Alyssa Lane
Fertility apps are used by people trying to conceive and those trying to avoid pregnancy. They offer features such as tracking menstrual cycles, predicting fertile windows, and providing communities for support. The market for women's health apps, including fertility apps, was expected to reach $3.9 billion by 2026. While the apps are not 100% effective for contraception, they are still used by many. In terms of insurance coverage, fertility apps are not typically covered by private insurance plans or Medicaid programs as they are not considered medically necessary. However, as of 2021, Maryland, Illinois, and Washington, DC, cover birth control apps across their Medicaid eligibility pathways. Additionally, some states have laws requiring certain health plans to cover infertility treatments, which may include fertility apps. The cost of fertility treatments can be high, and insurance coverage can be a determining factor in whether individuals can afford fertility treatments.
| Characteristics | Values |
|---|---|
| Fertility Awareness-Based Method (FABM) training covered by insurance | As of December 2022, a federal court rejected the Biden administration's attempt to end insurance coverage for FABM instruction. |
| States covering birth control apps | As of 2021, only Maryland, Illinois, and Washington, DC, cover birth control apps across their Medicaid eligibility pathways. |
| States requiring coverage of fertility services | 15 states have laws requiring certain health plans to cover at least some infertility treatments. |
| States with mandate to offer | California and Texas require group health plans to offer at least one policy with infertility coverage, but employers are not required to choose these plans. |
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What You'll Learn
Fertility awareness apps as birth control
Fertility awareness apps are designed to help women track their menstrual cycles, identify their fertile windows, and predict their next period. Some apps also provide a community where users can interact with each other or receive advice and insights from trusted reproductive health experts and professionals. These apps can be used as a form of birth control by helping women identify their fertile and infertile times in their cycle. However, it is important to note that fertility apps are not 100% effective for contraception and should not be relied upon as the sole method of birth control. Additionally, people with irregular cycles or certain health conditions may experience reduced accuracy.
When choosing a fertility app, it is important to consider the level of data privacy offered by the app. Some apps require users to input identifying details such as their birth date and email address, while others allow for anonymous use. It is also important to note whether the app shares data with third parties and how the data is stored. For example, the Euki app does not store user data with a third party, instead saving it locally to the user's device. However, this means that if a user forgets their PIN, they will need to start over as Euki cannot recover their data. Other apps, such as Clue, are subject to strict EU privacy laws and will not disclose data to American authorities, but they do require users to create an account and store data with a third party.
The cost of fertility apps varies, with some offering free versions and others requiring a paid subscription. For example, Clue offers a free version as well as a paid version called Clue Plus, which offers more features and data. It is worth noting that fertility awareness-based methods (FABMs) may be covered by insurance as preventive care. However, there have been attempts to end insurance coverage for FABM instruction, and it is not clear whether fertility apps would be included in such coverage.
Overall, fertility awareness apps can be a helpful tool for women who want to track their fertility and use that information to prevent or plan for pregnancy. However, it is important to use these apps in conjunction with other contraceptive methods and to prioritize data privacy when choosing an app.
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Insurance coverage for apps
Fertility treatments can be extremely expensive, with a single cycle of IVF costing up to $30,000 without insurance coverage. Many fertility treatments are not considered "medically necessary" by insurance companies and are therefore not typically covered by private insurance plans or Medicaid programs. However, some states have laws requiring certain health plans to cover at least some infertility treatments. For example, New York requires large group health plans to cover up to three IVF cycles and prescription medications, while Colorado mandates that individual and group health benefit plans cover infertility diagnosis, treatment, and fertility preservation for iatrogenic infertility.
The market for women's health apps, including fertility tracking apps, was projected to reach $3.9 billion by 2026. While fertility apps can be a helpful tool for family planning, they should not be solely relied on as a method of contraception. As of 2021, only Maryland, Illinois, and Washington, DC, cover birth control apps across their Medicaid eligibility pathways. Medicaid coverage for apps may depend on whether the app is considered over the counter (OTC) or prescription, as coverage for OTC contraception varies by state. Federal guidance from 2022 states that most private insurance plans and Medicaid expansion state programs must cover any prescribed "FDA-approved, cleared, or granted contraceptive product."
The Affordable Care Act (ACA) has recognized Fertility Awareness-Based Methods (FABMs) as valid family planning methods and requires insurance coverage for instruction in these methods. However, there have been attempts to remove this coverage, which would impact couples seeking family planning advice and women needing infertility diagnosis and treatment. In December 2022, a federal court rejected the Biden administration's attempt to end insurance coverage for FABM instruction, demonstrating the ongoing legal battles surrounding insurance coverage for fertility apps and treatments.
Some popular fertility apps include Euki, Clue, Period Tracker, Flo, Stardust, and Natural Cycles. These apps offer features such as menstrual cycle tracking, fertile window predictions, and support communities. While some apps are free, others charge a subscription fee, such as Natural Cycles, which costs $99.99 per year. It's important to note that the effectiveness of fertility apps can vary, especially for those with irregular cycles or certain health conditions. Additionally, data privacy is a concern, as some apps store user data with third-party remote servers.
