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The Role of Health Insurance in IVF Treatment in India

By Vikas Chandra Das
16 November 2022, 4:03 PM

Every couple wishes to have kids because they bring joy to the family. Unfortunately, women can often not conceive a child due to various reasons. Such scenarios are caused by infertility. In such cases, seeking medical assistance, such as invitro fertilisation or IVF treatment, is critical. It is a procedure that helps childless couples start a family. However, these infertility treatments are not cheap, and it may take several IVF attempts to conceive, adding to the cost. That's when having a health insurance policy that covers IVF plays a vital part.

Does Health Insurance Cover IVF in India?

Maternity and newborn coverage are typically included in regular health insurance plans, and IVF protection may or may not be included in all of them. New-age insurers cover IVF treatments and some also link it with maternity cover. Coverage usually differs from one insurer to the other, as some might only cover specific infertility treatments. If you want to receive compensation for IVF treatments, you should conduct extensive research and compare health insurance plans and insurers before finalising your choice. Some insurance companies only cover the testing costs and not the entire procedure. As the incidents of infertility rise in India and the number of couples undergoing IVF treatments rises year after year, many insurers are providing coverage for the treatment.

Treatments Covered Under Health Insurance

Some treatments covered under health insurance are:

  1. In Vitro Fertilisation(IVF): Eggs are gathered from a woman's ovaries and combined with the sperm in a laboratory to make an embryo, which is then implanted into the uterus.
  2. Intrauterine Insemination (IUI): The sperms are inserted directly into the uterus in the laboratory during ovulation.
  3. Gamete Intrafallopian Transfer (GIFT): This involves combining eggs with the sperms in the laboratory and inserting them into the Fallopian tube.
  4. Intracytoplasmic Sperm Injection(ICSI): Injecting a single sperm into a single egg in the laboratory to form an embryo and transplant it into the uterus.

Terms and Conditions to Know While Seeking Infertility Treatments

  • Eligibility: It is determined by your age, medical history, lifestyle and other health issues.
  • Waiting Period: The amount of time you must wait before you can use the policy's benefits. This can range between 2-4 years.
  • Validity: A policy's validity tells you how many times you can use it. Typically, you can only use this policy once.
  • Health Insurance Add-ons/Riders: Some additional benefits are available with premium policies. 

Types of IVF coverage 

Listed here are some of the IVF health insurances that are designed particularly to cover IVF treatments: 

  • Coverage of Infertility Diagnose: A thorough diagnosis is required before pursuing IVF treatments. The doctor orders a battery of tests to determine whether or not a couple can conceive naturally. As a result, your insurance provider may cover a variety of tests and procedures. This policy does not cover treatments performed after the diagnosis.
  • Infertility Diagnosis Cover with Limited Fertility Treatment: Some health insurance policies may cover limited treatment after the diagnosis. However, the coverage amount may vary depending on the insurance provider.
  • Medication Cover: The doctor may prescribe various medications during IVF treatments ranging from tablets and pills to hormones and injections. Some health insurance companies provide reimbursement for medication used in IVF treatments. However, to reap the health insurance benefits fully, it is necessary to carefully read the documents and consult with the provider about which medications are covered.
  • Complete Infertility Coverage: This policy covers the entire IVF treatment process, from diagnosis to treatment. Some may also include post-treatment. The policyholder must have a thorough discussion with the insurer to determine whether your health insurance provides this coverage.

Key points to Consider When you Buy Health Insurance for IVF Treatments

You should read all of the plan's terms and conditions before purchasing it. Before finalising health insurance for infertility coverage, consider the following:

  • Check the diagnostic coverage in the policy.
  • Check the eligibility criteria before buying the plan to undergo IVF treatments.
  • Check the procedures and treatments that are covered.
  • Check the length and limits of coverage.
  • Check the waiting period for the treatment, as it may vary for different insurers.
  • Check the medication coverage under the plan.

Conclusion

Infertility is no longer a barrier to becoming a parent. With advances in medical science, treatments such as IVF can help many couples realise their dreams of becoming parents. The cost of an IVF treatment in India ranges from INR 1 lakh to INR 4 lakhs per cycle. You may also be required to undergo these procedures more than once, which can be costly. This is why it is necessary to have health insurance that covers infertility treatments. It would be best to compare several insurance plans before deciding on the one that is best for you and your partner.

FAQs

1. Does infertility affect both men and women?

Yes, infertility is a medical condition, and the reason for the same is unknown. It can affect both males and females. 

2. Can this insurance be availed for the second child?

Yes, most health insurance policies cover both primary and secondary fertility treatments. Even then, it is advisable to discuss the details with the policy provider if you want to buy the policy for your second child.

3. Can I avail of this policy outside India?

No, most insurance policies do not cover infertility treatments taken outside India. If you are planning to undergo treatment outside India, you must search for such policies covering infertility treatments taken internationally.

4. If my partner is infertile, but I am insured, is this valid?

Usually, it is not valid if the policyholder is not the same person. However, it might be possible in the case of a floater plan if the spouse is also insured. You might need to check with the policy provider. 

5. Which is the best insurance for infertility treatment?

Knowing the kind of treatment you and your spouse should undergo for better results is essential. After this, you must opt for a health insurance plan that covers multiple types of infertility and its treatment. Before buying the policy, it is advisable to check all the inclusions and exclusions. 

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