Become a Surrogate in Massachusetts

Surrogacy is an arrangement in which a woman intends and agrees to become pregnant for and to carry a pregnancy for someone else (“Intended Parent(s)” or “IP(s)”) who is/are intended to be the child’s legal and natural parent(s) after birth. As you undergo the surrogacy process, you should know there are two types of surrogates: gestational surrogates and traditional (genetic) surrogates.

A Gestational Carrier (medical term)/Gestational Surrogate (“Non-Genetic Surrogate”) is not genetically related to the child she carries. Modern technology allows the gestational surrogate to become pregnant with and carry a fetus that’s genetically unrelated to her by transferring embryos to her uterus formed via in vitro fertilization (“IVF”) using donor eggs or the eggs of the intended mother.

A Traditional Surrogate (“Genetic Surrogate”) becomes pregnant and carries a fetus genetically related to her by either having embryos formed via IVF using her eggs and the intended father’s sperm or donor sperm transferred to her uterus, or by achieving pregnancy by intra-uterine insemination using the intended father’s sperm or donor sperm. A traditional surrogate is a biological mother, but she intends to become pregnant and carry a child with the intention of relinquishing potential parental rights to the intended parent(s) upon birth. She never intends to become pregnant to have her own child. Genetic Surrogacy is traditionally not achieved by sexual intercourse.

Until very recently, tax breaks and laws for those using an egg donor or surrogate to create or grow their family have been murky to non-existent.

Things started to change in 2003 when the IRS ruled that couples using IVF could deduct fees associated with their treatment. This included costs associated with fertilization and embryo transfer. Additionally, agency fees, donor fees, and even medical and psychological testing fees are covered as medical expenses. Finally, insurance premiums connected with post-procedure care and even your legal fees (as related to contract preparation) can also qualify.

When it comes to your surrogate expenses, however, it’s a different conversation entirely. For the most part, most expenses will not qualify as a medical deduction. The exception would be surrogate expenses that can be tracked to an underlying medical condition that you have that makes it impossible for you to carry your own pregnancy.

You should consult with your tax professional and doctor to discuss your history of infertility to see what deductions may apply. A tax lawyer may be able to offer additional insight. It is wise to discuss your questions and concerns with a tax professional, tax attorney, or CPA to find the best solution for your individual situation.

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.

Ever since the 1980s, 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.

When considering a surrogate, it is important to inquire if any of the surrogates you’re considering have 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 she has already established a relationship with and it could offer you some savings. It is best for your agency to contact her insurance and ask if there are any additional exclusions to be aware of.

In general, the surrogacy process could take up to 15-18 months. Of course, this time frame can vary greatly depending on your circumstances. If you need to find an egg or sperm donor or create embryos, this may add an additional 3-4 months to the process. The bottom line is that surrogacy is not a quick process.

But, up ‘til this point, has anything in your journey to parenthood been quick? So you know what it takes to be patient. The surrogacy process will be long, but well worth it in the end.

We at Family Inceptions Surrogacy Agency take the needed measures to ensure your surrogacy journey is as smooth as possible while we walk beside you every step of the way.

Let’s cut right to the quick- becoming a surrogate is a big deal. It’s a common phrase among adults, “…but first, do your research.” It’s true for most things in life, and becoming a surrogate is no different. Not only are you signing up for what might be a multi-year process, this is also a choice that comes with a lot of emotional difficulties, and at least on some level, is quite expensive.

In addition to that, while pregnancy is generally safe, things can happen during pregnancy and childbirth that are not pretty. So, before you jump in with both feet and decide to become a surrogate, do your research.

Here are a few things to consider before becoming a surrogate mother:

• Do you qualify? Only about 5% of women who apply to become surrogates will make it through the entire screening process. Things like age, health, past pregnancy, and birth records, fiscal stability, and mental health will be considered. In general, surrogacy is open to women aged 21-40 years old who are raising at least one of their own children. You need to have had an uncomplicated pregnancy and no more than two previous C-section deliveries. Additionally, you cannot be on any form of federal aid (food stamps, etc.). You will also be tested for nicotine and illegal drugs in your system.

• What are you willing to consent to? Part of your research should include considering what type of experience you’re hoping to have. Gestational surrogacy means that the child that you will carry will have no genetic connection to you or to your husband, so you will not need to worry about being asked to donate your own eggs. However, you will have a say on things like the number of embryos that you’re comfortable having transferred to your uterus, and the number of fetuses you’re willing to carry. You’ll also want to consider if you’d be willing to terminate a pregnancy, and if so, under what conditions.

