Introduction 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.

Methods 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.

Results 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.

Discussion 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.

The authors have declared no competing interest.

NCT05663645

Research reported in this article was supported through funding by the National Institutes of Health / National Center for Research Resources (UL1TR001442) and National Research Service Award (T32 HD007203). The statements presented in this work are solely the responsibility of the authors and do not necessarily represent the views of the National Institutes of Health.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The institutional review board of the University of California, San Diego gave ethical approval for this work.

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All data produced in the present study are available upon reasonable request to the authors.