Surrogacy Health Insurance: What You Need to Know
Why do I need health insurance for my surrogate?
Health insurance requires a financial commitment, so why is it so vital?
Surrogacy health insurance is one of the most important parts of a surrogacy arrangement. It ensures that the surrogate and the pregnancy are protected in case any complications should arise.
In a surrogacy arrangement, there are a lot of moving parts and various parties involved. Even with the greatest experts, state-of-the-art technology, and meticulous financial planning, medical bills can accumulate quickly.
“Childbirth in the United States is uniquely expensive, and maternity and newborn care constitute as the single biggest category of hospital payouts for most commercial insurers and state Medicaid programs.” According to The New York Times, “The cumulative costs of approximately four million annual births is well over $50 billion.”
ConceiveAbilities does not allow Intended Parents to leave their surrogate uninsured.
Help! Where do I start?
First and foremost, understand that health insurance for the pregnancy is very different from health insurance for the baby/babies. The insurance for the baby goes on the intended parent’s insurance, while surrogate health insurance is for the pregnancy. This post will mostly cover the insurance for the pregnancy.
Each time a surrogate enters the program, ConceiveAbilities has their insurance reviewed by our insurance partners, ART Risk Solutions. They are the industry experts at surrogacy insurance. If the Intended Parents choose to work with the surrogate’s insurance, they will give us a determination on the likelihood that the surrogate’s insurance will accept the claim.
“I’d say less than 5% of surrogate healthcare plans, state exclusively that they will cover a surrogate pregnancy.” said Deb Levy, Clinical Director and Surrogacy Specialist at ConceiveAbilities, “About 30% state clearly that they will exclude a surrogate pregnancy. And then everything else is somewhere in the middle: either it’s silent on surrogacy, the language is ambiguous, or the healthcare plan is self funded, which is most risky.”
Can I use my existing health care plan to cover the surrogacy arrangement?
Typically, insurance plans don’t cover non-members.
Why is using the surrogate’s own insurance plan risky?
For a number of reasons. First, because the surrogate’s employer could change insurance without warning. Second, the surrogate could change job positions. And third (and most commonly), the networks can change. The surrogate could be seeing a doctor in one network, and all of that sudden that doctor might be in a different network.
Can I purchase an individual plan for my surrogate from the individual market under the Affordable Care Act?
The current state of the individual market is currently in question under the current administration. Open enrollment begins November 1st and continues through December 15th. Plans are not required to disclose what their policy with be towards surrogacy until November 1st. Many companies, such as Humana and Aetna, are continuing to pull of the market.
Due to the uncertainty of surrogacy coverage under individual plan market, we no longer recommend purchasing an individual plan in the marketplace. We cannot assure that surrogates will be able to see their own doctor, or switch to a specialist. Often times, if the surrogate has her own insurance through her employer, there is a dual coverage exclusion, meaning, she cannot purchase another plan while remaining on her own plan. We advise all parents to review their alternatives.
What is my safest alternative to the individual market?
We recommend looking into the Universal Life plan through Lloyd’s of London through Art Risk Solutions. They have an open network specifically geared towards surrogacy coverage. The Lloyds coverage allows the surrogate to see any doctor that is mutually agreed upon by the Intended Parents and surrogate, and the option to switch to a specialist if they prefer.
So remember- Surrogate’s own plan (Riskiest), individual plan (Unknown), and Comprehensive Surrogacy Insurance (No Risk).
How much does a Universal Life Plan typically cost?
A singleton pregnancy (one embryo) is usually $27,000. A twin pregnancy can be $42,000. Most of our surrogates are accepted to the Lloyd’s of London premiere plan, so it is discounted to $25,000.
An individual plan can cost upwards of $17,000, including copayments, deductibles, and premiums. We recommend investing in a comprehensive surrogacy plan to ensure complete and peace-of-mind coverage.
What parts of the surrogacy procedure is covered in an individual plan?
Typically, an individual plan will cover from the point of confirmed pregnancy but this is not black or white.
It is best you consult with your agency and the clinic you are utilizing to find out what insurance coverage you have.
What if I am an intended parent from outside of the United States of America?
All international clients are responsible for covering the baby’s healthcare. This includes hospital expenses, baby expenses, and other surrogacy-related expenses that accumulate during the process.
The surrogacy journey can sometimes be met with various obstacles, such as financial responsibilities and insurance considerations. We are here to make sure you don’t feel lost and that you are guided every step of the way. Be sure to reach out to ConceiveAbilities or send us a message to check your options regarding your healthcare.
For more information visit ConceiveAbilities blog today, where you’ll find more on surrogacy, health insurance, and the path to creating families.