Many intended parents are surprised to learn that the insurance options for their surrogate are much more complicated than they anticipated. Let’s face it, insurance can be boring, hard to understand and frustrating.
It is, however, a crucial step that must be taken in order to protect the surrogate’s health and your financial exposure. While preparing for the cycle, it is important for your surrogacy agency’s insurance professional to perform a comprehensive insurance benefits analysis and look at the different options available for your particular situation.
If you are just getting started on your surrogacy journey, whether as a surrogate or Intended Parent, here are the answers to commonly asked questions about medical coverage during a surrogacy cycle.
What Types of ACA Surrogacy Insurance Are Available or Required?
Technically, none! There are no ACA medical plans that are specifically designed to cover a woman for surrogacy. She will need to have a medical insurance plan that does not have an exclusion for her using the maternity benefit of the policy while acting as a surrogate.
Can My Surrogate Just Use Her Own Insurance Plan?
It may be possible. Only careful evaluation of your surrogate’s personal policy by a qualified insurance specialist with knowledge of the fertility industry can determine whether your surrogate’s personal policy is suitable for use for a surrogate maternity cycle. There are many variables to consider and pay attention to throughout a surrogate journey. It is important to work with someone who understands the challenges, changes, special qualifications requirements as well as the timeline of enrollment requirements. Self funded, vs. fully funded policies, Employer Open Enrollment, or loss of employment are a few variables that may affect your cycle.
What Types of Insurance Plans Are Available For My Surrogate To Use?
There are two solid options available for your surrogate’s maternity care. The first is a traditional medical insurance plan, usually purchased under the Affordable Care Act (ACA) and based on the zip code where the surrogate lives.
The second option is a Surrogate Maternity Contractual Liability Insurance plan. This plan is underwritten by Lloyd’s of London and is not a medical insurance plan. Instead, it only covers the Intended Parents’ contractual obligation to pay for the surrogate’s medical expenses. It functions similar to a traditional medical plan.
How Much Does Medical Insurance For a Surrogate Cost?
Medical insurance costs for a surrogate can vary dramatically! A traditional plan under the Affordable Care Act can run between $11,000 and $13,000, and out-of-network costs push the price even higher.
Costs will be a bit higher if a Surrogate Maternity Liability Insurance plan is purchased and used as the primary coverage. Only surrogates carrying a singleton or twin pregnancy are eligible for this type of plan; it is not available for a triplet or higher order multiple pregnancy.
Average costs for this type of plan range from $25,500 to $28,350 for women carrying a singleton pregnancy, and $42,500 to $43,350 for women carrying a twin pregnancy.
Who is Covered Under a Surrogate’s Medical Policy?
Only your surrogate is covered by her medical policy. Your child is covered In Utero only. Your child once born, is not a dependent of the surrogate and will not be covered by her medical plan. In addition, any expenses related to the IVF cycle are not covered under this plan.
If a Surrogate Maternity Liability Insurance policy is used, only the medical expenses related to the surrogate pregnancy can be processed through the plan. It cannot be used for other medical expenses unrelated to the pregnancy; it does not cover any costs related to the IVF cycle.
Frequently Asked Questions About Surrogacy & Insurance
Have more questions about surrogacy & insurance? You’re not alone! Here are some of the most commonly asked questions we receive about navigating this complex topic. If you have any more questions about the surrogacy process, please don’t hesitate to contact our team: we are here to support you every step of the way.
Does Insurance Cover Surrogacy?
One of the most frequent questions we hear is, “Does health insurance cover surrogacy?” The answer to that question depends. Is surrogacy covered by insurance? Not officially; there is not an official ACA insurance plan for surrogacy. However, some plans accommodate surrogacy, while others have exclusions that make things difficult.
We recommend working with a qualified insurance specialist to navigate this factor of your surrogacy journey, whether you are a surrogate or an intended parent. They will be able to help you ensure that your insurance package is appropriate for embarking on a surrogacy agreement.
Can a Surrogate Be Without Personal Health Insurance?
Yes—health insurance is crucial for a medical and physical process as involved as surrogacy. However, this does not always mean that hopeful surrogates without a current insurance plan cannot participate in this process.
At Extraordinary Conceptions, we understand that US-based health insurance can be complicated to navigate, especially during times of change or upheaval, such as switching jobs, ending a marriage, or moving to another state. This is why working with an agency is so important; we are able to connect our surrogates and families to insurance specialists who can evaluate their potential or current providers to see if they are ideal for this process. We can also help surrogates or families enroll in a health insurance package that works for their unique circumstances.
Will the Baby Use the Surrogate’s Insurance?
During pregnancy, yes, the baby uses the surrogate’s insurance plan. Should any unexpected circumstances arise whilst the baby is in utero, they will be fully covered by the surrogate’s insurance plan. However, that is only the case during those 9 months!
Once a surrogate baby has been born, they will be legally considered the intended parents’ child— this is an important contractual aspect of this process. Once the child has been born, the Intended Family will obtain legal parentage, which officially makes the baby their dependant, not the surrogate’s. Therefore, a surrogate’s insurance will no longer cover the baby after birth. That becomes the responsibility of the Intended Parents.
Will Surrogates Receive Medical Bills?
No! Surrogates are not expected to pay a dime towards any portion of this process, including medical bills. This is the case for both altruistic and commercial surrogacy agreements. In fact, every pregnancy or surrogacy-related expense that a surrogate faces will be reimbursed. Reimbursement packages include medical expenses, maternity clothes, and lost wages from missed days of work.
In some places, like Canada, a surrogate’s medical expenses are covered by their national health insurance provider. For surrogates in the USA, some expenses may be covered by medical insurance, while others will be paid for by their intended parents. In some cases, intended parents can cover some expenses with their own health insurance plan.
It is important for intended parents to be prepared to take on a significant financial responsibility during the surrogacy process. They will be expected to cover their surrogates’ expenses, and in the case of a commercial agreement, also provide her with a compensation package between $30,000-$70,000.
Does My State Mandate Coverage for Fertility Treatments?
It might! However, this depends on where you are located. While many states do offer locally-mandated coverage for various fertility treatments, others do not. Furthermore, the regulations and specific requirements for locally-mandated fertility treatments are different on a state-by-state basis.
Currently, the following states have some form of legislation regarding insurance for experiencing infertility: Arkansas, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Montana, New Hampshire, New Jersey, New York, Ohio, Rhode Island, Texas, Utah, and West Virginia. However, this legislation can look very different depending on location and does not automatically guarantee coverage for surrogacy. In fact, some of these locations (like Louisiana) have many restrictions surrounding surrogacy and are not recommended as locations for this process overall.
For more information about your own state’s laws surrounding surrogacy insurance and legislation, get in touch with our team. We can help you navigate the “legalese” to ensure that you are informed and ready to proceed!
Contact Us
Yes, medical and surrogacy insurance can be a little confusing, which makes working with an experienced surrogacy agency like Extraordinary Conceptions a huge benefit! We can help you evaluate her current health insurance plan and/or get a new plan if necessary. This brings you tremendous peace of mind, so you can focus on getting to know your surrogate and enjoying your journey together.
When beginning a surrogacy cycle, it is easy to forget about her medical coverage need, but it is a crucially important step. Please reach out to your Extraordinary Conceptions surrogacy caseworker for more information and to get started!