• What is a realistic compensation expectation? A quick search through Craigslist or Google can have you thinking that surrogacy means a six-figure income in under a year flat. We want to be the first ones to tell you that this is a bold-faced lie. The first thing that you need to know is that surrogacy can be a long process. You don’t earn compensation until you’re pregnant with a confirmed heartbeat, which means it could take months before you ever earn any compensation. In addition, many places inflate compensation number to attract applicants. Before jumping at the highest compensation package that you find, consider your motives. If you’re in this simply for the compensation, you’re not likely to have an enjoyable experience at all. Finally, compare compensation packages from many agencies. The ones paying the highest amount of compensation may lack in areas of perks and support. You’ll want to be educated on the total picture of compensation before signing with a particular agency.

• What will be expected of you? You already know that you’ll be pregnant, but will you also be required to eat only organic whole foods? The answer to this is probably not, but it does highlight the importance of learning what is expected of your behavior during the course of your experience before moving forward. You may be placed on travel restrictions, which could impact family vacations. Additionally, you’ll be expected to make and keep medical appointments as well as communicate about how those visits go.

Once you’ve considered these things, you will be in a much better place to decide if you’d like to move forward or not as a surrogate.

Gestational surrogates can make up to $65,000 with Family Inceptions. This includes a $35,000-$45,000 base compensation, plus additional monthly stipends and allowances throughout your surrogacy journey.

Family Inceptions offer a generous compensation package to our surrogate mothers, and what you choose to do with the money you earn as a surrogate is completely up to you. Whether you choose to put a down payment on your home, save up to send your own children to college, or create a small business for yourself, there are many ways that this money can benefit you and your family greatly.

Of course, there is no way that the gift you bring to the future parents—and the rest of the world—could ever be quantified. It is a gift for which no one can ever repay you in full precisely because the life you will nurture, and all the hopes and dreams you carry, are priceless.

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Here’s a little bit about the show:

Who ever thought that making a baby could be so hard? Luckily, the fertility journey isn’t meant to be traveled alone. So grab a seat and let’s talk about fertility and alternative family building with leading industry expert, Eloise Drane.

FERTILITY CAFÉ is a weekly podcast focusing on all aspects of the fertility journey—from finding the right clinic and best reproductive endocrinologists, to navigating the egg and embryo donation process, to the ins-and-out of surrogacy including medical, legal, and financial aspects.

Eloise has helped hundreds of people build (and grow) their families over the last 15 years, and speaks candidly about the processes involved in making the dream of a baby a reality NOW.

Whether you’re an intended parent, a woman considering egg donation, thinking of becoming a surrogate yourself, or a friend or family member of someone dealing with infertility, this podcast will give you the insider information you’ve been seeking.

Medical insurance in surrogacy is so important. Not only is surrogacy a major financial undertaking for the intended parents, but the idea of unchecked medical costs could also be downright terrifying. This is why, for the protection of both our surrogates and our intended parents, we require every match that we facilitate carry insurance.

While most people in the US do have health insurance, surrogacy is a tricky thing. Many insurance plans will have exclusions for surrogacy pregnancy. This is particularly true for women serving in or covered by a spouse who serves in the armed forces.

If a surrogate does not have a personal insurance plan that covers surrogacy, an intended parent is required to purchase and carry a medical insurance plan that will cover your related medical expenses during the course of your pregnancy.

Perhaps one of the best ways to get affordable health care coverage is with the Affordable Care Act (ACA). This plan is open to anyone and does cover surrogate pregnancies (in most states), but you can only be enrolled in the plan over one period of six weeks every year. This period is known as open enrollment.

When tax season rolls around, it’s normal for surrogates to wonder whether their surrogate compensation is taxable — and whether they have to report their pay as a surrogate to the Internal Revenue Service.

The best way to determine whether you must pay taxes is whether you received a 1099-MISC form from your intended parents, your surrogacy agency, or your escrow service. If you receive a 1099-MISC for your compensation, you must definitely claim income on your taxes.

What if your surrogacy agency or intended parents don’t issue a 1099? Is surrogate compensation taxed in this situation?

Often, the question of whether a surrogate mother will pay taxes first arises during the drafting of the Gestational Surrogacy Agreement. Your lawyer may include a clause that holds intended parents accountable for any taxes that a gestational carrier may or may not be expected to pay on her compensation. As soon as you have a surrogacy attorney, talk with them in depth about this process to make sure you understand what taxes (if any) you might expect to pay after your surrogacy journey. You and your intended parents should always be on the same page about this topic before your surrogacy contract is finalized and signed.

