Ep 262: Making IVF Affordable: Future Family’s Innovation in Fertility Financing and IVF Insurance

In this episode of Fertility Docs Uncensored, your hosts Dr. Carrie Bedient from the Fertility Center of Las Vegas, Dr. Abby Eblen from Nashville Fertility Center, and Dr. Susan Hudson from Texas Fertility Center are joined by Claire Tomkins, CEO and Founder of Future Family. Together, they discuss innovative ways to make fertility treatment more financially accessible and less overwhelming.

Claire shares insights into the financing options Future Family provides, designed to ease the financial burden of fertility care. She also highlights the emotional support services available to help patients navigate the challenges of their fertility journey. Additionally, Claire introduces Future Family’s groundbreaking IVF insurance product, which aims to give patients greater flexibility and peace of mind during treatment.

Tune in to learn about how these resources can help make your fertility journey smoother, more affordable, and better supported. Let’s dive in!

Transcript

Susan Hudson (00:01)

You're listening to the Fertility Docs Uncensored podcast, featuring insight on all things fertility from some of the top rated doctors around America. Whether you're struggling to conceive or just planning for your future family, we're here to guide you every step of the way.

Susan Hudson MD (00:22)

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Susan Hudson MD (01:03)

Hello everyone, this is Dr. Susan Hudson from Texas Fertility Center with another episode of Fertility Docs Uncensored. I am here with my amazing co-host, Dr. Carrie Bedient from Fertility Center of Las Vegas.

Carrie Bedient  MD (01:16)

Hey everyone!

Susan Hudson MD (01:18)

and Dr. Abby Eblen from Nashville Fertility Center.

Abby Eblen MD (01:21)

Hi guys, how you doing?

Susan Hudson MD (01:23)

and we are so excited to have Claire Tomkins here with us today. How are you doing, Claire?

Claire Tomkins (01:29)

Great to be here, doing well. Thanks so much, Susan.

Susan Hudson MD (01:33)

Absolutely. She is the founder and CEO of Future Family and we're going to dive into that in a little bit. Before we started recording, we started talking about hobbies and things that we dive into and we never expected to find to be fun. And I understand you have become quite a pickleball aficionado.

Claire Tomkins (01:54)

Oh My gosh, Susan, I love that you're bringing up like my other love besides working on fertility, which is playing pickleball. It's true. I got into this a few years ago, kind of by accident. It was part of a, just a team offsite. And I discovered that it is, in my opinion, one of like the most fun sports. And what's amazing is that my seven year olds, all the way to, you know, members, other members of the family, their grandparents can all play.

It's super fun. It's super fast moving and it's kind of become all the rage in, um, well, I think across the U S I, I certainly need to discover this. It was already like trending by the time I got involved, but it is super fun. If you haven't tried it, I highly recommend.

Abby Eblen MD (02:26)

Yeah, everywhere I think.

Susan Hudson MD (02:35)

So how competitive are you in pickleball? I recently met somebody who is like pretty high. They were wanting to like climb the ranks.

Claire Tomkins (02:43)

I know. that's the funny thing is like that it's not just pickleball. Unfortunately, it's like even my husband will no longer play Scrabble with me because I'm apparently too competitive. It's like it's just a game, Claire. Like doesn't matter. Like I'm like, that's not what the Scrabble dictionary. You can't play that. So I think it's not just a pickleball problem, but I am fairly competitive on the court. And I've been told I had to tone it down for when we have the parents social.

Susan Hudson MD (03:07)

So Abby or Carrie, do either of you play pickleball?

Claire Tomkins (03:10)

Yeah, has anyone else been on a pickleball court or am I the only one out here?

Abby Eblen MD (03:11)

I've actually played it. used to play tennis. I'm not, I'm not athletic at all, so I'm not very good. But the one thing I did realize about pickleball that just like what you said, my son who's 22 is very competitive. and you know, He's the kind of kid that he likes to do stuff. And so he's like, mom, let's go play pickleball. And it's really fun because I can be pretty competitive with him because the court is so small. It's a lot smaller than a tennis court. So I love it. It's really fun. I like it a lot. huh.

Claire Tomkins (03:38)

It's really good exercise. It's never like never dull or like a slow moment. Yeah, we recently had a huge thing with a big family with a huge Thanksgiving get together and we literally we had everything from the five year old up to the grandparents on the pickleball court like everyone having fun. So it's good. The theme of like our talk today. It's good family fun.

Carrie Bedient  MD (03:59)

So I always think of pickleball as exactly what it sounds like, where you've got these little paddles that are like ping pong paddles, and then you have these giant dill pickles that you are pulling across, and I don't know why that's happening.

Claire Tomkins (04:16)

Well, there are pickles involved when we play because whoever is the runner up gets a large jar of dill pickles. But the actual paddles look and feel a lot to me like ping pong paddles, only a little larger in terms of their surface area.

