When you’re looking into insurance to use for surrogacy you will find that not all are created equally. A growing number of insurances have restrictions and won’t cover expenses of surrogate pregnancies. Finding great coverage that is affordable and doesn’t have strings attached is possible. But it takes some work.
There are insurance professionals who can figure this out for you. But even before you pay for an insurance review, you should take the first steps on your own. In the next section we will go through how to search the insurance plan to see what is and isn’t covered. But first let’s take a moment to understand the different levels of coverage and what information you are looking for. The key is to find out what your insurance thinks about surrogacy, whether they willing to cover expenses and how much they will cover.
Here are the 4 main ways that insurance companies look at coverage for surrogacy. To put it another way, there are 4 types of coverage:
Surrogacy is expressly allowed
Rejoice! You have insurance that can be used for surrogacy. Be mindful that plans can change slightly each year so be sure to review this regularly. Nevada became the first state to require insurance companies to cover surrogate pregnancy as they would other pregnancy. Let’s hope that more states follow suit. The example below is from a Nevada based health plan on the ACA marketplace.
Close up of the clause:
Here surrogacy information is listed under the exclusions “what is not covered” section. If I was reviewing this insurance for myself, my interpretation is that if the member/person whose name is on the plan is:
The intended parent… this plan is not going to cover the expenses of using a surrogate
The surrogate… this plan offers maternity coverage
The surrogate… this plan will not cover the medical expenses of the newborn
Surrogacy is not mentioned at all
Silence, the policy documents don’t say anything about the member acting as a surrogate. While this type of insurance may very well cover the medical expenses of surrogacy, it is in a grey area. There is still a chance that they will deny claims, however, it can be argued that it wasn’t listed as an exclusion. Sometimes intended parents will choose to purchase a backup policy just in case.
No examples to look at this time as it’s hard to show an example of something that doesn’t exist. This is when you search the plan document and there truly is no mention of surrogacy under maternity care, exclusions or anywhere else.
Surrogacy is allowed but there are ambiguities, restrictions or liens
Depending on the restrictions or specifics of the liens, this insurance may still be a favorable option. In some cases the cost of satisfying the lien is still less than the cost of a whole new health plan.
Some insurance companies are very clear on the terms on their liens such as what documentation to provide, and what percentage of compensation the insurance will collect in accordance with local laws. Other insurance companies don’t provide this information up front. If you’re considering using an insurance that has a lien or restriction, it may be wise to work with a knowledgeable lawyer and insurance specialist.
Here are two examples lien language in an insurance document.
Surrogacy is expressly excluded
This insurance will not cover medical expenses during surrogacy. So sad.
This example comes from a North Carolina based health plan on the ACA marketplace. Again we see the surrogacy information listed under an exclusions section, this time specific to family planning. My interpretation is that for:
The intended parent… this plan is not going to cover the expenses of using a surrogate
The surrogate… this plan is not going cover expenses
Not covered, don’t use it! You will need to look for a new health plan.
Now that we’ve gone through how insurance companies treat surrogacy and gestational carriers, let’s go through how to analyse an actual policy to see its level of surrogacy friendliness.
- How to find the best surrogate friendly insurance
- 4 Types of surrogacy insurance – From great to dismal
- How to check health insurance for surrogate friendliness
- How to find good surrogacy insurance on the ACA marketplace
