If you are thinking of growing your family but are facing infertility, fertility insurance can play a role in helping you manage the financial costs associated with IVF and surrogacy.
You can also get help reviewing your insurance with a surrogacy specialist when you fill out our online form.
Read on to learn about the differences between health insurance and fertility insurance and whether your surrogacy IVF journey could be covered by your insurance.
What is Fertility Insurance?
Fertility insurance is a type of health insurance that is meant for families who are facing infertility or are unable to conceive without assistance and helps cover the costs associated with fertility treatments, such as IVF fertility medications, egg retrieval and embryo transfer.
Depending on the plan, fertility insurance may also include coverage for diagnostic tests, consultations with reproductive specialists and certain procedures.
Does Insurance Cover In Vitro Fertilization?
It depends. Coverage levels vary widely between insurance providers and policies, with some offering comprehensive benefits and others only providing limited or no fertility-related coverage. Some key points to consider include:
- Coverage Availability: While some insurance plans may fully cover IVF, others might only provide partial coverage or none at all.
- State Mandates: Certain states have laws requiring insurance companies to cover IVF treatments, but these laws can differ widely in terms of scope and requirements.
- Additional Costs: Many plans may not cover related expenses, such as fertility medications, embryo freezing or genetic testing, which can add to the overall cost.
- Pre-authorization: Some insurance companies require pre-authorization before beginning IVF treatments, meaning you may need to provide documentation to justify the need for the procedure.
It’s essential to thoroughly review your specific insurance policy and discuss coverage details with your provider to understand what is included and what costs you may be responsible for when considering IVF.
In some states, infertility treatment coverage is mandated for traditional insurance providers. (These states are: Arkansas, California, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia.)
What is the Cost of In Vitro Fertilization with Insurance?
The cost of IVF with insurance can vary but will likely be lower than if you did not have insurance, but some insurance providers may have limited coverage for IVF, especially if you live in a state that does not mandate infertility treatment coverage.
What Can Fertility Insurance Cover?
Fertility insurance is intended to cover many of the expenses that come with building a family when you need assisted reproduction or are facing infertility.
This can include things like:
- IVF and IUI
- Donor egg facilitation
- Donor sperm facilitation
- Egg retrieval and freezing
- Embryo freezing
- Embryo banking
- Counseling for infertility patients
- Fertility medication
- Frozen embryo transfer
- Genetic testing
- Diagnostic testing
Provide tips on choosing the right plan, including factors to consider and questions to ask insurance providers.
What Insurance Covers In Vitro Fertilization?
The best insurance for fertility coverage is often fertility insurance providers because they specialize in fertility, but if you have employer-provided health insurance that is not a fertility-specific insurance, you may still have coverage.
Below we’ve gathered some information for some of the common insurance providers and information on coverage for IVF and fertility treatments.
Does Tricare Cover IVF?
In most cases, no, Tricare will not cover IVF. However, there are exceptions. Learn more here.
Does Blue Cross Blue Shield Insurance Cover IVF?
Sometimes. Because Blue Cross Blue Shield has multiple plans, some plans my cover IVF and other infertility treatments. Learn more from your state or regional Blue Cross Blue Shield website.
Does United Healthcare Cover IVF?
Sometimes. Employers can add supplemental insurance for fertility, so if you are on a plan with this supplemental insurance, you may have coverage for IVF or other infertility treatments. Check with your insurance provider for details on your coverage.
Does Aetna Cover IVF?
Sometimes. Aetna may cover IVF or infertility treatment, and lists in-network providers that may be available depending on your specific insurance plan.
Does Cigna Cover IVF?
Sometimes. Cigna is more likely to cover IVF and infertility than other major insurers, but there are limits to coverage and there may be some states and plans where coverage is very limited.
Does Progyny Cover IVF?
Yes, Progyny covers IVF for those enrolled as well as other fertility preservation treatments and infertility treatments.
You can find information when you talk to a representative of your insurance company. If you need additional help reviewing your insurance policy coverage of IVF and surrogacy, or finding IVF-friendly insurance for surrogacy, contact us today.
Frequently Asked Questions
What is the best insurance for infertility?
The best insurance for infertility depends on the treatments needed, and more often than not, the most cost-effective insurance option is the insurance coverage will come from employer-provided insurance. That being said, the most comprehensive coverage for infertility usually comes from fertility-specific insurance companies like WINFertility and Progyny. Fertility-specific insurance companies are more likely to cover things like IVF and surrogacy.
Why is infertility not covered by insurance?
Infertility is often not covered by insurance because many insurance companies don’t consider it “medically necessary.” There also may be some hold out on coverage because of the experimental nature of IVF when it first began, although now infertility treatment is relatively common.
What is the difference between WINFertility and Progyny?
WINFertility and Progyny are both fertility insurance companies, but they are separate fertility insurance companies.
How much does IVF with Progyny cost?
Many parts of IVF may be covered if you have Progyny insurance, but coverage is dependent on your plan. Read more about coverage here.