Video Lesson
Experts you'll learn from
Financial Coordinator
Colorado Center for Reproductive Medicine NY
Director, Third Party & LBGTQ
RMA of Northern California
Written Lesson
Packages & Bundle Programs
Many clinics offer package programs or “guarantee” programs that allow you to bundle the cost of multiple cycles at a discounted rate per-cycle.
When a fertility patient buys a package of treatments, she is purchasing cycles and transfers in bulk, up-front, at a discount to what she’d pay for each treatment individually. She *does not get money back for cycles she does not use. *
Since many patients require more than one cycle to be successful, this can be a potentially helpful option; however, many patients end up “leaving money on the table” because they use less than the full amount of services they paid for. In one FertilityIQ survey, two thirds of patients succeed on their first retrieval, and over half succeed on the first transfer from that first retrieval.
Bundles can come in many forms and combinations and below we provide some generic examples. Let’s presume a typical retrieval and lab services cost ~$15,000 and each transfer costs ~$3,000.
1-Cycle Bundle
Patient pays $20,000 for one retrieval with access to unlimited transfers.
If they succeed on the first transfer, they overspent by $2,000 because the retrieval and one transfer (as mentioned above) would otherwise cost $18,000. If they use 3 transfers, they saved $4,000, because that retrieval would have cost $15,000, and the three transfers would have cost a combined $9,000.
We should note that we’re being simplistic here and are ignoring whether a patient might be paying a la carte for other expenses like monitoring, anesthesia and the like—for convenience, we’re lumping these together in the “retrieval” costs.
2-Cycle Bundle
The patient spends $25,000 for two retrievals and two transfers that would ordinarily cost $36,000 (two retrievals at $30,000 plus two transfers at $6,000).
If they succeed on the first transfer of the first retrieval, they overspent by $7,000 ($25,000 minus $18,000). If they require a second retrieval and transfer they saved $11,000 ($36,000 minus $25,000).
3-Cycle Bundle
The Patient pays $35,000 for three retrievals and three transfers that would ordinarily cost $54,000 (three retrievals at $45,000 plus three transfers at $9,000).
If they succeed on the first transfer of the first retrieval, they overpaid by $17,000 ($35,000 minus $18,000). If they require a third retrieval and transfer, they saved $19,000 ($54,000 minus 35,000).
3-Cycle Bundle With 100% Refund
Essentially, this package has the same dynamics as above, but if after three cycles they do not succeed, they receive their money back. In this situation, the patient received $54,000 of treatment (three cycles and three transfers) for nothing (that is, aside from the money spent outside the program like the cost of medications, which we'll explain below).
In theory, this patient has been compensated for the worst possible outcome (no baby) with the most possible value (lots of free treatment). This is why refund programs are unique.
Questions to Ask When Considering Bundles & Packages
Package and bundle programs contain a fair amount of fine print often containing details within the clauses that help make it worthwhile for clinics to go “at risk” in offering such programs. As a result, you’ll want to probe on a few details.
Eligibility Criteria
While clinics often advertise bundles and packages to entice prospective patients to learn more about the clinic, often only a small subsegment of patients will be deemed “eligible”. Often patients over a certain age or body mass index are denied access as are people who've previously miscarried, who’ve been unsuccessful in previous treatments, or who are deemed to have concerning blood work levels. In many ways, the patients who’d benefit most are prohibited from accessing these programs.
In the eyes of some, if a clinic refuses you access to a program, it’s a sign they’re skeptical they can deliver good results quickly. Conversely, if a clinic allows you into a program, it may reflect higher confidence you’ll be successful early in treatment (and thus may not need to be in a program).
What Counts as “Success”
Access to more treatment within the bundle ends once a patient is “successful”. For most of us, “success” means bringing home a baby. However, it’s in the clinic’s (or the third party who oversees the program) favor to define success in lesser terms, namely a “positive beta”, “pregnancy”, or “pregnancy through the first trimester”. As you can see below, lesser definitions of success are common. These details are important because, unfortunately, 10%–30% of IVF pregnancies do not culminate in a delivery.
Exclusions
The reality is most bundle or package programs do not cover any more than roughly half the costs patients will pay in any given cycle. Drugs and add-ons (e.g. ICSI which is used in 80% of cycles and costs $3,000–$5,000 extra) are often left out of the equation. Therefore, committing yourself to larger bundles with more cycles often means larger outpays than what’s advertised. Pushing your clinic to include more add-ons (e.g. ICSI, PGT biopsy) can be worthwhile.
Duration
Many bundle and package programs have expiration dates by which, if treatment isn’t used, it's forgone. These timelines can be as short as a year which is problematic because it's common for patients to take a break and regroup after a failed cycle or resume treatment based upon work or travel schedules. Generally speaking, it’s useful for patients to request a longer period for when treatment can be used.