Abby Eblen MD (04:35)

They're really short though, because it's like you, like with the tennis racket, you can reach really far, but you find pretty quickly with a pickleball racket or whatever you call it, you can't reach that far. So you have to actually run over to the ball a lot quicker.

Susan Hudson MD (04:48)

A little piece of trivia, pickleball is actually named after somebody's dog named Pickle.

Abby Eblen MD (04:53)

Really? That is some trivia, Susan.

Claire Tomkins (04:56)

A trivial pursuit question right there.

Abby Eblen MD (04:58)

Yes.

Carrie Bedient  MD (04:59)

Yeah, I like that.

Susan Hudson MD (05:02)

All right, well, let's do a question real quick and then we'll dive into our topic. So our question today is, we've been trying to conceive for over a year and all labs are normal. I'll spare you the numbers. I'm on round three of letrozole 2.5 milligrams and I randomly decided to Google, does saliva hurt conception? With an answer of an overwhelming yes, I feel so defeated and hopeful at the same time.

I have a BS in biochemistry, I've taken plenty of human anatomy, human science classes, and I've never in my education or medical history ever been told this. Why isn't this something that doctors mention? I've been consistently seeing my OB and the same person for the follicle ultrasounds and no one has mentioned anything like this.

Abby Eblen MD (05:53)

I'm totally confused what she's talking about with saliva. is she talking about? Where is it?

Carrie Bedient  MD (05:58)

Are we?

Susan Hudson MD (05:58)

I think she's talking of as a lubricant.

Carrie Bedient  MD (06:01)

Like nobody's tongue is that long for this to be a functional problem. If it is that long, get some genetic carrier screening.

Abby Eblen MD (06:05)

No, yeah, I don't know where she's hearing that.

Susan Hudson MD (06:11)

Well, okay, okay.

But honestly, if somebody is going to go do a collection for a semen analysis, all of our andrologists are going to say you can't use any lubricant or you have to use special lubricant and don't use saliva because saliva does have properties where it breaks down proteins. And so it can theoretically impair sperm function.

Abby Eblen MD (06:42)

See, I think that's more contamination. If you're doing an IUI, you don't want to get saliva contamination up inside the healthy environment of uterus that doesn't have any germs. I've never thought about it breaking down the sperm. I've never heard that before.

Carrie Bedient  MD (06:55)

So I understand why the KY jellies and the other like actual lubricants, the oils, they don't want them to use because those are thicker and they're more viscous. And when you put them on, they don't necessarily dry up or move. And so anything that's got to travel through them, like a jet of ejaculation fluid, is going to potentially get a legit contamination. I don't understand, like saliva, there's a lot of a lot of saliva there. Like it's just not, it's not gonna stick and it's gonna evaporate very quickly. And I just, I'm really failing to see how it could potentially break down enough of those proteins because it's not like, I mean, what, do you guys remember what speed sperm flies out of the penis at? Like, I don't remember off the top of my head, but it's phenomenally fast.

Abby Eblen MD (07:32)

Yeah, me too.

Really fast.

Yeah, like a sneeze.

Susan Hudson MD (07:46)

Yes, and the sperm that are actually making it are up inside your uterus.

Abby Eblen MD (07:51)

Lickety spirit, no pun intended.

Carrie Bedient  MD (07:51)

Yeah. So I, I just don't know. I don't know. I looked it up super quick in my highly technical Google search and 28 miles per hour is the speed of. And so I'm, I don't know guys. I don't know that this is real. I think it's real.

Abby Eblen MD (08:10)

That's pretty fast.

Claire Tomkins (08:18)

So you mean that like the fact that no one brought this up to this patient is legitimate? Like why would you bring it up? Cause it's just not an issue. like The fact that she's asking, like, well, why wasn't it brought up? It's like, Well, probably wasn't brought up cause it's kind of a non-issue.

Abby Eblen MD (08:25)

Yeah. Right, yes.

Carrie Bedient  MD (08:32)

Yeah, it's kind of like telling someone, you know, hey, that skyscraper, don't jump off that. We weren't going to do that anyway. It was going to make a difference. Yeah, it's just, you know, don't sit on the elephant in the middle of the room. It's not going to happen.

Abby Eblen MD (08:32)

There you go.

Hahaha

Susan Hudson MD (08:47)

What would probably also be more helpful is I'm assuming since you said all of your testing was normal and all of those types of things that you're probably ovulatory. And so what probably is the biggest message here for me is that taking medications to ovulate or super ovulate when you already ovulate and not using those in combination with insemination and only using them in combination with timed intercourse really doesn't change your chances of pregnancy all that much. Now if you don't ovulate, that's a whole different ball game. But if you're ovulatory and you're just taking letrozole or Clomid and using that with timed intercourse you're not doing that much that's actually forwarding your cause. So I would recommend potentially kind of kicking things up a notch, potentially using insemination to bump up those statistics.