In the debate about whether income from being a surrogate is taxable or not, the answer often comes down to the language used in the surrogacy contract and the tax laws of the state where a surrogate resides. In your research, you may find a few phrases thrown about:

• “Gift”: Some accountants can avoid certain taxes on surrogate compensation by claiming a percentage of the compensation as a “gift” from the intended parents. However, compensation usually is higher than the annual exemption for gift tax, so surrogates may need to pay taxes on a portion of their compensation payments.
• “Pain and suffering”: Some accountants and surrogacy professionals will avoid taxation by claiming that surrogate compensation is payment for pain and suffering. How well this holds up in court is debatable; after all, a gestational carrier is voluntarily entering this process of “pain and suffering,” which may negate that tax-exemption status.
• “Pre-birth child support”: Child support is tax-exempt, so some attorneys word compensation as pre-birth child support in order to protect carriers from taxes. But, there is no legal standard for “pre-birth” child support, so enforcement and legal interpretation may vary.

As mentioned, because there are no court cases setting a precedent for this topic, the effectiveness of this language is up for debate. When it comes to taxes on surrogacy compensation, it’s a good idea not to assume anything without the assistance of a professional.

Just because you want to be a surrogate doesn’t mean you qualify to become one. There are a lot of factors that are taken into consideration. Candidates are evaluated on their age, medical history, financial independence, location, their thoughts on termination, and even their desire for contact and communication.

I referenced ASRM previously, which is the governing body that professionals seek to help develop the standard they use in their practices.

According to the American Society for Reproductive Medicine, or ASRM, to be a surrogate or a gestational carrier, a woman:

• Must be at least 21 years old
• Must have carried and successfully delivered a full-term baby

Besides that, clinics and agencies will have their own specific requirements that must be considered.

Here are the specific requirements we, at Family Inceptions, require from our select group of surrogate mothers: Do I Qualify to be a Surrogate?

Assuming you meet all the qualifications, the next step would be to fill out an application with Family Inceptions Surrogacy Agency.

When it comes to matters of fertility and family building, the DIY route may cause undue amounts of stress and frustration. Going through a reputable agency will ensure that all parties involved are protected from scams (which unfortunately does happen) or from being matched with an unreliable donor or surrogate.

Here are some pros and cons to consider about going through a surrogacy agency or going the independent route:

Match through a surrogacy agency if:

• You’re a first-time surrogate: You are unsure about how to start or find intended parents for your journey.
• You need support and guidance: You would like help, guidance, counseling, and support readily available and throughout the entire process, including the pregnancy and delivery.
• Matching: You are insecure about interviewing and negotiating compensation directly with the intended parents.
• Advocate: You like that there is someone else ensuring that your best interests are paramount.
• Legal: You’re not sure about what all should be included in your contract with your intended parents.
• Security peace of mind: you want to make sure your intended parents can afford the journey and that they will be there to get the baby.
• Professional referrals: You want to make sure all the professionals that will assist you in your journey are experienced and understand the process.

Match independently if:

• You’re an experienced surrogate: You’ve already done a successful journey and know the time and commitment it takes to complete a successful journey.
• No middleman: you like the idea of organizing every aspect of the surrogacy journey on your own, including interviewing the intended parents, matching, medical and compensation negotiation.
• Saving money: You want to help the intended parents save money.
• Complications/Disagreements: You are confident you can handle any issues that arise between you and your intended parents.
• Compensation: Just because you decide to go independently, does not mean you are going to get a higher compensation.

To become a Gestational Surrogate, we at Family Inceptions need to learn some information about your personal and medical history. Our knowledge of your health and medical history allows us to determine if you are compatible with the surrogacy process for Gestational Surrogacy so that it will not involve any increased risks for you. This will also help us match you with an appropriate recipient.

First, you should know what the requirements are for becoming a surrogate. You must fulfill the following criteria:

• Must be between the ages of 21-40.
• Must have delivered at least one healthy child that you yourself have raised or are raising.
• Must have no prior pregnancy complications—No deliveries before 35 weeks-unless delivered twins or more.
• Must have no more than 2 c-sections
• Must have no more than 5 deliveries
• Must provide proof of support person.
• Must have willingness to be completely committed to the Intended Parents.
• Must adhere to our strict screening and counseling protocol.
• Must have a stable financial base—Not receiving any form of government assistance (State funded insurance, Food stamps, WIC, Housing, AFDC)
• Must clear all criminal background checks
• Must be a non-smoker and non-drug user
• Must have a reliable form of transportation.
• Must have U.S. citizenship or a permanent residency status.
• Must meet height and weight guidelines for your body mass index (BMI).
• Must be able to provide medical records to clinic
• Must undergo a psychological evaluation
• Must comply with medical testing required of both you and your husband/partner.
• Absence of any active sexually transmitted diseases, cancer, substance abuse, significant medication use, and prior chemotherapy or radiation therapy.
• Must be willing to do a home assessment.