Insurance for Infertility Treatments in the USA: A Comprehensive Guide

Infertility affects millions of individuals and couples in the United States, making access to fertility treatments not only a medical concern but a financial challenge. According to recent estimates, around one in six couples struggles with infertility. Fortunately, modern medicine offers a wide range of diagnostic and advanced procedures—from IVF and IUI to egg freezing and genetic testing—that can assist in achieving parenthood. However, the cost of these services is often high, prompting many to ask: “Does my insurance cover infertility treatments?”

This guide explores the top options for infertility insurance in the United States, how coverage varies by state and insurer, what is included or excluded, and how to compare plans and quotes to find affordable and comprehensive coverage.

What Is Infertility and What Treatments Are Available?

Infertility is typically defined as the inability to conceive after 12 months of regular, unprotected sexual intercourse. For women over 35, this timeframe is often reduced to six months. Infertility can be caused by various factors affecting either or both partners, and the available treatments are wide-ranging.

Diagnostic Services

Before starting treatment, individuals often undergo a series of diagnostic procedures. These include:

• Hormonal testing

• Semen analysis

• Ovarian reserve testing

• Hysterosalpingography (HSG)

• Laparoscopy

• Ultrasound assessments

These tests help gynecologists and obstetricians determine the root cause of infertility and develop a treatment plan. Insurance coverage for diagnostic services varies by policy and state, but many health plans cover at least basic infertility testing.

Common Fertility Procedures

In Vitro Fertilization (IVF)

IVF is one of the most well-known and effective fertility treatments. It involves retrieving eggs from the ovaries, fertilizing them with sperm in a lab, and transferring the resulting embryo into the uterus. IVF costs can range from $12,000 to $20,000 per cycle, not including medications, making it one of the most expensive procedures. It is also one of the most sought-after services to be covered by insurance.

Intrauterine Insemination (IUI)

Also known as artificial insemination, IUI involves placing sperm directly into the uterus at the time of ovulation. It’s less invasive and less expensive than IVF, usually costing between $300 to $1,000 per attempt.

Egg and Embryo Freezing

Egg freezing (oocyte cryopreservation) and embryo freezing are popular options for individuals who want to preserve their fertility for future use. This is especially common among cancer patients undergoing chemotherapy or individuals who want to delay parenthood.

Surrogacy and Gestational Carriers

In some cases, individuals may turn to surrogacy or gestational carriers. While emotionally fulfilling, these options are often excluded from insurance coverage and are among the most expensive paths to parenthood.

State-Specific Infertility Insurance Mandates

Insurance coverage for infertility treatments in the U.S. varies significantly by state. Some states mandate insurance plans to provide fertility treatment coverage, while others do not. This means your location can greatly influence your access to inclusive and affordable care.

States with Strong Mandates

Some states have comprehensive mandates requiring insurers to cover a broad list of infertility treatments, including IVF and fertility preservation.

• Massachusetts: Often ranked as the top state for fertility coverage. It mandates coverage for all FDA-approved infertility treatments, including IVF and IUI.

• Illinois: Requires group health plans to cover diagnosis and treatment of infertility, including four IVF cycles.

• New York: Covers up to three IVF cycles and ensures access regardless of sexual orientation, gender identity, or partner status.

States with Limited Mandates

These states may only require insurers to offer coverage, not mandate employers to include it in their policies:

• California

• Texas

• Connecticut

States with No Mandates

There are still over 25 states with no legal requirement for fertility coverage, including:

• Florida

• Georgia

• Alabama

• Idaho

• Wyoming

Residents in these states must rely on private insurers or employer-sponsored plans.

Employer-Based Coverage: A Growing Trend

While state laws are critical, employer-based insurance has become a powerful avenue for accessing fertility treatment coverage. More and more large companies are offering fertility benefits as part of their healthcare packages. These benefits often include:

• IVF coverage

• Egg and sperm freezing

• Genetic testing

• Surrogacy reimbursement

• Fertility coaching

Large vs. Small Employers

Large Group Plans: Companies with 50 or more employees often have more flexibility and budget to offer inclusive fertility benefits.

Small Group Plans: Smaller employers may offer limited or no fertility coverage due to higher costs and fewer policy options.

If you’re employed, contact your HR department to ask:

• “What infertility benefits are included in my plan?”

• “Can I get a quote for IVF coverage?”

• “Is egg freezing covered for non-medical reasons?”

List of the top 10 insurers providing insurance for infertility treatments, highlighting their offerings and coverage options.

Progyny

Progyny is a leading fertility benefits management company that partners with employers to provide comprehensive fertility coverage. Their plans often include multiple IVF cycles, genetic testing, and access to a wide network of fertility clinics. Progyny’s approach focuses on personalized care and support, aiming to reduce time to pregnancy and improve outcomes.

Aetna

Aetna offers fertility coverage through its health plans, which may include IVF, IUI, and fertility preservation services. Coverage details vary by plan and state, so it’s essential to review your specific policy. Aetna also provides a fertility concierge service to assist members in navigating their treatment options.

UnitedHealthcare

UnitedHealthcare provides fertility benefits as part of its health insurance plans. Their coverage may include IVF, IUI, and related services, depending on the plan and state regulations. UnitedHealthcare also offers access to a broad network of fertility specialists and clinics.

Cigna

Cigna’s fertility coverage includes services such as IVF, IUI, and diagnostic testing. The specifics of coverage can vary based on the plan and state mandates. Cigna emphasizes personalized care and support for members undergoing fertility treatments.