Carrie Bedient  MD (09:41)

Can I ask our listeners more questions like this? This is, well this is one of the things.

Abby Eblen MD (09:44)

We haven't had a question like this in a while, have we?

Claire Tomkins (09:48)

Well, wait, but also didn't the question start with didn't was the beginning saying like it had been two years?

Abby Eblen MD (09:53)

Greater than a year, I think is what she said. Yeah.

Carrie Bedient  MD (09:54)

It would been more.

Claire Tomkins (09:55)

Oh, maybe greater than a year, because I'm also just thinking like at some point you probably start to recommend wanting to consider moving to IVF, which is significantly more effective than using IUI. So maybe that's another part of this is just like, I mean, we see a lot of patients who struggle or even do IUI because it's less expensive. And, you know, I work a lot on the financial side, but it's less successful. you're like, wait. And obviously from a woman's perspective, it's more like you have a goal in mind. So you don't want to do like, successive rounds of IUIs that fail and you're not getting anywhere when IVF could have a much higher chance of success. So that feels like it's part of the equation here is like, you know, six months to a year of trying, maybe you're an IVF candidate.

Abby Eblen MD (10:30)

Absolutely.

Susan Hudson MD (10:36)

Well, she also mentioned that she's working with her OB. So I would also say this is probably the time to a reproductive endocrinologist, get the full evaluation, because even though I'm sure you've had some testing, it's very rare for you to go from an OB straight to an REI and there being no additional testing that your REI wants to have. We have usually more little tools and tests in our bag of tricks that we can help you kind of really dig into seeing.

Is there something else going on that is not self-evident at this point in time?

Claire Tomkins (11:09)

Yeah.

Carrie Bedient  MD (11:11)

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Carrie Bedient  MD (11:38)

So going from that discussion to this next one, Claire, what you've had some fertility experience that kind of, I think, led to and fed where you are now. So what was your experience that landed you in the fertility world?

Claire Tomkins (11:56)

Yeah, I mean, it's funny. I just realized this as we were talking, but I think that you can actually sort of see the evidence in the background here, like my kids' school pictures. So that's exactly right. I, unlike the three of you who obviously went through years and years of medical school with an intention to get into fertility and help more patients successfully build their families, mine was a different journey altogether. I got into the space by having stood and been in those patient shoes. So I was, you know, probably a story that's become more common across the US. think 2016 was the year on record that more women gave birth in their 30s than their 20s. So it's kind of like one of those Malcolm Gladwell, I know we're doing a lot of trivial pursuit today. I love it. But it's kind of like a Gladwellian tipping point, right? On the scale of human history, women start giving birth in their 30s instead of their 20s. I was in that category. But, you know, I didn't expect that I would have any fertility troubles because I still thought of myself as relatively young and energetic. And I went through six rounds of IVF to conceive my daughter Natalie. And that was quite the journey. But since then, I've really gotten perspective because I've maybe not seen it all and heard it all. You probably have, but I've certainly seen really long journeys. But then I've also seen the success rates improve in IVF. And I find that extremely hopeful. So now we're seeing many couples be successful, at least after their third round, if not sooner.

That's been an amazing thing about working in this industry is seeing how it's progressing, seeing as how more couples can be successful. And I do have three IVF kiddos. I have my daughter, Natalie, and I have IVF twins. So that's how I got into this space. Having been in the patient shoes, my whole background for many years has been in finance. worked in consumer finance across different sectors. And one of the things I've become really passionate about is how to take some of the financial stress out of something that is already stressful emotionally and physically. And so that's the angle at which we come at things at Future Family.

Susan Hudson MD (13:46)

That's awesome. That's awesome. So tell us a little bit about Future Family in kind of the big perspective. How long have you been around? What do you do in the fertility space?

Claire Tomkins (13:58)

Yeah. So this is actually our eighth year as a company. So we've been running the business for eight years. My daughter, Natalie is nine, started the company when she was one years old. And our primary focus again has been on how to support patients. So we really think of ourselves as working with physicians like all of you and providing health like part of the other side of the equation, which is both financial as well as like digital coaching and care resources.

So our platform is patient facing works in conjunction with your clinic and we do several things for patients. We do, as I mentioned, provide digital care and coaching because we find that patients often have questions as they go through this journey and medical questions go to their doctor, but sometimes after hours questions that are more like psycho emotional support can come to us. And then in addition to that, we offer the financial products and services that hopefully again, relieve some of the stress. So we are the largest today financing company for fertility in the US. We've extended over 200 million in credit to American families. We've helped support over 10,000 patients. It's really a passion of ours that we think paying for fertility upfront for most families is not the right decision. So we offer super flexible financing plans. It started just a few hundred dollars a month and we offer them for IVF as well as egg freezing. And so you can really start your family without having to drain your savings or undertake significant debt or credit card, we actually offer this unique product for that. So that's been a lot of what we do. And then obviously today we're also excited to talk about a new area that we're getting into.

