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What Does Infertility Insurance Cover?

Every infertility insurance plan is different, so it is important to look around before you buy in to one. You want to make sure that all diagnostic tests, medications, and fertility treatments are covered by your insurer. Typical infertility insurance plans cover the most inexpensive treatment that is suitable for you and your partner. They also generally only cover treatments for a certain number of cycles, typically between three and five. Infertility insurance may cover one or all of the following treatments: 

• IUI
• IVF
• ZIFT
• GIFT

Infertility insurance may also cover diagnostic test procedures, including laparoscopic surgery. Moreover, your infertility provider may cover medications, though some injectable medications are not covered. Typically, the use of donor eggs and donor sperm is not covered by infertility insurance.

Who Can Get Fertility Insurance?

Unfortunately, not everyone can get fertility insurance. Though it varies from insurer to insurer, there are normally certain qualifications that you have to meet before being approved for fertility insurance. To qualify for infertility insurance, couples who already hold an insurance policy usually need to be:

• under the age of 40
• struggling with fertility for a specific period of time (ranging from one to five years)
• policy holders for at least one year

Couples that do not already have insurance coverage and are currently undergoing investigation for infertility issues will most likely not be approved for fertility coverage. In these instances, it is a good idea to look into whether your fertility clinic offers any kind of refund program or financing option to their clients.

Laws Governing Fertility Insurance

Depending upon where you live, there are different laws regarding fertility insurance. Some states have a mandate that requires all employers with more than 50 employees offer health care coverage that includes some type of fertility insurance.

These states include:

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

Other states have no mandate requiring employers to offer fertility insurance.

Are You Covered?

Before undergoing fertility treatments, it is important to check your insurance policy to see if any fertility treatments are included with your plan. Be sure to ask your employer for a copy of your full insurance policy, listing all inclusions and exclusions.

If fertility treatment or testing is not specifically excluded in the policy, your provider is required to pay for the treatments. Write a letter to your insurance provider asking for detailed information regarding your infertility insurance or speak with your insurance broker. If you are not covered, you may be interested in investing in an infertility insurance policy. Call your local providers and ask for an insurance quote.