header Health Insurance

Does Health Insurance Cover Infertility Treatment?

By Juhi Walia
11 October 2022, 10:59 AM

Infertility treatment is expensive and often not covered by health insurance. This can be a financial burden for couples who are struggling to conceive. It is important to check with your health insurance provider to see if it covers fertility treatment before going for it. 

There are many different types of infertility treatments available, and the cost can vary depending on the type of treatment. Some couples may get coverage for infertility treatments through their employer. Others may need to purchase a separate fertility insurance policy. Some couples may also qualify for government assistance.

What is Infertility?

Infertility is a condition that results in the inability to conceive or carry a pregnancy in full term. It may be due to various factors, including hormonal imbalances, medical conditions, or psychological issues. Infertility can be devastating for couples hoping to start a family. While there are treatments available that can help some couples conceive, others may never be able to have biological children.

Causes of Infertility 

There are many possible causes of infertility, both in men and women. In men, a common cause of infertility is a low sperm count. This can be due to a variety of factors, including genetic defects, health problems, or exposure to certain toxins. Another possible cause of male infertility is a blockage in the sperm ducts, which can prevent sperm from reaching the eggs.

In women, one of the most common causes of infertility is polycystic ovarian syndrome (PCOS). This is a condition in which the ovaries produce too many hormones, which can interfere with the development of eggs. PCOS can also cause irregular periods, making it difficult to become pregnant. Other possible causes of female infertility include endometriosis, in which the tissue that lines the uterus grows outside of the uterus, and uterine fibroids, which are non-cancerous growths in the uterus.

Health Insurance Coverage for Infertility Treatment

There is no simple answer to this question, as different health insurance policies cover different aspects like preventive care, doctor's visits, hospitalisations, surgeries, and prescription drugs. Some health insurance policies may cover infertility treatment, while others may not. It really depends on the individual policy. Some things that may be covered by health insurance for infertility treatment include diagnostic testing, medication, and surgery. It is important to check with your individual health insurance provider to see what is covered under your policy.

Infertility Treatment Covered Under Health Insurance 

There are several infertility treatment procedures covered under health insurance. These include in-vitro fertilisation (IVF), artificial insemination, and other assisted reproductive technologies (ART). Make sure your health insurance covers these types of treatment because every policy has different terms & conditions:

1. In Vitro Fertilisation (IVF)

  • In vitro fertilisation (IVF) is a medical procedure in which eggs are retrieved from a woman's ovaries and fertilised with sperm in a laboratory. The resulting embryos are transferred to the woman's uterus.
  • IVF is costly, and many health insurance companies do not cover it. However, some states have laws that require insurance companies to cover IVF. Some employers offer health insurance plans that include IVF coverage.
  • If you are considering IVF, it is important to check with your insurance company to see if it is covered. If it is not, you may need to pay for the procedure.

2. Intrauterine insemination (IUI)

  • Intrauterine insemination (IUI) is a type of fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilisation. IUI is often used when a man has a low sperm count or when there are other issues with the quality of his sperm. It may be used in cases of unexplained infertility.
  • IUI is typically covered by health insurance, but coverage may vary depending on the specific policy. Some insurance plans may cover IUI as a part of fertility treatment, while others may only cover IUI if it is medically necessary. It is important to check with your insurance provider to see what is covered under your plan.

3. Gamete Intrafallopian Transfer (GIFT)

  • GIFT is a fertility treatment that involves transferring eggs and sperm into the fallopian tubes. It is typically used when the cause of infertility is unknown or when other fertility treatments have failed.
  • GIFT is considered to be a relatively safe procedure, but there are some risks involved. These include the risks associated with any surgery, as well as the risk of ectopic pregnancy.
  • Health insurance policies vary widely in terms of what they cover. Some policies may cover the cost of GIFT, while others may not.

These three are common treatments that can be covered under health insurance. But before buying any health insurance, make sure they cover these types of treatments.

Things to Check Before Buying Health Insurance for Infertility Treatment

When considering health insurance for infertility treatment, there are a few key things to keep in mind:

  • Make sure that the policy covers the specific treatments you're looking for. Some policies may only cover certain types of treatment or may limit the number of treatments covered. 
  • Check to see what the policy covers in terms of costs. Some policies will only cover a portion of treatment costs, while others may cover the full amount.
  • Make sure to check the policy's waiting period before coverage takes effect. This is important because some policies may have a waiting period of 12 months or more before coverage kicks in, which could delay your treatment.
  • Check the policy's exclusions to avoid any surprises down the road. 

Conclusion

Healthcare costs are rising, often leaving people in a tough position. This is especially true for people who have to decide between paying for medical treatment for infertility and other health issues. Luckily, many insurance companies do cover infertility treatment, but you need to research ahead of time to see if you are covered and find out how much you would need to pay out-of-pocket. We hope this blog has helped you find out how to pay for your fertility treatment. If you like this article, share it now.

Read more -

FAQs

1. Is IVF your own baby?

When the IVF procedure is performed by using your/your spouse’s eggs and your spouse’s/your sperm, the baby is your own.

2. Which health insurance company covers IVF?

BMB Nirbhaya Scheme by Bharatiya Mahila Bank covers IVF.

3. Can you choose gender with IVF?

No, you can't choose gender with IVF.

4. Why is IVF not covered by insurance?

Many fertility treatments are not considered “medically necessary” under insurance companies, so they don't cover IVF health insurance.

5. How long does an IUI take?

The IUI procedure takes 2 hours normally.

Health Insurance banner
Health Insurance

Plans starting at only ₹7/day*

Enter your details to buy Health Insurance
By proceeding, I agree to the Terms & Conditions