Susan Hudson MD (15:28)

Well, let's talk a little bit about coaching. We'll talk a little bit about kind of your historic products, then we'll hop into the new stuff.

Claire Tomkins (15:32)

Yeah, absolutely. Yeah. So the really the first product that we launched on the platform was a combined financial product with built in digital care and coaching. So again, very informed by the patient experience. So everyone who decides that they want to finance their fertility through Future Family gets basically a very flexible financing plan. Building your family is actually the fourth largest expense in the U S right. So it's your mortgage, your auto, your education and your family. So we've become the specialists in family building loans.

And again, it's much better than draining 25 to 30 K out of your savings. And we'll finance you up to $50,000 to start your family. So again, for a few hundred dollars a month, you know, know, when this is happening, it's happening to us in our late twenties, early thirties, early forties, we're trying to also buy a home and do a lot of other things. So there's a lot of reasons you'd want to finance your fertility. And where we came into this market was we noticed that there were only those sort of generic solutions. You could go to a bank, but it was kind of a cumbersome process or you could go online, but they didn't really understand fertility. So we ended up saying, wait, these are families. Families should get low interest rates. Families should get a lot of perks. And furthermore, we should make it easy for families to pay for their fertility by funding it direct to the clinic and the pharmacy. So now someone can get one monthly financing plan, and we actually send funds directly to the clinic and the pharmacy and so forth. So you kind of only ever pay one medical bill. Again, having been a patient, I remembered that it was stressful to have to go to the clinic and I wanted to see my doctor, I wanted to Carrie, I wanted to see Susan, but I would have to like offer up my credit card upfront. So we've solved a lot of that with this very seamless kind of payment integrated coaching solution. Yeah.

Abby Eblen MD (17:11)

Hey, Claire, I'm curious and I have no business background. No one ever told me to take any business classes when I was in college. So if I wanted to have this financing plan, like what would it mean in terms of dollars and cents? And I'm sure it's different for different people, but if you're 20 something and I'm much older than that and I still, that would be overwhelming to me a little bit too. So tell me kind of what you tell patients when they contact you and kind of what kind of money per month this would cost or how you ask them to pay it.

Susan Hudson MD (17:42)

And what's the process?

Claire Tomkins (17:44)

All great questions, but that's exactly right. And I think that's also where I spend a lot of my time is doing education and trying to take the stigma out of like, of course it's such a big expense. You wouldn't think to pay it upfront or you wouldn't think to pay cash or use a credit card. So that's exactly right. It's, you know, The process is quite simple. You come to futurefamily.com and you go through a digital online application.

It says get started, and as you would imagine, it just pulls in a little bit of your personal information, like your name, your address. It'll ask you what clinic or doctor you're working with, right? So you go through a short online application designed to take less than two minutes. You fill it out, and then you'll get your options on financing for fertility. And know, 85 % of Americans finance their car. 89 % of Americans finance their home. This is the fourth largest expense.

We highly recommend financing because again, draining your savings leaves you very exposed at the moment you're starting a family. And putting on a credit card is really like the worst solution. And we see it a lot because now you're hurting your credit score. You're unlikely to pay off that large amount for some time and you're paying really high interest. Sometimes it can be double digits, super high. So an easy financing plan will allow you to usually pay anywhere from 350 to 500 a month. Those are the average kind of ranges.

Can be a little bit more, a little bit less, but that's usually a manageable monthly payment. We offer a five year, 60 month term, but you can prepay at any time with no penalty. So you get this real flexibility that you can start your family for an affordable or budgetable line item. If you decide to pay off your plan early, you're not facing any penalties. And we've found that for the couples and patients who've been able to help, it takes out a lot of the stress, lot of the financial stress. And if you need a second cycle, very common, we're going to talk about that. We can finance you up to $50,000, which is really truly like a family starting loan.

Susan Hudson MD (19:38)

Do y'all have any options for people who are needing to go above and beyond that? People who are needing gestational carriers and things like that.

Claire Tomkins (19:48)

I'm so glad you asked that Susan. mean, We're working on that very actively. So my goal with the company just in general has been to be able to offer financial solutions to all pathways to parenthood. So I'm very hopeful, you know, I'm sure we'll talk again. I'm very hopeful that we'll be able to expand those credit lines even more, you know, even larger. We've done a lot of work. We used to only finance credit scores above 680. We've been able to expand the market. We now finance 620 and above.

giving a lot of flexibility to consumers no matter where they are in that kind credit building and family building journey. So we continue to really focus on those types of solutions.

Susan Hudson MD (20:22)

What are other criteria other than credit scores that are required to participate in something like that, like US citizenship, job status, things like that?

