Does Health Insurance Cover IVF Treatment?

Motherhood is a blessing, and a child brings immense joy to not just parents, but to the entire family. However, lifestyle changes throughout the years have made conceiving naturally harder for most women. Hence, infertility is a more common problem than you can imagine. 

What is Infertility ?

Infertility is the failure to conceive a child after at least a year of regular, unprotected intercourse.

Infertility is categorised into two types – primary and secondary. Primary infertility is when you are unable to conceive after unprotected sexual interactions for a year. Alternatively, secondary infertility occurs when you have conceived once but cannot conceive again.

According to the ISAR (Indian Society for Assisted Reproduction), over 10-15% of couples find it hard to conceive and need medical intervention. This number is expected to continue to rise in the future, according to doctors. That's where IVF comes in. 

Does General Health Insurance Covers IVF ?

Traditionally, general insurance doesn’t cover IVF. But in the last few years, some insurance companies have taken the initiative of introducing infertility treatment in their plans. Some insurers include IVF coverage in their base policies, while others offer it as an add-on. A few insurance companies are also planning to tie IVF treatment to maternity coverage or policies with higher limits.

The coverage level will differ from plan to plan, and not all of them might offer comprehensive coverage for all types of IVF and infertility treatments. So, before you pick a health insurance plan, ensure that you study them all. Select health insurance that covers infertility treatments.

Even if you find the best health insurance cover IVF, it won't be easy. A majority of IVF health insurance plans will include a long wait time and a cap or sub-limit.

Range of Infertility Treatments that Might be Included in Health Insurance

Some infertility procedures that your health insurance may cover are as follows:

1. IVF or In Virto Fertilisation

This is a procedure where doctors gather your eggs and sperm from your partner. They combine them in the laboratory to make an embryo, which is then implanted in your uterus. It is a lengthy procedure that includes expensive medicines, procedures, tests, and hospitalisation as well. 

2. IUI or Intrauterine Insemination

Unlike IVF, your eggs and sperms aren’t extracted in this procedure. Instead, when you are ovulating, your partner’s sperm will be inseminated directly into your uterus. It increases the chances of healthy sperm and eggs forming the embryo, and is especially effective if the fertility issue lies with the male. It is not as expensive as IVF, but you will need your insurance to cover the procedure, medications, and tests.

3. GIFT or Gamete Intrafallopian Transfer

Just like IVF, your eggs and your partner’s sperms are extracted and mixed in a dish. However, instead of planting the formed embryo in your uterus, they are just placed in your fallopian tubes to let the embryo form naturally. There will be expensive tests and medications along with the expenses of the procedure itself.

4. ICSI or Intracytoplasmic Sperm Injection

This procedure is extremely similar to IVF. However, unlike IVF, the doctors inject a single sperm into your egg in the lab to form an embryo which is then placed in your uterus. This decreases the chances of conceiving twins or triplets, which often happens in IVF. 

Hence, you must check and compare the health insurance plans to be sure that they cover the treatment you will undergo for your infertility.

Types of IVF Insurance Coverage

The majority of health insurance policies cover all types of emergencies, including ambulance, infant, maternity, and so forth, which is quite helpful for IVF. Given how costly the procedure is, any assistance would help ease the financial load. Here are the several types of insurance coverage:

1. Cover for Intertility Diagnosis

Before you dive deep into IVF, you will need to get diagnosed if you are infertile or not. Some insurance companies offer cover for infertility diagnosis. Depending on your insurance, it might cover the tests, medicines, and procedures.

2. Infertility Diagnosis with Limited Fertility Treatment

Some health insurance covers include the limited expenses for fertility treatments along with infertility diagnosis. How much coverage you get and for what treatments will vary among insurance service providers.

3. Medication Cover

IVF includes a wide range of medications, from simple oral pills to injectable drugs. And most of these medicines are expensive. Some insurance policies cover your expenses for these medicines.

4. Full Infertility Coverage

This kind of coverage includes infertility procedures like IVF. Since the procedure is expensive, not all companies offer cover for this. But don’t settle for anything less. There are companies that provide a comprehensive IVF cover, look for them. And since it is an infertility cover, other procedures are often covered as well. 

Your Comprehensive Checklist to Pick Insurance that Covers IVF

Here are some things you should check before picking your insurance that covers IVF:

• Check who is eligible for infertility treatment coverage.
• Make sure they cover the cost of infertility diagnosis in the policy.
• See if the procedure you might go through is covered in the policy.
• Check for the coverage and sub-limit extent for various infertility treatments are covered or not.
• Consider the waiting period of the coverage.
• Make sure the cost of medicine used in the treatment is covered.
• Find out how many claims you can raise under that policy.
• Check if any expenses related to infertility treatments are available as add-ons.

Wrapping It Up

IVF is an expensive procedure that has become more common these days. So, more and more insurance companies are trying to provide cover for it, for some part at least. Make sure you study and compare each insurance before settling on one. For more details, visit our website and get the best health insurance, Group Insurance plan for your needs.