Egg donation is a process where a woman donates her eggs (oocytes) to help someone else conceive a child. The medical procedures are usually smooth, but sometimes medical complications can arise, which leads to the question of who pays for unexpected medical expenses of the donor. This is where egg donor insurance, sometimes referred to as an Oocyte Donor Insurance Policy or ODIP, comes into play. In this blog, we discuss what ODIP is, what it covers, and when it should be purchased, as well what caps on out-of-pocket medical expenses.
What Does ODIP Cover?
An ODIP covers any complication that may stem from undergoing the egg donation procedure. This includes infections, lesions, overstimulation, adverse medication reactions, and any complication whereby the donor would need treatment at an emergency room, urgent care, or doctor's office.
ODIP is strictly for egg donation complications. ODIP does not cover routine aspects of the egg donation process such as monitoring, retrieval procedures, or medication costs. These routine expenses are typically paid for by the intended parents directly. ODIP is there to step in if something goes wrong medically after the donation.
Why Do IPs Buy ODIP?
The fact that there is a specialized and affordable insurance that covers egg donation complications is a big benefit for egg donors and intended parents (“IPs”), especially when general medical insurance policies can only be obtained certain times of the year and may be more expensive.
The purpose of having an ODIP is to cover any medical complications that might arise during the egg donation process and allow intended parents to limit their out-of-pocket exposure. While most egg donations proceed without issues, complications may occur, and these can lead to unexpected medical bills. By having ODIP, IPs can ensure that these potential costs are covered for the egg donor.
Even if the donor has her own medical insurance, it's common for IPs to purchase an ODIP policy. There are a couple reasons: (1) The parties do not need to worry about whether the private insurance will cover egg donation complications. The ODIP can be the first insurance to cover any medical expenses; (2) Private insurance may take a long time to process a claim, leaving the donor with the medical expenses months later, long after the escrow account has closed and it may be difficult to make the intended parents pay the bills. Having ODIP ensures that any potential complications during the egg donation process are covered regardless of the private insurance.
How Long Does ODIP Cover For?
The policy is good for four months OR one cycle of medication. If a new cycle of medication needs to be administered, then a new policy must be purchased even if it is in that four-month coverage period. This is due to a claim needing to be traced back to a medication cycle.
When is ODIP Typically Purchased?
ODIP insurance should be purchased at least 3-5 business days prior to the medication start date. If a start date isn't known, but a policy must be put in place, you may enter in a tentative start date and when a proper start date becomes clear, you may adjust the date if medication has not been administered. This ensures that the donor is protected from the start, and any potential complications can be addressed promptly without financial stress. IPs often coordinate with their fertility clinic or agency to arrange this coverage ahead of time.
What Out-of-Pocket Expenses Could IP Be Responsible For?
ODIP policies have typically covered up to $250,000 for medical complications arising from the egg donation process.
Egg donation contracts with ODIP provisions will have a limit to the out-of-pocket intended parents are responsible for. This limit ensures that even if complications occur, IPs are only responsible for a predetermined amount of medical expenses beyond what ODIP covers. The exact limit will depend on what the two sides and their attorneys agree to. The Intended Parents should speak with their agency or broker about what expenses could fall outside of the policy.
While it is unlikely that there will be medical expenses outside of ODIP, Intended Parents will benefit by having a monetary limit on potential medical expenses in the egg donation agreement and know they will not be responsible beyond the limit.
Conclusion
In conclusion, having an ODIP is a good idea and offers protection for both the donor and IPs in the egg donation process. To purchase an ODIP or learn more about the plans, contact an insurance broker that specializes in third party reproduction. Your agency or lawyer can refer you to a company that offers these plans. They may be surprisingly affordable given the amount of coverage. If you have questions or need assistance with drafting or reviewing an egg donation agreement, contact us now.
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