Claire Tomkins (20:31)

Yeah, great questions. I it's designed to be the most flexible and open program for patients in the US. We do require that you at least have a visa that is good for the duration of the time that you're considering paying back this loan. But certainly, residency is sufficient. We've helped lots of couples. Maybe they're in the US on a visa. That's completely acceptable to us.

That's right. I you'll go through a standard application for credit. So it helps if you have obviously income, employment. But many of these are the things that you absolutely have if you're considering starting your family, right? And where we've been able to really innovate is by offering really affordable plans and low interest rates because we really understand this consumer. We have been this consumer. It's great, right? It's like families, you know? So we're able to talk to our bank partners and say, look, these are people we want to be lending money to and starting more families in the US.

Susan Hudson MD (21:24)

Absolutely. All right, so drum roll. We want to hear about what's new at Future Family.

Claire Tomkins (21:30)

Amazing. Well, I'm so excited to talk about this. It's one of the first times I've had a chance to really talk about our new product line. And it's been like a personal passion of mine. So we will be introducing the first ever nationwide IVF insurance. this is another financial product, I think, based on my background, this has been something I'm very passionate about innovating in the space. And IVF insurance is kind of like what it sounds like, which is the good news.

If you are not successful after two cycles of IVF and you're carrying IVF insurance, you can make a claim on your IVF insurance policy and it will be refunded to you. So we are aiming to effectively cap the cost of IVF success in two cycles. So the couples will have funds to pursue additional treatment if they need it. And you know, cause I just told you at the top of the show that I actually ended up going through six rounds, which is less common these days. It's more successful than it was a decade ago. But nonetheless, I know from firsthand experience what that is like.

Carrie Bedient  MD (22:33)

So how does someone qualify for this insurance? Because there are some people where you would look at it and say, okay, this is a good bet because she's 25, she's got blocked tubes, he doesn't have sperm problems, like this is a slam dunk. And then there are other people who perhaps have decreased ovarian reserve or there's a major male factor or there's an age issue. How do those people get it? Because those people are the ones who really need it because they're realistically going to need multiple cycles. How does that work?

Claire Tomkins (23:04)

Yeah. So one of things that I think is interesting, but we will obviously find this out as, we introduce this product and as we work with doctors, like the three of you is, you know, how, how, if at all, this changes the conversation with patients to try and make it even more success focused. Um, Because there are no real restrictions, for instance, on IVF insurance, that there's no age restrictions. However, as an example, you cannot be underwritten for insurance if you are 38 and above and you also want to use your own eggs. So there's no age restrictions. Of course you can have IVF insurance as a 38 year old woman, but because of the limits of like, it's not very successful. Unfortunately, at that point, if the quality of the eggs is not as, as high as we would see if you were in your twenties. So that there are some, I don't even say they're nuances. They're actually, they're more than nuances. They're like fundamentals of being able to do this is that we really have taken a huge data set and looked at what are the successful pathways. And we think it's going to be a dialogue with a doctor. We think it's going be dialogue with a doctor of like, what's my most successful pathway? Then in most cases, we'll hopefully be able to provide insurance around that pathway. I would say from the patient side for a long time, the way we talk about it internally at Future Family is that, and I imagine you feel the same way, it's like, it's not really about IVF cycles. No one really actually wants an IVF cycle. It's really about success. We're really like, what is the pathway or the cost of success.

Carrie Bedient  MD (24:31)

So just to make sure that I'm understanding this, it sounds like if you're 40 coming in and you really want IVF or you really want to conceive and you buy this insurance policy, if you do those two cycles using your eggs, it doesn't cover it. But if you go through with donor egg, for example, where success rates are phenomenally high, then it's two cycles are covered with that if you are not pregnant.

Claire Tomkins (24:33)

Yeah.

Carrie Bedient  MD (24:57)

And I mean, the likelihood of somebody not being pregnant after two donor cycles is thankfully low. But that, am I thinking of this correctly? And like a 25 year old who came in who wanted this insurance, it doesn't matter if she's DOR, decreased ovarian reserve, or any of the lower egg counts, she can get it because of the statistics that are involved. Am I thinking about this correctly?

Claire Tomkins (25:01)

When you're thinking about the right way, it's going to be like a lot of financial products, like a loan, like an insurance policy, like if you go to get trip insurance, home insurance, wherever, there's going be a lot of variables that are taken in to decide if you're eligible for coverage and to price you. So the same thing will happen with IVF insurance. You will fill out a short application online that will include things like your age and who's the intended egg source and so forth. And then you will get also a doctor's form. So the how it works of IVF insurance is, a little bit similar to the financing I described earlier. You go online, you fill out a short digital application. It'll ask some personal information. It'll ask your age. It'll ask about your intended egg source and your intended sperm source. And then you'll find out initially a preliminary quote and if you're eligible. For instance, if you were to say, I'm 40 and I want to use my intended egg source is my own eggs, it'll say, unfortunately, you're not eligible for coverage at this time. And there's a long FAQ and a lot of information to help you understand. We also hope to educate the medical community and your doctor, who you're making a lot of decisions in concert with.

