For each future parent who decides to use surrogacy, an important question: how does surrogacy work with insurance? It is important to consider when your surrogacy journey will begin. Many couples choose to start their surrogacy efforts between December and January, a period of time during which U.S.-based agencies are often filled with work (many would say “crazy busy”). It's important to be aware that the timing of your pregnancy will affect both your insurance options and your budget.

What Insurance Covers Surrogacy

It is important to understand: what insurance covers surrogacy? Your surrogate should be covered by health insurance when she becomes pregnant with your child. If you’re from a country with universal health care or a national medical care system, the United States’ private insurance-based system can seem baffling. But when pursuing surrogacy in the U.S., Intended Parents need to familiarize themselves with their insurance options.

Surrogates do not generally have health insurance that provides maternity coverage. Only about 10% of potential surrogates can get such coverage from their own policies. Most often, a surrogate's insurance will include copayments and deductibles of $5000 or more; before such expenses can be covered by the insurance company, these costs must be paid out-of-pocket. In that case it is probably less expensive to invest in a new policy without any deductible at all

What Insurance Companies Cover Surrogacy

The question arises: what insurance companies cover surrogacy? Although infertility affects about 12 percent of women of childbearing age in the United States, only 15 states currently require insurance companies to cover treatment. Most do not include basic IVF procedures in their required coverage. Only a few insurers cover surrogacy procedures, and no state requires it.

Here is what is and isn’t generally covered by insurance:

• Insurance companies do not cover costs associated with the transfer of embryos to surrogates, nor do they pay for fertility treatments.

• No insurance company will pay for donated eggs; some employers may offer a group health plan that covers the cost of freezing woman's own eggs.

• IVF is rarely covered by insurance providers. Some will offer one procedure as part of an infertility benefit package, but this treatment plan is usually quite limited and excludes certain patient groups.

• Some private health insurance companies WILL cover the cost of artificial insemination IF the surrogate is using her own eggs and a donor's sperm.

• Some insurance companies exclude medical coverage for surrogate pregnancies from their plans.

• However, if an insurance company does not specifically state that a transgender person's pregnancy will not be covered, it must by law cover the costs that they normally would as long as there is no exclusion in their policy.

• In most cases, when a couple uses a surrogate mother to carry their child, the costs not covered by health insurance are paid for by the parents of that child.

• Many health insurance companies will cover the cost of a woman's pregnancy, but they won't pay for fertility treatments—that is usually up to the surrogate or donor.

• Some health insurance companies will give you the option of adding a temporary policy to your plan that covers costs associated with surrogacy—including fertility treatments, labor and delivery.

Whose Insurance Pays For Surrogate Pregnancy? 

It is important to understand: whose insurance pays for surrogate pregnancy? Intended parents may agree to pay their health care expenses out of pocket, for any treatments not covered by insurance—or they can request that the embryo donor cover those costs. Regardless of who pays what and how, it's a good idea to have an agreement in writing so there are no unpleasant surprises later on. 

It is always wise to check with the health insurance company: depending on the organization, it may allow policy holders to add temporary coverage. If so—and only if so—be sure you understand exactly what is covered.