Infertility Insurance

Getting pregnant isn’t always straightforward. If you and your partner are having difficulties getting pregnant, you may be thinking about investigating various fertility treatments in order to increase your chances of conception.

Unfortunately, fertility drugs and treatments are very expensive, and IUI and IVF treatment cycles can soon add up to exorbitant amounts. However, there are now a number of different types of infertility insurance provided by various insurance providers. This fertility insurance may help you on your path to your conception.

What is Infertility Insurance?

Infertility insurance is one type of coverage offered by insurance providers. It is designed to help couples finance their fertility treatments. In exchange for a monthly premium, insurance providers will supply you with coverage for various infertility procedures, including fertility testing, artificial insemination, and embryo transfer. In the event that you or your partner needs to undergo fertility procedures, your insurance provider will pay for a portion of these services. Certain states and countries now require that insurance providers offer customers infertility insurance.

Why Purchase Infertility Insurance?

Insurance is there to help you through rough times. Whether it's medical insurance, dental insurance, life insurance, or pet insurance, the right coverage can help you and your family deal with financially challenging times.

And as the incidence of infertility increases throughout North America (there are more than six million Americans currently facing infertility), infertility treatments are becoming more and more in demand.

Unfortunately, many fertility treatments remain out of the question for most Americans because they are just too expensive. Fertility medications can cost thousands of dollars a month, and most ART procedures will run at least $4,000. Many couples who have to pay for treatments out of their own pockets simply end up going bankrupt. Infertility insurance is there to make sure that you have the option of getting treatment without the threat of bankruptcy.

Types of Infertility Insurance

There are a few different types of infertility insurance. Depending upon your family’s fertility history, one type of insurance may be better suited for you.

  • Standard Health Insurance: This type of fertility insurance involves paying a monthly premium to your insurance provider. In exchange for this monthly premium, your insurance provider will pay for certain fertility treatments, up to a maximum dollar amount.
  • Refund Programs: Refund programs are offered by a number of private insurance providers as well as some infertility clinics. If you sign up for one of these programs, you will have to pay for all fertility treatments up front. However, if your treatments are not successful, you will receive between 70% and 100% of your money refunded.
  • Financing: If you choose to undergo fertility treatment, you can take out a loan in order to pay for the treatment. Many programs do not require you to repay the loan in full unless you get pregnant.

Treatments Covered by Infertility Insurance

Depending upon your insurance plan and provider, different fertility treatments will be covered. To avoid any unpleasant surprises, be sure to check that your insurance coverage includes all diagnostic tests, medications, and fertility treatments. Most insurance plans cover only the most inexpensive treatment that will be effective for you. Additionally, your insurer may only provide coverage for a specific number of treatment cycles (typically three to five). Some fertility treatments that are usually covered by fertility insurance include:

  • IUI
  • IVF
  • ZIFT
  • GIFT

Infertility plans typically cover all diagnostic tests and procedures, including diagnostic surgery. However, certain medications, particularly injectables, are not always covered. Additionally, sperm donation and egg donation procedures are typically not covered.

Who Can Get Fertility Insurance

Not everyone can qualify for infertility insurance coverage. Depending upon your insurer, you will have to meet certain qualifications before you can be approved. Most couples need to be:

  • under the age of 40
  • facing infertility for a certain period of time (between one and five years)
  • policy holders for at least 12 months

Most couples who have already been diagnosed with infertility will also be refused infertility insurance. If you and your partner do not have an infertility insurance policy, you might want to look into financing or refund programs to help pay for fertility treatments.

Legal Issues

Most countries have some kind of laws governing infertility insurance. In the United States, some states have made it mandatory for employers with more than 50 employees to offer fertility insurance as part of regular health care coverage. These states include:

  • New York
  • New Jersey
  • Montana
  • Arkansas
  • California
  • Massachusetts
  • Ohio
  • Connecticut
  • Texas
  • Maryland
  • West Virginia
  • Rhode Island
  • Hawaii
  • Illinois


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