So you can have that discussion like is IVF insurance an important part of your treatment plan? So there's this component and then you will, the second step after you've done that short digital application to find out if you're eligible for coverage, your next step will be a medical form and that'll introduce some new variables that will affect again, your coverage limits and your pricing. And then last but not least, if you choose IVF insurance and you purchase insurance, now that means you are eligible, you're covered, you have an insurance policy and if you fail two cycles of IVF, you will be able to make a claim and you'll be able to get your money back. And we are covered all the way through live birth. This has nothing to do with pregnancy. Pregnancy is not success in our business. This is through live birth.

Susan Hudson MD (27:01)

So other than age beyond 38, what are some other qualifiers for this type of product?

Claire Tomkins (27:05)

Yeah, mean, it's such a, is such a con like to underwrite insurance is complex. So it's, it's a lot around a number of different variables, but you know, as doctors, you probably know many of them, right? Things that would negatively impact, either your ability to get insurance or the cost of insurance. Those are different things, whether you're eligible for coverage or what the cost of coverage may be would be, could be some negative lifestyle habits might impact either your eligibility or simply again, the cost of coverage.

We know things like tobacco use negatively impact your chance of success. there's a lot You're going to find that like many things in fertility, there's a lot of personal questions, some of which some of them you'll answer as a patient. Some of them you'll have your doctor answer and then we'll be able to determine. Hopefully we can offer you, hopefully you're eligible for coverage. And if you are eligible for coverage, what your, your premium, your costs will look like. I think that's a question we're going to get a lot is like, what's the cost of IVF insurance? Right. So part of where we design this product was a lot around trying to come up with the lowest cost path to success. We've seen over the years a lot of financial products that I think can be confusing to consumers based on interviews, feedback, and how we've seen people using financial services. So we've seen some things like bundling programs where, well, I think they're very well intended. Consumers get confused about why they have to pay so much upfront for something and then of course we inevitably have patients who get pregnant on the first cycle and now they sort of subsidize someone else's IVF. So it's very confusing. So insurance is a very standardized product. It's on average, not for every patient, it'll vary by your patient and your background, but on average, it'll be roughly a 20 % cost to the total cost of two cycles of IVF, of your coverage. So it is, yeah. No, go ahead, I love the questions.

Abby Eblen MD (28:51)

Some curious, you made a comment about smoking and it made me think back to when I got life insurance and I had somebody come to my house and they took my blood and they checked for breakdown products of cigarette smoking and so things like that. I assume that things like people who are heavier don't do quite as well. So does weight make a difference? Does smoking make a difference? And if those things do, how are you gonna be able to measure those and really have confirmation that if somebody says they're not a smoker, that they're really not a smoker. Are you gonna?

Claire Tomkins (29:23)

Yeah, I mean, so, you know, all great questions. And it's just the sort of product that's going to get so many, you know, so many questions because they're all, there's this thing that you can think about. Yeah, it's sort of fascinating. So, I mean, insurance applications generally, you know, some of them can be representations or warranties that you make, right? So if you decide that you want to represent that you don't smoke, you know, there's no intention by Future Family to come and figure out if that's in fact true. But if you were in fact, a smoker and you didn't disclose that your policy could be invalid, right? So just like with a lot of things, insurance and insurance regulation is very, very strict. Like if you want to seek insurance, you must accurately report the questions on an insurance application. That'd be true for auto insurance or homeowners insurance. You say you've got, you know, burglar system and you don't, your homeowners insurance policy can cancel you out. So same thing, same rules apply. We trust consumers and our patients to be truthful. So.

Abby Eblen MD (29:56)

Gotcha.

Claire Tomkins (30:19)

But that's right. The variables can all affect either your eligibility or the cost of insurance in general. And like all things with, you know, hopefully innovation in general, I believe the price will come down over time. And the averages that we're seeing today are roughly 20 % of cost of care. So, you know, it is a markup, but then you have complete financial protection where we've been on the front lines of this business for so long that we've seen the not good cases where you go through two cycles. You've either taken on medical debt or used your savings. Maybe you've spent as much as $40,000. You don't have the outcome you wanted. And now it's complicated to seek more treatment. This will protect you 100 % against that financial loss.

Susan Hudson MD (31:03)

If you have traditional insurance and a lot of traditional insurance may pay for some of fertility, but not pay for all of it, like they may not pay the lab part or they only pay say 5,000 out of 25,000, different things like that, is this type of policy able to be stacked on top of traditional health insurance?

Claire Tomkins (31:11)

Yes, 100%. So again, it's the general kind of like rules, rules of the road of insurance is you really can't insure something that you didn't pay for. If else is paying for the IVF, like your employer, you wouldn't be able to get a policy where your employer pays the bills. You and I could probably argue that maybe there's some psychological, like emotional loss that you should be compensated for, but we don't cover that today. Maybe in the future.

