3 Things to Know About IVF Insurance Coverage

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ConceiveAbilities - IVF Insurance

It’s no secret that IVF can come with a steep price tag. From the cost of medication and monitoring to the procedure itself, not to mention any additional preimplantation genetic testing (PGT), fees can easily total thousands of dollars for just one cycle.

Fortunately, more states are recognizing infertility as a medical issue – one that warrants insurance coverage. We’ll explore best insurance for fertility treatments, as well as the best states that cover IVF insurance, to help you determine your options.

How much is IVF with insurance?

Just like IVF and surrogacy needs vary from person to person, so too do the costs – with or without insurance. Here’s a look at some of the numbers at large:

  • $12,000: average out-of-pocket cost of one IVF cycle

  • $1,500-$3,000: average cost of IVF medications, which are not included in the baseline price

  • $19,234: average total cost for one cycle

  • $6,955: added cost per additional cycle

  • $1,000-$2,500: cost of ICSI treatment

  • $3,000: cost of PGT (which may actually run anywhere between $1,800-$7,500 per cycle)

  • $500: average annual storage fee for frozen eggs or embryos

  • $3000-$5000: average cost of a frozen embryo transfer (FET)

  • $25,000-$30,000: average total cost of one cycle with an egg donor

  • $100,000+: approximate cost of one cycle with a gestational carrier

These are averages, but the numbers don’t lie: IVF is expensive without some form of discount, refund program or insurance. Fortunately, IVF insurance may cover all or, more often, some part of the process. This alone can knock the cost down by thousands of dollars, making IVF – as well as surrogacy and egg donation – a much more manageable means of family building.

Does any insurance cover IVF?

Yes! More and more insurance plans are including infertility services, and that means at least one IVF cycle may be covered to some degree. Under the Affordable Care Act, there are several different categories that insurance policies may fall under:

  • No fertility insurance coverage
  • Insurance Coverage for Infertility Diagnosis
  • Insurance Coverage for Infertility Diagnosis and Limited Treatment
  • Full Infertility Insurance Coverage
  • Medication Coverage (which may or may not include fertility drugs)

It’s important to have a clear idea about what coverage looks like in your state because not all states are willing to offer the same degree of care without paying a premium.

The best insurance for fertility is based on your personal needs. You’ll want to confirm if individual aspects of the process are included and to what extent, including:

  • Fertility testing
  • Fertility Medication
  • Monitoring
  • IVF procedure
  • Additional procedures, such as ICSI or PGT

It’s also important to confirm any surrogacy coverage needs. Other questions to ask:

  • Are in-network labs required for testing and monitoring, especially if you or your surrogate live out of state?
  • Is medication covered?
  • How many cycles are covered?
  • Are there any other boundaries to be aware of with this coverage?

Another general insurance note if working with a surrogate: some costs are paid toward maternity health insurance coverage. In the U.S., the lowest risk may be to purchase a stand-alone policy, the cost of which can range anywhere between $25,000 to $41,000.

What states cover IVF insurance?

There are currently 15 states, including Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia that mandate some level of fertility coverage. Again, it’s important to do your research to confirm the degree of coverage you will receive and if there are any stipulations. If you live outside of one of these states it doesn’t mean IVF will be impossible for you, but it may require a bit of planning and financing in order to make it more manageable.

We’re here to support you through all the nuances of your IVF journey. To discuss insurance and all things surrogacy and egg donation, please don’t hesitate to contact our team.