Is fertility usually covered by insurance?

Asked by: Eldon Dietrich  |  Last update: August 25, 2025
Score: 4.6/5 (43 votes)

Health Insurance As you now know, some health insurance plans will either partially or fully cover the costs associated with fertility treatment. However, one insurer may include a stipend for fertility medication, while another insurer may give you a lifetime monetary allotment - the options vary widely.

Are fertility issues covered by insurance?

Under the California infertility health insurance laws, insurance companies must offer infertility insurance coverage for diagnosis and treatment of infertility. California does not require insurance companies to provide health insurance coverage, but they must offer the option for infertility benefits.

How to find out if your insurance covers fertility treatments?

You need to call and ask for an explanation of benefits. If the insurance customer services won't help you can reach out to your company HR. The only thing that will ``ensure'' your insurance covers it is to make sure fertility is a covered service in the explanation of benefits.

How do you qualify for fertility treatment?

Why it's done
  1. Fallopian tube damage or blockage. Eggs move from the ovaries to the uterus through the fallopian tubes. ...
  2. Ovulation disorders. ...
  3. Endometriosis. ...
  4. Uterine fibroids. ...
  5. Previous surgery to prevent pregnancy. ...
  6. Issues with sperm. ...
  7. Unexplained infertility. ...
  8. A genetic disorder.

How do I get my fertility checked?

Fertility tests for women
  1. Blood tests. Samples of your blood can be tested for a hormone called progesterone to check whether you're ovulating. ...
  2. Chlamydia test. Chlamydia is an STI that can affect fertility. ...
  3. Ultrasound scan. ...
  4. X-ray. ...
  5. Laparoscopy.

Are You in Your 30s-40s and Curious How Insurance Can Cover Your Fertility Journey?

16 related questions found

How much does a fertility visit cost?

Consultations: Fertility specialist consultations cost $200 or more. Donor eggs, sperm, or embryos: Using donor eggs, sperm, or embryos can increase costs. The price may be different depending on whether the eggs and/or sperm are fresh or frozen. Also, you may have costs for agency and storage fees.

What states cover infertility?

The states that mandate private insurers to cover some form of fertility coverage are Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Montana, New Hampshire, New Jersey, New York, Ohio, Rhode Island, Texas, Utah, and Virginia.

Can you get IVF for free?

Although NICE recommend up to 3 cycles of IVF should be offered on the NHS, some ICBs only offer 1 cycle, or only offer NHS-funded IVF in exceptional circumstances. You can also ask your GP or contact your local integrated care board (ICB) for more information about NHS-funded IVF treatment in your area.

What disqualifies you from IVF?

Who is not a good candidate for IVF? In vitro fertilization may not work for everyone. Conditions that may interfere with IVF success include fibroid tumors, ovarian dysfunction, abnormal hormone levels, and uterine abnormalities. Women with these issues may face lower rates of pregnancy with IVF.

What is the best insurance for infertility?

Best Fertility Insurance Companies of 2023
  • UnitedHealthcare: Best Coverage.
  • Cigna: Best for High-End Treatments.
  • Aetna: Best Additional Resources.
  • Blue Cross Blue Shield: Best for Multiple Rounds of Treatment.
  • Progyny: Best for Assisted Reproductive Technologies.

Is IVF painful?

While most individuals who have undergone IVF do not describe it as painful, there are moments that may cause minor to moderate discomfort.

Why don t insurance companies cover fertility treatments?

Because infertility has long been considered a women's health issue, insurance companies perceived it as a niche issue and denied coverage to those experiencing it. This is despite the fact that nearly half of all cases are due to “male factor infertility.”

How to get insurance to pay for IVF?

Here are five key ways to secure IVF coverage.
  1. Ask Your Employer for Benefits. This may seem like a bold move if your company doesn't already offer them. ...
  2. Ask Your Insurer for Coverage. ...
  3. Purchase Non-Group Insurance. ...
  4. Participate in Clinical Research Trials. ...
  5. Seek Employment from a Company That Provides Infertility Coverage.

Does Starbucks cover IVF?

Yes they do! You get a 25k lifetime max for procedure costs and a separate 10k amount for medications. I was able to do two egg retrievals and three embryo transfers with the benefit before my medication allotment ran out, I'm actually still working on the 25k, but I know it's close to being used up.

Is PCOS covered by insurance?

No insurance coverage: While some insurance policies do not cover fertility treatment, most health insurance policies will at least cover diagnosis and treatment of underlying conditions that may cause infertility, such as polycystic ovary syndrome (PCOS), endometriosis, fibroids, and certain conditions for men, such ...

How do most people afford IVF?

If you have health Insurance, your plan may cover IVF. But coverage for IVF varies significantly from plan to plan, and not everyone is eligible for this type of coverage. Certain health plans may require that a person has an infertility diagnosis to qualify for coverage, for example.

What is the BMI limit for care fertility?

If your BMI is lower than 19 or greater than 35, you will not be eligible for fertility treatment with Care Fertility. If you are female and providing eggs and/or having an embryo transfer as part of your treatment you need to check your body mass index (BMI).

How to do IVF with no money?

Baby Quest Foundation provides financial assistance through fertility grants to those who cannot afford the high costs of procedures such as IVF, gestational surrogacy, egg and sperm donation, egg freezing and embryo donation.

Does Blue Cross Blue Shield cover IVF?

Members diagnosed with infertility can receive up to three (3) annual drug cycles for in vitro fertilization (IVF). You must receive prior approval and buy your prescriptions through our pharmacy programs.

How do I financially plan for IVF?

Creating a budget for fertility treatment can be summarized in a few steps:
  1. Determine the cost of treatment.
  2. Review your insurance.
  3. Evaluate your financial situation and how much you can realistically pay each month.
  4. Look for ways to reduce costs.
  5. Create a repayment plan.

What not to do before IVF?

Lifestyle choices that should be avoided before starting IVF treatment include cigarette smoking, alcohol consumption, illicit drugs, and intensive exercise.

Can you pick gender with IVF?

This is the process of a couple or individual choosing the genetic sex of the child, boy or girl, by testing the embryo(s) created through IVF before one is implanted in the uterus. Sex selection is only possible using IVF embryos. The term sex selection is preferable to the past term of gender selection.

How do I test my fertility?

Fertility tests for women and people assigned female at birth (AFAB) may include:
  1. Fertility blood tests. Certain hormonal imbalances can interfere with egg production and maturation. ...
  2. Ovarian reserve testing. ...
  3. Genetic testing. ...
  4. Pelvic ultrasound. ...
  5. Sonohysterogram. ...
  6. Hysterosalpingogram. ...
  7. Hysteroscopy.

What is the cheapest state for IVF?

Low-cost IVF in Arizona

Arizona has 2 fertility centers with the lowest in the country pricing for IVF: New Direction Fertility and Southwest Fertility Center. Their pricing is around $6,500 and $6,700 per cycle. The pricing doesn't include anesthesia, that is usually $500-600.