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Insurance and Company Benefits Covering Fertility and Surrogacy Costs

by | Employer

Surrogate and couple

Surrogate and couple

Having a baby is expensive, so when intended parents use a gestational surrogate, the costs only increase. In gestational surrogacy, a prospective parent with the intent to have a child (the intended parent) uses a surrogate who is impregnated with a fertilized egg (embryo) and gives birth to a child who is not biologically related to the surrogate. Intended parents proceed with gestational surrogacy usually in cases of infertility, if they are a same-sex couple, or if the intended parent cannot carry the baby to term. Once the intended parents choose the venue for entering into a gestational surrogacy contract, then all the finances and payment details are arranged.

Achieving fertility comes with a steep price: a one-time artificial insemination (IUI) can be around $500, but this procedure often requires numerous attempts, resulting in costs reaching $5,000 or more. An egg donation costs a minimum of around $20,000. Finally, gestational surrogacy fees can be up to $150,000 when including an agency fee, lawyers’ fees, surrogacy payment, and infertility care and pregnancy medical costs. Today, more companies are offering surrogacy benefits to employees to help relieve some of the costs associated with infertility and assisted reproductive technologies, (ART) such as IVF, egg and sperm donation, embryo donation, as well as gestational surrogacy arrangements. With professional and personal experience working with surrogates and surrogacy agencies, I’ve seen the advantages for companies when they implement fertility benefits and encourage intended parents to find qualified surrogates by working with an experienced agency.

The Law and Insurance-Provider Coverage for Infertility and Surrogacy Costs

The Affordable Care Act (ACA) mandates that “essential health benefits” must be covered by insurance providers. Insurance providers cannot exclude coverage for “essential health benefits” but unfortunately, many do not consider fertility care an essential benefit. In the case of surrogacy, maternity is considered an essential health benefit. Any ACA plan in compliance with the act should cover maternity for a gestational surrogate. This is not a guarantee though because the insurance provider could try and argue that being a paid carrier is a for profit excluded activity or that the intended parents are the primary insurers. It is crucial to note that the ACA does not guarantee that an insurance provider will cover infertility as it is not considered an essential health benefit. Currently, there are no ACA medical plans that are specifically designed to cover all gestational surrogacy costs.

Big Companies Are Racing to Offer Fertility and Surrogacy Benefits

According to the International Foundation of Employee Benefit Plans (IFEBP), 24 percent of U.S. employers offered fertility benefits in 2016, which again rose to 31 percent in 2018. Most notably, employer-provided benefits covering gestational surrogacy and other ART methods can save intended parents, surrogates, and donors tens of thousands of dollars per IVF cycle! Some examples of companies that currently offer fertility benefits include:

  • Starbucks: Offers a $20,000 IVF benefit to all employees, including their part-time baristas
  • Unilever: Pays for IVF, egg freezing, and surrogacy expenses
  • Viacom: Pays for in vitro fertilization, egg freezing, and surrogacy expenses
  • Intel: Pays up to $40,000 for employees’ fertility treatments, along with another $20,000 for prescription coverage. Intel opened the benefit to employees “regardless of infertility diagnosis”
  • Bank of America: Provides unlimited IVF coverage

Be Proactive While Navigating These Benefits and Surrogacy Costs: Use a Surrogacy Agency

Typically, an insurance plan under the ACA that might be purchased for a gestational surrogate ranges between $400 to $600 per month, and comes with deductibles, co-pays, and coinsurance due until you reach the out-of-pocket maximum. Out-of-network costs are usually significantly higher and are only available if the plan is not an HMO.

Before an intended parent delves into actual finances, it is important to understand that insurance and company benefit programs are complex and involve many moving legal parts. To ensure that intended parents are moving towards a direction best suited for their situation, a great option is to use the services of a surrogacy agency, which can provide financial tips for managing surrogacy costs. At the right surrogacy agency, an insurance professional will comprehensively analyze the intended parents’ options with their insurance and employer-providers, respectively. Surrogacy agencies not only handle the insurance plans and benefits programs at companies but there is also an experienced team dedicated to helping the intended parents and gestational surrogates bring a healthy baby into the world. Surrogacy agencies vary in the range of services they provide. Some have intended parent coordinators who work to seamlessly match the parties, and some work with reputable reproductive attorneys who work to provide legal services and represent the parties on a gestational surrogacy agreement. The goal of surrogacy agencies is to support their clients along the journey of third-party reproduction by helping them manage finances as well as ethical and legal details. Surrogacy agencies ensure that the parties can respectively focus on delivering a happy, healthy child.

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