In keeping with our theme of Family Inceptions School being in session, this week, we're talking insurance and surrogacy for intended parents. There are many costs associated with fertility treatment, pregnancy and eventually, the delivery of one (or more) children in the case of multiples. Whether it's the in vitro process, your gestational surrogate's care or unexpected NICU costs; considering insurance coverage, what you have, what your surrogate has and what you may need is highly recommended. It's also important to note that there's a difference between insurance for the actual pregnancy and coverage for the baby/babies once they are born. The insurance for the child goes on the intended parent's insurance or a separate newborn insurance plan, while the surrogate's insurance can be used for the pregnancy.
Your Insurance Coverage
Ever since the 1980's, there are only fifteen states that require insurance companies to cover infertility treatment in general. Not many insurance companies cover the cost of in vitro fertilization (IVF) let alone the embryo transfer to a gestational surrogate. Depending on your specific plan however, your policy may cover the cost, donor needs (if applicable), medications and very rarely your surrogate's care.
Therefore, one of the first things you should do is contact either your human resources department (if your insurance is through yours or your partner's job) or your insurance company directly to ask exactly what is and isn't covered. On your call, you want to ask specifically what is covered (screening, medications, actual procedures) and if there is a lifetime maximum.
Another question to ask your insurance is when a newborn can be added to your policy. For example, if it's possible to add your baby in the third trimester, this will make sure your child is covered for the delivery.
Your Surrogates Insurance Coverage
When considering a surrogate, it is important to inquire if any of the surrogates you're considering has health insurance. Some policies will cover a "surrogate pregnancy". If this is the case, she will be able to stay with all of her in-network providers that she has already established a relationship with and it could offer you some savings. It is best your agency contact her insurance and ask if there are any additional exclusions to be aware of.
There are some concerns however when using your surrogate's insurance. Her insurance might change should she get laid off, switch jobs or if the company switches insurance. This could impact what will be covered and if the doctors she is currently being treated by are still in network.
Surrogacy and the Affordable Care Act
Recently, the Affordable Care Act (ACA) has become a viable option when it comes to covering surrogacy costs. However, much like standard insurance companies, it's not necessarily included in all states. This is why we recommend seeing if your surrogate's state of residence allows the use of ACA.
Utilizing the ACA plan can offer a tremendous savings and offer helpful benefits. There are no caps in coverage and should treatment result in a twin pregnancy, the pricing will remain the same. Given too that the coverage is based on the resident state of your surrogate, whether the intended parent is domestic or international will not be a factor.
Like most insurance plans, the ACA has an open enrollment period. This year the enrollment period is between November 1st and December 15th with an effective date of January 1st. Depending on the timing of your planned surrogacy, this might be something you need to factor in. Another factor is the current uncertainty of the ACA under the recent administration.
Overall, intended parents need to provide health insurance of their surrogate. Using the surrogate's own insurance, an individual plan or the ACA holds several uncertainties so it is best to speak to your agency to determine which is the best and most economical option for you.
If you feel that gestational surrogacy is the path for you, whether you're interested in being a surrogate or using a surrogate, I can help educate you! Please fill out this form or call 844-404-BABY.