Overall, the insurance coverage for fertility apps and treatments is complex and ever-evolving. While some states have made strides in mandating coverage, there is still a long way to go to ensure equitable access to fertility treatments and family planning methods for all. Employers are also recognizing the importance of comprehensive fertility benefits to attract and retain employees, especially among younger generations. As healthcare costs continue to rise, individuals seeking fertility treatments or using fertility apps may face significant financial burdens, especially if insurance coverage is lacking.
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The Affordable Care Act (ACA) and fertility awareness apps
The Affordable Care Act (ACA), signed into law in 2010, requires that private payers provide FDA-approved contraceptive methods, sterilization procedures, and patient education and counselling for persons with reproductive capacity without copayment or other cost-sharing requirements, with limited exemptions. The law also requires that plans cover, at no cost, at least one form of contraception within each of the contraceptive categories identified by the FDA.
In 2016, "instruction in fertility awareness-based methods" was added to the list of "preventative care and screenings" for which the ACA prohibits insurers from imposing cost-sharing measures on patients. This gave women and couples more choices for family planning and provided women with access to an important tool for monitoring their health. However, in December 2022, a federal court rejected the Biden administration's attempt to end insurance coverage for FABM instruction. The current attempt to take FABM instruction away from ACA insurance coverage is a step backwards, especially considering that fertility treatments are often not considered "medically necessary" by insurance companies and are therefore not typically covered.
Fertility apps are a type of fertility awareness-based method that can be used to track menstrual cycles, predict fertile windows, and provide communities for support. Some popular fertility apps include Euki, Clue, and Period Tracker. These apps can be helpful for people who are trying to get pregnant or avoid pregnancy by timing sex or insemination according to their goals. However, it is important to note that fertility apps should not be relied upon as a sole method of contraception, as they are not 100% effective and may be less accurate for people with irregular cycles or certain health conditions.
While the ACA has helped improve access to reproductive health services, there are still concerns about ongoing access in the wake of the Dobbs decision. For example, the administrative burden of prior authorization continues to be a point of concern for clinicians, especially with the confusion around the legality of abortion services in several states.
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Medicaid coverage for apps
Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage to millions of Americans. This includes low-income people, families and children, pregnant women, the elderly, and people with disabilities. Each state has its own eligibility requirements, which often consider income, household size, family status, disability, age, and other factors.
In general, fertility treatments are not considered "medically necessary" by insurance companies and are therefore not typically covered by private insurance plans or Medicaid programs. However, a handful of states require coverage of fertility services for some fully-insured private plans, and some states have laws requiring certain health plans to cover at least some infertility treatments. For example, in 2019, New York passed a bill to require IVF and fertility preservation services for comprehensive private health insurance policies.
In terms of fertility apps, it is important to note that fertility awareness instruction is considered preventive care and was previously covered by insurance in the same way other family planning methods were. However, there have been attempts to end this insurance coverage for fertility awareness-based methods (FABMs). As of December 2022, a federal court rejected the Biden administration's attempt to end this coverage, but it is unclear if this decision will be permanent.
Therefore, while there is no guarantee that fertility apps will be covered by Medicaid, it is possible that they could be considered under the umbrella of fertility awareness instruction or preventive care. It is recommended to check with your specific state's Medicaid agency and insurance plan to determine if fertility apps are covered.
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Fertility apps and personal data
Fertility apps are mobile apps that help consumers track their menstrual cycles, ovulation, fertile windows, and stages of pregnancy. They are often used by people who are trying to conceive, as well as those trying to avoid pregnancy. Fertility apps collect sensitive and intimate data, including information about users' cycles, health, pregnancies, and sex lives. This data is often kept for long periods, shared with other companies, or sold to third parties, raising concerns about data privacy and the potential for re-identification and data breaches.
The handling of personal data by fertility apps has come under scrutiny due to potentially misleading privacy policies and settings. While some apps claim to protect user privacy and not sell data, the fine print may allow them to share or sell data to other companies or advertisers. For example, popular apps like BabyCenter, Glow, Ovia, and What to Expect have been found to collect extensive personal data, including information from data brokers and third-party sources, and allow user tracking and data sharing with advertisers.
It is important for users to carefully review the privacy policies and terms of use of fertility apps before providing their personal data. Some apps, like Euki, prioritize data privacy and allow users to access the app without creating an account, storing data locally on the user's device instead. Clue, a fertility app based in Germany, is subject to strict EU privacy laws, providing additional data protection for its users.
While the monetization of data by fertility apps is a concern, it is also worth noting that fertility treatments can be expensive, and insurance coverage for these treatments varies. In the United States, certain states have laws requiring health plans to cover at least some infertility treatments, but many fertility treatments are not considered "medically necessary" and are not typically covered by private insurance or Medicaid. As a result, individuals may turn to fertility apps as a more affordable option, despite the potential risks associated with data privacy.
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Frequently asked questions
Yes, fertility awareness apps are considered family planning methods.
Fertility awareness apps are covered by insurance as preventive care. However, this may change in the future.
Fertility awareness apps are not always free. For example, a Natural Cycles subscription costs $99.99 a year.
Yes, Euki is a free fertility awareness app that does not store your data with a third party.
If your insurance claim is denied, you can appeal the decision. You may also be able to request an independent external review of the denial.
