Dayo Olumayowa, Turcotte Victoria, Reyes Breanna, Flores Ortega Ricardo E, Kaiser Bonnie N, Aarons Gregory A, McMenamin Sara B, Su H Irene, Romero Sally A D
medRxiv. 2025 Mar 28:2025.03.27.25324807. doi: 10.1101/2025.03.27.25324807.
A large public university added health insurance coverage of 50% co-insurance for up to two cycles of in vitro fertilization (IVF) to eligible faculty and staff.
We describe the design and conduct of a randomized controlled trial to evaluate the effectiveness of a health insurance educational intervention on health insurance literacy and IVF benefit utilization. The intervention materials included 1) Key insurance terms; 2) Examples of premiums and deductibles across the insurance plan options; 3) Examples of how premiums and deductibles affect out-of-pocket costs; and 4) A guide to find in-network providers/facilities. The primary outcome is health insurance literacy. Secondary outcomes are IVF services and insurance benefit utilization, out-of-pocket costs, and financial hardship related to fertility care. We collected validated patient-reported outcomes at three timepoints over 1 year. We will integrate mixed methods data to explore whether the intervention was effective, feasible, acceptable, and appropriate.
Among 394 faculty and staff screened, 217 (55%) reproductive-aged (18 to 50 years) employees consented, completed the baseline survey and were randomized in a 2:1 fashion. Participants were female (81%), married (63%), and worked as a staff employee (72%). Approximately 39% reported an infertility diagnosis, and 28% had undergone prior IVF treatment. Participants reported feeling slightly confident when using their health insurance plans and moderately confident being proactive when using their health insurance plans.
Our goal is to improve health insurance literacy and utilization of health insurance benefits for IVF care, thereby expanding family-building options for reproductive-aged individuals.
一所大型公立大学为符合条件的教职员工增加了高达两个周期体外受精（IVF）的50%共保医疗保险覆盖范围。
我们描述了一项随机对照试验的设计与实施，以评估医疗保险教育干预对医疗保险素养和IVF福利利用的有效性。干预材料包括：1）关键保险条款；2）各保险计划选项的保费和免赔额示例；3）保费和免赔额如何影响自付费用的示例；4）寻找网络内提供者/机构的指南。主要结果是医疗保险素养。次要结果是IVF服务和保险福利利用、自付费用以及与生育护理相关的经济困难。我们在1年中的三个时间点收集了经过验证的患者报告结果。我们将整合混合方法数据，以探索干预措施是否有效、可行、可接受且恰当。
在394名接受筛查的教职员工中，217名（55%）处于生育年龄（18至50岁）的员工同意参与，完成了基线调查，并以2:1的比例随机分组。参与者为女性（81%）、已婚（63%），且为职员（72%）。约39%的人报告有不孕诊断，28%的人曾接受过IVF治疗。参与者表示在使用医疗保险计划时略有信心，在积极主动使用医疗保险计划时信心中等。
我们的目标是提高医疗保险素养以及IVF护理的医疗保险福利利用率，从而为生育年龄个体扩大组建家庭的选择。