Abby Eblen MD (31:44)

Right.

Claire Tomkins (31:47)

But this is really more about the cost of care. So if you had a cycle and it was supposed to cost 22,000, but your out of pocket was only 16, you could ensure that 16. That's right. So there's some flexibility and coverage. It's really, as you, think, intuitively thought, it's really about us trying to provide insurance against your financial loss, against anything out of pocket to you. So that's how we thought about it. And a lot of people also ask, well, how do you know how much it costs? We don't require that the physician quote the two full two cycle costs. We have a lot of data on our platform. And so we're pretty good at estimating and we can't guarantee that you couldn't end up out of pocket for you know, a few thousand dollars, depending on if your costs of care vary, but you'll be able to make those decisions upfront with you know, with a consultative you know, ability to do Q and A is like, okay, how much coverage do you really need slash want here?

Abby Eblen MD (32:18)

Okay.

Susan Hudson MD (32:36)

In your coverage, are you willing to look at things like reciprocal IVF, donor embryos, kind of things that are more outside the box as well?

Abby Eblen MD (32:46)

Not mainstream.

Claire Tomkins (32:47)

Yeah, absolutely. I think that that's exactly right. I think, you know, it was, as it was said earlier, you know, donor cycles are very, very successful. I think unfortunately there's still at times can be almost a little bit of stigma around donor, but we've had so many successful donor pregnancies on our platform and I'm a huge advocate for it. And so I think, you know, that's an interesting conversation that we might be having, we might be talking more about in the context of insurance.

I think once you start to really shift that conversation meaningfully towards success, you end up wanting to talk about like, look, you know, is your intention really to try many, many cycles? And also that's financially very draining. Or is your intention to, you know, find a pathway to really be able to be a parent?

AbYeah, I mean, those are very personal decisions. I mean, those are decisions that only you know, a parent, a mom or dad or father, a couple can make for themselves. But I think they're really important conversations in the context of healthcare. As usually people have something in mind and sometimes the pathway can be, I just want an opportunity to try and see if I could be a parent. And sometimes it's very focused on wanting to realize the dream of parenthood.

Susan Hudson MD (33:56)

Very neat.

Carrie Bedient  MD (33:58)

Are there any products like this that have existed up until this time? Because I don't know that I've heard of anything that's specifically like this. I mean, I've heard of the financing model. Yeah.

Abby Eblen MD (34:08)

Yeah, it's very unique. Yeah.

Claire Tomkins (34:11)

Yeah, so there, as far as we know, this is the first nationwide IVF insurance.

Susan Hudson MD (34:18)

This is really interesting, especially for, I see a lot of patients who maybe have insurance through smaller companies and those smaller companies don't have fertility riders. We've all had that situation where someone's like, well, I want to go get insurance that'll help cover this. And I'm like, you can't go to the healthcare marketplace and get IVF coverage. It just doesn't.

Claire Tomkins (34:26)

Right.

Susan Hudson MD (34:43)

It may exist in six months or a year from now, but we'll see what happens. But it's neat to have something that can essentially be your own personal rider.

Claire Tomkins (34:53)

Exactly right. And I mean, I think, know, philosophically you would imagine as a IVF mom, like I'm very in favor of expanded coverage for everyone. I just think the reality of the current healthcare system is there are often out of pocket costs and there are often cases where you may need, you know, this kind of financial protection. And we, we hope that it will make, you know, it easier for couples to make the decision to do IVF because, because those high success rates and easier to feel like if they need more cycles that they can, they don't have the financial stress of adding in additional treatment to their plan.

Susan Hudson MD (35:26)

Are there limitations as to what clinics you can use as a patient? Say I decide to purchase this IVF insurance, is there a list of clinics I have to choose from or can I go to my physician of choice? How does that work?

Claire Tomkins (35:44)

Yeah, so we partner with, I mean, just, you know, hundreds and hundreds of physicians and clinics across the nation. So you have a wide choice. I think every geo and zip code is covered. If for some reason your clinic is not on the IVF insurance program yet, you could certainly refer them to Future Family. And that's a super easy process to start working with us as a company and being on our platform. So, you know, we do some standard checks, like we, know, when we have onboarding of a clinic, it's like board certified reproductive endocrinologist, like we hold certain standards, right? So it really means something to be a Future Family partner in clinic. But yes, broad nationwide availability of the product. Also, we have patients who travel for treatment, so there's no restrictions on that, right? You could be living in New York or flying to Colorado or Las Vegas. So that's all good. You can live anywhere. You can get treatment anywhere that's within the Future Family network.

And you can switch doctors with your insurance policy as long as, again, this is a clinic that's been through Future Family onboarding. Absolutely.