Kaiser Permanente

Kaiser Permanente offers comprehensive fertility services, including IVF, IUI, and fertility preservation. Their integrated care model allows for coordinated treatment across various specialties, ensuring a streamlined experience for members.

Blue Cross Blue Shield (BCBS)

Blue Cross Blue Shield is a federation of 36 independent health insurance companies that offer fertility coverage in many states. Coverage details vary by state and plan, so it’s important to review your specific policy. BCBS plans may include IVF, IUI, and related services.

Tricare

Tricare provides healthcare coverage for military families, including fertility treatments. However, IVF coverage under Tricare is limited to specific cases, such as when infertility is related to a service-connected injury. Even in qualifying cases, coverage may only be available at select military treatment facilities, and out-of-pocket costs can still apply.

Future Family

Future Family is a fertility benefits provider that offers personalized support and financing options for individuals undergoing fertility treatments. Their services include IVF financing, one-on-one coaching, and access to a network of fertility clinics. Future Family aims to make fertility treatments more accessible and affordable.

Oscar Health

Oscar Health offers fertility coverage as part of its health insurance plans in select states. Their plans may include IVF, IUI, and related services, depending on the plan and state regulations. Oscar Health emphasizes technology-driven care and member support.

Anthem

Anthem, a subsidiary of Blue Cross Blue Shield, provides fertility coverage in several states. Their plans may include IVF, IUI, and related services, with coverage details varying by state and plan. Anthem offers access to a broad network of healthcare providers and specialists.

What Is Usually Included in Infertility Insurance?

Insurance coverage for infertility treatments can be comprehensive or limited, depending on the plan. Here are some services that may be included:

• Initial consultation with a reproductive endocrinologist

• Hormonal and diagnostic testing

• Ultrasounds and semen analysis

• Intrauterine insemination (IUI)

• IVF (may have limits on number of cycles)

• Egg retrieval and embryo transfer

• Coverage for medications used during IVF

• Fertility preservation for cancer patients

What Is Often Excluded from Coverage?

Unfortunately, many plans exclude certain procedures or set strict criteria for access:

• IVF for single individuals or same-sex couples in some states

• Experimental treatments like mitochondrial donation

• Surrogacy arrangements

• Egg freezing for non-medical reasons

• Preimplantation genetic testing (PGT) unless medically indicated

• Fertility treatments for individuals over a certain age

LGBTQ+ Considerations and Equality in Coverage

While infertility isn’t always a medical diagnosis for LGBTQ+ individuals, they still require assisted reproduction to build families. Some insurers and states have updated their policies to reflect non-discrimination based on:

• Sexual orientation

• Gender identity

• Partner status (single vs. married)

Make sure to compare your options to find a highly trusted insurer offering inclusive coverage. The best insurance plans now offer access to fertility services for everyone, regardless of sexual orientation or marital status.

How to Compare Infertility Insurance Plans

Comparing insurance policies is essential to find the best fertility coverage at the lowest prices. Use online tools or speak with a licensed insurance agent to compare:

• Monthly premiums

• Deductibles and co-pays

• Coverage limits per cycle/year/lifetime

• In-network specialists (e.g., obstetricians, gynecologists)

• Preauthorization requirements

• Waiting periods

You can often get a quote online in minutes to start comparing options side by side.

How to Get IVF Covered by Insurance

Many ask, “How do I get IVF covered by my insurance?” Here’s a quick guide:

1. Check your policy documents or call your insurer.

2. Ask if IVF is covered, and what requirements must be met.

3. Inquire about cycle limits, lifetime maximums, and medication coverage.

4. Seek a referral from your OB/GYN or gynecologist to a fertility clinic.

5. Submit pre-authorization forms if needed.

If IVF is not covered, ask your employer to consider adding it or look into supplemental fertility benefit programs.

Alternatives When Insurance Doesn’t Cover Fertility Treatments

Not all individuals have access to insurance that covers infertility. If you’re in this situation, there are still options:

Self-Pay Discounts

Many clinics offer self-pay packages that include multiple IVF cycles at reduced rates. These can also bundle services like egg retrieval, embryo freezing, and medications.

Fertility Loan Programs

Several lenders offer low-interest medical loans specifically for fertility treatments. These loans may provide instant approval and flexible terms.

Grants and Scholarships

Organizations across the country offer grants to help cover IVF, egg freezing, or adoption expenses.

Adoption and Surrogacy Support

If traditional fertility treatments are not viable, some employers offer financial support for adoption or surrogacy. These are often separate from insurance policies but may be available as part of employee benefits.

Key Considerations Before Choosing a Fertility Insurance Plan

When evaluating different policies or benefit programs, keep in mind:

• Coverage limits: How many IVF or IUI cycles are covered?

• Eligibility rules: Is there a waiting period or diagnostic requirement?

• Provider network: Are your preferred doctors and clinics covered?

• State laws: Do you live in a state with a fertility mandate?

• Inclusive language: Are LGBTQ+ individuals and single parents supported?

To sum up: Choosing the Best Path to Parenthood

Access to infertility treatments can open the door to a deeply desired future for many families. With a wide range of services—from diagnostics to advanced procedures like IVF and egg freezing—insurance plays a critical role in making parenthood more attainable and affordable.

In a world where infertility treatment is both essential and expensive, insurance can be a powerful ally—if you know how to find the best coverage tailored to your needs.

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