Will Insurance Cover Surrogacy
Surrogacy is a beautiful journey that allows intended parents to build their families with the help of another woman, the gestational carrier. It is also an expensive process costing on average around $120,000. With surrogacy being such a costly process, it’s no surprise most intended parents want to know if their insurance will cover their surrogacy.
Due to the immense complexity of insurance coverage for surrogacy, it is recommended to work with professionals like those at Surrogate Steps to ensure your surrogacy journey goes as smoothly as possible.
That said, this comprehensive guide covers the basics of surrogacy insurance and will help answer many of your questions about surrogacy insurance, including whether insurance will cover surrogacy, the types of insurance plans available, the costs involved, and more.
Will insurance cover my surrogacy?
The first question many intended parents have is whether their insurance will cover surrogacy.
The answer is complicated and depends on many factors and the part of the surrogacy process in question.
When considering surrogacy and insurance, it’s crucial to read the fine print of your health insurance policy. Look for any clauses related to “gestational carrier,” “surrogate pregnancy,” or “third-party reproduction.” If these terms are mentioned, your insurance might provide some level of coverage.
Most health insurance policies do not explicitly cover surrogacy-related expenses, necessitating the purchase of additional surrogacy insurance. That said, some policies might cover certain aspects of the process.
For example, when creating your embryos (a crucial part of gestational surrogacy), some insurance policies will offer fertility treatment coverage. However, when it comes to treatments involving the surrogate (such as the embryo transfer), insurance providers will rarely provide any coverage because the surrogate does not have an infertility diagnosis.
Coverage for the pregnancy itself varies as well. Some surrogates will have insurance that covers the surrogacy pregnancy, other surrogates will not.
An insurance review by a professional must be conducted to legally determine if the surrogate’s insurance will cover the cost of the surrogate pregnancy and delivery. If the surrogate has a surrogacy-friendly plan, the intended parents may still be obligated to cover costs not covered by the policy, such as deductibles, co-pays, and in some instances, monthly insurance premiums.
Even in cases where the surrogate’s insurance plan does not explicitly exclude a surrogacy pregnancy, it might still include a general exclusion provision that would result in the policy not being surrogate-friendly.
If your surrogate does not have a surrogate-friendly policy, it is important to consider the timing of the open market (open enrollment) to ensure ample coverage for your surrogate’s pregnancy.
What types of insurance plans are available for my surrogate’s pregnancy?
Your surrogate may have coverage for her surrogacy pregnancy through her existing health insurance plan as described above.
If not, there are three main options available for your surrogate’s maternity care.
The first is an insurance plan offered through the surrogate’s employer. The second is a medical insurance plan purchased under the Affordable Care Act (ACA), also known as the healthcare marketplace. The third option is a private health insurance plan.
Private surrogacy insurance plans are typically underwritten by Lloyd’s of London.
Can my surrogate use her insurance plan?
Some policies will cover a “surrogacy pregnancy.” If this is the case, the surrogate will be able to use her own health insurance plan and stay with her in-network physicians.
If your surrogate has her own insurance plan, but the policy is not surrogate-friendly, or if she does not have health insurance, then a policy must be obtained for the surrogate to cover the surrogacy pregnancy and delivery.
Such policies may be available with her or her spouse’s employer, in the healthcare marketplace, or through private insurance brokers.
Does insurance cover the surrogate baby?
In surrogacy, the surrogate is acting as a surrogate and not the legal mother or parent. The surrogate child will always be the legal child of the intended parent or parents. Thus, once the child is born, the child cannot be on the surrogate’s policy, as the child is not a dependent of the surrogate. The intended parents must place the child on their health insurance policy from birth, and the child will be covered under the intended parent’s policy, per the intended parent’s policy coverage and terms.
If the intended parents do not have a health insurance policy, or they are not U.S. residents, then the intended parents may purchase a policy for their child to take effect upon birth. This is done through a private insurance policy and is typically referred to as Newborn Care coverage, and can cost anywhere from $10,000 to $30,000 or more.
How much does medical insurance for a surrogate cost?
Insurance available through the surrogate’s employer or the ACA’s open market is required by law to include maternity care as an essential health benefit, however, there are exceptions to this rule, including in part if the surrogate’s health insurance plan is self-funded.
When it comes to a health insurance plan there are several items to consider in terms of payment, including in part: (1) monthly premiums, (2) deductible, and (3) total out-of-pocket limit. These costs vary greatly from plan to plan and from state to state. For example, monthly premiums can differ between $200 per month to over $1500 per month.
If a policy needs to be purchased during non-open enrollment, surrogate-friendly health insurance tends to be more expensive and can cost upwards of $30,000.
Thus, when it comes to health insurance, it is important to understand if the policy is surrogate-friendly, and what your overall costs will be. Working with a professional can ensure that you will be protected and have all the overall cost information.
Can we purchase additional insurance for surrogacy?
All insurance providers will tell you that verification of benefits does not guarantee payment of claims. While this doesn’t typically pose an issue, some intended parents do feel more comfortable obtaining a secondary policy that the surrogate can use in case her insurance provider refuses payments on any claims involving the surrogacy pregnancy or delivery. Such a plan is purchased through a private insurance provider and the cost can be anywhere from $3,000 to $5,000. This amount however only guarantees access to the secondary health insurance plan, if the intended parents need to activate the secondary insurance. Upon activation of the private insurance policy, the intended parents would be charged for the secondary full policy amount which can be another $30,000.
Having a full health insurance review of the surrogate’s health insurance conducted by a professional before entering into the arrangement will provide the intended parents with the information they need to make informed decisions and assess risks as to whether it is beneficial to obtain a secondary health insurance policy for their surrogate.
Can you be a surrogate without health insurance coverage?
In short, no. A surrogate must have a health insurance policy that will cover the surrogacy pregnancy and delivery, and in some states, such a policy must stay in place for one full year following the pregnancy. If a surrogate has non-surrogate-friendly insurance, or if a surrogate does not have health insurance at all, then the intended parents need to work with a professional, whether it be through their surrogacy agency, attorney, or insurance broker, to secure an insurance policy for the surrogate.
Recap of Surrogacy Insurance
Whether or not insurance will cover surrogacy depends on the insurance plan held by the intended parent and surrogate.
Fertility treatments not involving the surrogate (like the egg retrieval) may be covered by the intended parent’s insurance whereas treatments involving the surrogate (like the embryo transfer) are rarely, if ever, covered.
Coverage for the pregnancy usually depends on the plan held by the surrogate herself. If the gestational carrier has a surrogacy-friendly plan, the intended parents may still be obligated to cover costs not covered by the policy, such as deductibles, co-pays, and in some instances, monthly insurance premiums. If the surrogate does not have health insurance or her coverage does not cover surrogate pregnancies, the intended parents will need to secure and pay for a new insurance plan for the surrogate.
Due to the complexity of the insurance coverage for surrogacy, it is important to consult with a professional, such as a surrogacy attorney, agency, or insurance broker, to understand the costs of health insurance for the surrogate that you choose to match with, to conduct a full insurance review to ensure your surrogate’s health insurance is surrogate-friendly, and to understand the overall cost to you in regards to your surrogate’s health insurance coverage.