Is IVF Covered in Health Insurance?

Is IVF Covered in Health Insurance?

Welcoming a new member of your family is the most joyous experience, right? But, for some couples, parenthood is challenging. The blame goes to infertility which prevents a couple from conceiving a child. It is such a heartbreaking situation. Fortunately, IVF treatment has become the solution to it. But, not everyone can afford it as this treatment is expensive. But, do health insurance plans cover IVF treatment? Let’s know that!

What is infertility?

Infertility means having a problem getting pregnant after trying it for more than a year. This is a common issue in both men as well as women. Primary and secondary infertility are two different types of infertility.

Primary infertility means when a couple cannot naturally conceive a child after a year of trying. Secondary infertility refers to a situation where a couple already has a child but now struggles to conceive again.

Does a health insurance plan cover IVF treatments? 

Earlier, infertility treatment was not covered under health insurance because it was not considered a necessary treatment. But, now things are changing and that is why new-age insurance companies are crafting plans that offer IVF treatment costs or provide it as an add-on. A few plans even bundle it with maternity coverage.

However, you must know that some plans cover specific treatments. So, it is always better to verify the exclusion and inclusion part. Also, some insurers provide infertility health insurance plans with expense caps, longer waiting periods, or coverage limits. So, always compare different plans before you choose any.

What causes infertility and what treatments do health insurance cover? 

Many reasons behind infertility. Some of the most common ones are:

  • Obesity
  • Diabetes
  • Smoking
  • Stress
  • Sedentary lifestyle
  • Unhealthy eating habits
  • Excessive alcohol consumption
  • Infections
  • Female or male reproductive condition
  • Irregular sleep pattern
  • Surgical abortion
  • Advancing the age of women
  • Pollution
  • Genetic reasons
  • Frequent usage of contraceptive solution

List of infertility treatments that health insurance covers: 

The most common infertility treatment procedures that may be covered by health insurance are listed below. Some might need additional coverage options.

  1. IVF: This method collects eggs from the ovaries and mixes them with sperm in a lab to form the embryos. After that, the experts implant the embryos into the uterus.
  2. GIFT: This technique mixes sperm and eggs in a lab dish before placing them directly into the fallopian tubes.
  3. IUI: During this process, sperm is inserted directly into a woman’s uterus during ovulation which is usually done in a lab setting.
  4. ICSI: Here, the single sperm is injected into a single egg in a lab dish. After the embryo is made, it is transferred to the uterus.

You may not know different IVF treatment procedures are covered under health insurance. But, as not every insurer offers the same, it is important to check their terms and policies. The treatments that are categorized under health insurance are:

  1. Infertility diagnosis only cover
  2. Full infertility insurance cover
  3. Medication cover
  4. Infertility diagnosis and limited fertility treatment cover

What to consider when opting for a health insurance plan for infertility treatment?

Whenever you purchase coverage or add-ons for infertility treatment, it is important to keep the following points in mind:

  1. Ensure that the plan covers the expenses for diagnosing infertility problems
  2. Understand who qualifies for infertility coverage by checking the eligibility criteria
  3. Know which treatment process is included in the coverage
  4. Look into the limitations of the coverage including its extensiveness
  5. Stay familiar with the waiting period for infertility treatment as it may vary
  6. Find out whether the insurance covers the expenses of medications
  7. Explore to see if there are any additional benefits.


If you meet the eligibility criteria to take infertility insurance, take it. But, before you opt for any plan, check everything to avoid future mishaps. This will ensure a smooth journey.

If you are an insurance advisor looking to keep up with new products and information, then join TurtlemintPro which enables you to offer better quality and unbiased advice to your clients with the help of constant upskilling, tech and expert support.


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