Susan Hudson MD (36:43)

If somebody's clinic is currently working with Future Family, is this product automatically offered at those or is it some are some aren't?

Claire Tomkins (36:53)

Yeah, really good question. think so clinics today we're just in the process of making sure that clinics today are set up so they can offer IVF insurance to their patients. And again, we invite any and every clinic in the US to offer IVF insurance to their patient and to get in touch obviously with a Future Family team if they're not already.

Susan Hudson MD (37:11)

Very good.

Abby Eblen MD (37:11)

I think for many years of doing this, patients ask, well, can we finance this? And usually the answer is, well, not real easily. like Susan said, it has to be special circumstances. And so I think this is a great product. And I don't think we partner with you, but I want to. This sounds like a great, yeah, because I mean, there's definitely a need. I there's definitely a niche, think, in every clinic of patients that would benefit from this policy for sure, this insurance plan.

Claire Tomkins (37:26)

Great, well we absolutely should, I love that.

Carrie Bedient  MD (37:37)

The thing that gives me the most hope about all of this is that this is able to exist now because that means that our success rates are good enough to make this a viable business plan for patients, for businesses. mean, that's That to me is just the biggest sign of hope of, okay, we're making it. Like not everybody's perfect. Not everybody's going to get pregnant, but this is the sign that this can happen is huge.

Claire Tomkins (37:57)

That is such an amazing comment and thought. So one thing we didn't touch on, but it's absolutely brought up by that is that this is actually really for the first time ever. And when I'm not playing pickleball, really am like pretty much a geeky finance nerd. So this has really been about bringing the insurance industry for the very first time into the fertility industry. And so we've had these amazing partners. We've partnered with Munich Reventures because they're the largest global reinsurance firm.

And we've partnered with the top actuarial firm, exactly what you were saying. Like when we first met them, they were, they'd never done anything in fertility and they were like, Claire, we don't know this is insurable risk. And I was like, I'm telling you, look at the success rates year over year. It's amazing. And I think that it's also hopeful because over time we should be able to ensure many more couples and for much less money and maybe get the employers involved as well in this. But yeah, that's exactly right. It wouldn't have been, I don't think it would have been possible 10 years ago. The data wasn't good enough to allow us. Insurance would have been too expensive. It would have been like, well, why buy insurance? Because, you know, the cost of a cycle. But it has really come down and I think it will continue to come down. But, again, in large part due to all the great work that happens in your offices.

Susan Hudson MD (39:04)

That would have paid for a cycle.

Abby Eblen MD (39:06)

Yeah.

Carrie Bedient  MD (39:07)

Yeah.

Susan Hudson MD (39:16)

Wonderful. Well, I think this is very exciting news for the fertility front. Claire if somebody wanted to reach out to Future Family. What's the best way to contact you guys?

Claire Tomkins (39:30)

Yeah, great. I just, we try to make it really easy. We have a great team and I encourage you to just visit futurefamily.com. All the information you need to get started is at futurefamily.com. We make it very easy to onboard to the digital platform. And then you do get the, you know, the help and the pleasure of connecting to someone on the team who's a financial specialist and eventually a coach and registered nurse. If you have questions.

Susan Hudson MD (39:55)

Fantastic. Anything else you'd like to share today about Future Family?

Claire Tomkins (39:58)

We covered so much, just that it really is a very mission driven company. We really focus a lot on, many of us have been through the IVF journey. I'm certainly not the only one at the company. And we really focus on how can we make this just a little bit easier, a little less stressful, and hopefully a lot more successful.

Abby Eblen MD (40:00)

Bye

Susan Hudson MD (40:17)

Awesome.

Carrie Bedient  MD (40:17)

That's awesome. Well, thank you for doing what you do. That makes it easier for us to do what we do.

Abby Eblen MD (40:20)

Yep. Exactly.

Susan Hudson MD (40:23)

It does, it does.

Claire Tomkins (40:23)

I can say the same, know, thank you for doing what you do because I wouldn't have my kids without you.

Susan Hudson MD (40:28)

Well, it brings us joy in our lives. That's why we come to work every day and keep on going. So to our audience, thank you also so much for listening and subscribe to Apple Podcasts to have next Tuesday's episode pop up automatically for you. And also be sure to subscribe to YouTube. That really helps us spread reliable information and help as many people as possible.

Carrie Bedient  MD (40:49)

Visit fertilitydocsunsensored.com to submit specific questions you have and sign up for our email list. And keep in mind, book is coming out this fall, it should be this year. So tell your friends and hopefully we'll have that out to you soon.

Abby Eblen MD (40:58)

And as always, this podcast is intended for entertainment. It's not a substitute for medical advice from your own physician. All right. We'll see you later. Bye.

Carrie Bedient  MD (41:12)

Bye.

Susan Hudson MD (41:13)

Bye.

Claire Tomkins (41:13)

Bye.

Carrie Bedient  MD (41:13)

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