxic chemicals such as carbon monoxide, nicotine and cyanide in cigarettes have a direct impact on reproductive eggs. For males, vast differences can be seen in sperm density, sperm count and sperm motility. A healthy diet, regular exercise, and an overall healthy lifestyle can increase the chances of being fertile in both men and women. Canada's food guide was revised in 2019 and details on what is considered healthy eating can be found here.
A history of sexually transmitted diseases like chlamydia can also cause infertility in both men and women when left untreated for long periods of time. Being under or overweight can also have an impact.
In some cases, there may also exist things that are beyond your control. For men, low sperm counts and poor sperm quality can be genetic.
Chronic illnesses like diabetes and previous treatments for cancer including chemotherapy, radiation and some surgeries can have a negative impact on fertility in both men and women.
In some cases, taking preventative lifestyle measures and trying to conceive before the age of 35 is all you need. Some cases are a lot more complicated.
Are There Other Options?
For those who are not eligible for prescription drug coverage through Manulife's plans, or who cannot afford IVF treatments at all, there are a few other options to consider.
A portion of medical expenses related to IVF treatment can be claimed back through your federal income tax, of course depending on the province. Reimbursement amounts may vary based on your income tax bracket, province of residence and amount claimed.
Another way to ease the pain of paying upfront for IVF treatments is to find a clinic that offers financing options.
There are also non-profit organizations like Generations of Hope and Fertile Future who provide private grants to cover IVF for qualified patients. Fertile Future specializes specifically in helping people conceive who have suffered from cancer.
Effortless IVF in Calgary provides a natural alternative to traditional IVF treatments at around half the cost.
You could also consider crowdfunding. Some people have been able to raise money to cover their IVF treatments by starting a crowdfunding campaign to tell their story and solicit donations from their friends, family, and communities.
If you're at the point where you're considering IVF, you would have likely tried everything else. The cost of treatment alone might make you feel like you're at the end of the road, but there are other options for support.
Other Manulife Benefits
Manulife offers a variety of other health, dental, life and travel insurance plans extending beyond the need for prescription drug coverage. They also provide investment help and disability insurance.
If your employer does not provide suitable insurance plans for you and your family, it's worth considering shouldering the monthly premiums yourself. If you are an employer, Manulife offers many different options for group health plans.
While basic health care coverage is free in most parts of Canada, it does not cover things like accidental dental, physiotherapy or other expensive treatments that are necessary for the overall wellbeing of Canadians.
Nor does basic health care cover prescription drugs, unless you are over 65. Again, you might not think insurance is a big deal until you need it. Having proper coverage in place before you need it can end up saving you thousands of dollars.
Even Manulife's most basic FlexCare plans cover visits to naturopaths and dieticians, which can act as preventative measures for infertility and other illnesses down the road.
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Infertility rates are twice as high as they were in the '80s, and a lot of couples are now turning to in vitro fertilization treatments. But it's expensive and there are only 4 provinces that provide coverage or tax breaks on the actual treatment itself, and that's provided you are a resident.
If you're not in Ontario, Quebec, Manitoba or New Brunswick, you won't find assistance from the provincial government to assist with IVF costs. You'll have to foot the bill yourself.
Basic health care plans do not cover prescription drugs, and most prescription drug plans provided by private insurers don't include brand name fertility drugs.
Some Manulife benefits offer enhanced plans to cover a portion of IVF treatment-related fertility drugs.
The best thing you can do is take preventative measures by living a healthy, active lifestyle, go easy on the drinking and smoking and try to conceive before the age of 35.
Of course, we know it's not always that easy. Federal income tax breaks on medication, financing plans, and private grants could be other routes to consider if the cost of IVF treatment is out of reach.
We hope this helped to clear up some of the confusion surrounding IVF coverage in Canada. Check out our blog for more tips on how to choose the best Manulife benefits for you and your family.